[HIV-related public stigma and knowledge regarding the campaign slogan "undetectable=untransmittable" among Japanese...

Objectives　This study targeted adult males and females living in Japan with the following three objectives. The first was to clarify the public stigma toward people living with HIV (PLWH). The second was to clarify changes in public stigma by gathering information about the "undetectable=untransmittable" (U=U) campaign. The third was to clarify the relationship between changes in public stigma and contributing factors, and the experiences of PLWH.Methods　We conducted a cross-sectional online survey in September, 2019 for male and female internet research monitors in their 20s to 60s who were heterosexual, not HIV-positive, and not acquainted with PLWH. In total, the results from 2,268 people were analyzed. Public stigma toward PLWH was measured by a modified vignette for PLWH using a social distance scale for people with mental illness. The social distance scale included "becoming a neighbor," "greeting and talking," "asking them to take care of your children," "becoming friends," "becoming colleagues at work," and "marrying your relatives." We provided information on "U=U" to participants and then evaluated the changes in acceptance of each social distance factor into four categories: "unacceptable," "acceptable ⇒ unacceptable," "unacceptable ⇒ acceptable," and " acceptable."Results　All items in the social distance scale except "greeting and talking" exhibited significantly positive changes (male odds ratio 1.76 to 4.18, female odds ratio 2.25 to 7.00) after providing information. The factor most often deemed "unacceptable" was "marrying your relatives," in 57.5% of men and 58.1% of women; 37.0% of men and 37.3% of women answered "asking them to take care of your children;" and 19.0% of men and 11.1% of women answered "becoming friends." Multinomial logistic regression analysis demonstrated that experience with PLWH in both men and women was associated with "marrying your relatives." The experience of watching television and listening to radio programs, watching movies and plays, and reading books related to PLWH was significantly related to the category of "unacceptable" compared with "acceptable." (Male odds ratio 0.38 to 0.63, female odds ratio 0.50 to 0.56).Conclusion　The acceptance of PLWH was low in personal matters, such as family and child-rearing. The explanation of "U=U" improved acceptance in each social distance factor. Independent experiences, such as viewing, appreciation, and reading about PLWH, improved acceptance.