Modeling the Effect of HIV/AIDS Stigma on HIV Infection Dynamics in Kenya

Area of Science:

• Epidemiology
• Mathematical Modeling
• Public Health

Background:

• Stigma toward people living with HIV/AIDS (PLWHA) impedes global health responses, leading to poor adherence to prevention and delayed treatment.
• Internalized and enacted stigma are key components of HIV/AIDS-related stigma, which remains a significant public health challenge, particularly in sub-Saharan Africa and Kenya.
• Despite global efforts since the early 21st century to reduce stigma, HIV/AIDS continues to be a major concern in Kenya.

Purpose of the Study:

• To develop a data-driven, time-dependent stigma function capturing both internalized and enacted stigma.
• To integrate this stigma function into a compartmental model of HIV dynamics.
• To explore the impact of varying stigma levels on HIV prevalence, treatment-seeking behavior, and disease-related deaths in Kenya, and to project progress toward 2030 UN goals.

Main Methods:

• Developed a time-dependent stigma function incorporating internalized and enacted stigma.
• Embedded the stigma function within a compartmental model for HIV dynamics.
• Rescaled the model to a coupled system for HIV prevalence and treatment-seeking fraction, estimating parameters from published data for Kenya's growing population.

Main Results:

• The model allows for the estimation of HIV dynamics parameters using published data.
• Analysis explores scenarios with varied internalized and enacted stigma levels.
• The study provides insights into the potential impact of public health interventions on key HIV metrics.

Conclusions:

• Mathematical modeling of stigma is crucial for understanding HIV dynamics.
• Public health interventions targeting stigma can significantly impact HIV prevalence and mortality.
• The model can inform strategies to achieve UN HIV and stigma reduction goals in Kenya by 2030.