Why addressing HIV stigma should be our number one priority in the HIV response

Area of Science:

• Public Health
• Social Science
• Epidemiology

Background:

• HIV stigma significantly impedes progress towards UNAIDS 95-95-95 goals.
• Stigma negatively impacts all stages of the HIV care cascade, from prevention to viral suppression.

Purpose of the Study:

• To outline the detrimental effects of HIV stigma on HIV care outcomes.
• To provide guidance on effective stigma reduction interventions.
• To establish priorities for understanding and addressing HIV stigma.

Main Methods:

• Review of existing literature on HIV stigma and its impact.
• Analysis of stigma reduction strategies across public, self, and structural domains.
• Argument for theory- and evidence-based, context-tailored, co-designed interventions.

Main Results:

• HIV stigma adversely affects HIV prevention, testing, linkage to care, treatment initiation, adherence, and viral suppression.
• Effective interventions must address multiple forms of stigma.
• Stigma reduction requires systematic development and community involvement.

Conclusions:

• Prioritizing stigma reduction is essential for HIV eradication.
• Interventions must be evidence-based, context-specific, and co-implemented.
• Improved measurement of stigma through transparent reporting of definitions and operationalizations is needed.