Annals of Behavioral Medicine

, Volume 43, Issue 3, pp 362–371 | Cite as

AIDS-Related Stigma, HIV Testing, and Transmission Risk Among Patrons of Informal Drinking Places in Cape Town, South Africa

  • Eileen V. Pitpitan
  • Seth C. Kalichman
  • Lisa A. Eaton
  • Demetria Cain
  • Kathleen J. Sikkema
  • Donald Skinner
  • Melissa H. Watt
  • Desiree Pieterse
Original Article

Abstract

Background

AIDS-related stigma as a barrier to HIV testing has not been examined within the context of high at risk environments such as drinking venues. Of particular importance is whether AIDS-related stigma is associated with HIV transmission risks among people who have never been tested for HIV.

Purpose

We examined: (1) AIDS-related stigma as a barrier to testing, controlling for other potential barriers, and (2) whether stigma is associated with HIV risks among HIV-untested individuals.

Methods

We surveyed 2,572 individuals attending informal drinking establishments in Cape Town, South Africa to assess HIV testing status, AIDS-related stigma endorsement, and HIV transmission sexual risk behavior.

Results

Endorsement of AIDS-related stigma was negatively associated with HIV lifetime testing. In addition, stigma endorsement was associated with higher HIV transmission risks.

Conclusion

AIDS-related stigma must be addressed in HIV prevention campaigns across South Africa. Antistigma messages should be integrated with risk reduction counseling and testing.

Keywords

HIV/AIDS-related stigma HIV testing HIV risk behavior Alcohol Substance use 

References

  1. 1.
    UNAIDS. UNAIDS report on the global AIDS epidemic 2010. 2010:364. Available at: http://www.unaids.org/globalreport/Global_report.htm.
  2. 2.
    Anon. A Motsoaledi: HIV Counselling and Testing (VCT) campaign. 2010. Available at: http://www.info.gov.za/speeches/2010/10032611051001.htm. Accessed June 28 2011.
  3. 3.
    Kamb ML, Fishbein M, Douglas JM, et al and Project RESPECT Study Group. Efficacy of risk reduction counseling to prevent human immunodeficiency virus and sexually transmitted diseases. JAMA 1998;280:1161–7.PubMedCrossRefGoogle Scholar
  4. 4.
    Voluntary HIV-1 Counseling and Testing Efficacy Study Group. Efficacy of voluntary HIV-1 counseling and testing in individuals and couples in Kenya, Tanzania, and Trinidad: A randomized trial. Lancet 2000;356:103–12.CrossRefGoogle Scholar
  5. 5.
    Government of South Africa. Key facts of the National Communication Survey on HIV/AIDS, 2009. 2009. Available at: http://www.info.gov.za/issues/hiv/survey_2009.htm#implications.
  6. 6.
    Peltzer K, Matseke G, Mzolo T, Majaja M. Determinants of knowledge of HIV status in South Africa: Results from a population-based HIV survey. BMC Public Health. 2009; 9:174–174.Google Scholar
  7. 7.
    Fenton M, Leggio L, Kenna GA, Swift RM. HIV testing in hazardous drinking: A survey analysis. Subst Use Misuse. 2010;45(1–2):204–212.PubMedCrossRefGoogle Scholar
  8. 8.
    Arasteh K, Des Jarlais DC. HIV testing and treatment among at-risk drinking injection drug users. J Int Assoc Physicians AIDS Care (Chic). 2009;8(3):196–201.CrossRefGoogle Scholar
  9. 9.
    Kalichman SC, Simbayi LC. HIV testing attitudes, AIDS stigma, and voluntary HIV counselling and testing in a black township in Cape Town, South Africa. Sex Transm Infect. 2003;79(6):442–447.PubMedCrossRefGoogle Scholar
  10. 10.
    Berendes S, Rimal RN. Addressing the slow uptake of HIV testing in Malawi: The role of stigma, self-efficacy, and knowledge in the Malawi BRIDGE Project. J Assoc Nurses AIDS Care. 2011;22(3):215–228.PubMedCrossRefGoogle Scholar
  11. 11.
    Meiberg AE, Bos AER, Onya HE, Schaalma HP. Fear of stigmatization as barrier to voluntary HIV counselling and testing in South Africa. East Afr J Public Health. 2008;5(2):49–54.PubMedGoogle Scholar
  12. 12.
    Earnshaw VA, Chaudoir SR. From conceptualizing to measuring HIV stigma: A review of HIV stigma mechanism measures. AIDS Behav. 2009;13(6):1160–1177.PubMedCrossRefGoogle Scholar
  13. 13.
    Hatzenbuehler ML, Nolen-Hoeksema S, Erickson SJ. Minority stress predictors of HIV risk behavior, substance use, and depressive symptoms: Results from a prospective study of bereaved gay men. Health Psychol. 2008;27(4):455–462.PubMedCrossRefGoogle Scholar
  14. 14.
    Hatzenbuehler ML, O’Cleirigh C, Mayer KH, Mimiaga MJ, Safren SA. Prospective associations between HIV-related stigma, transmission risk behaviors, and adverse mental health outcomes in men who have sex with men. Ann Behav Med. 2011; 42(2):227–234.PubMedCrossRefGoogle Scholar
  15. 15.
    Morojele NK, Kachieng’a MA, Mokoko E, et al. Alcohol use and sexual behaviour among risky drinkers and bar and shebeen patrons in Gauteng province, South Africa. Soc Sci Med. 2006;62(1):217–227.PubMedCrossRefGoogle Scholar
  16. 16.
    Weir SS, Pailman C, Mahlalela X, et al. From people to places: Focusing AIDS prevention efforts where it matters most. AIDS. 2003;17(6):895–903.PubMedCrossRefGoogle Scholar
  17. 17.
    Kalichman SC, Simbayi LC, Kaufman M, Cain D, Jooste S. Alcohol use and sexual risks for HIV/AIDS in sub-Saharan Africa: Systematic review of empirical findings. Prev Sci. 2007;8(2):141–151.PubMedCrossRefGoogle Scholar
  18. 18.
    Weir SS, Morroni C, Coetzee N, Spencer J, Boerma JT. A pilot study of a rapid assessment method to identify places for AIDS prevention in Cape Town, South Africa. Sex Transm Infect. 2002;78 Suppl 1:i106–113.PubMedCrossRefGoogle Scholar
  19. 19.
    Kalichman SC, Simbayi LC, Jooste S, et al. Development of a brief scale to measure AIDS-related stigma in South Africa. AIDS Behav. 2005;9(2):135–143.PubMedCrossRefGoogle Scholar
  20. 20.
    Link BG, Phelan JC. Conceptualizing stigma. Annual Review of Sociology. 2001;27:363–385.CrossRefGoogle Scholar
  21. 21.
    Narayan S, Jon A. Krosnick. Education moderates some response effects in attitude measurement. The Public Opinion Quarterly. 1996;60(1):58–88.CrossRefGoogle Scholar
  22. 22.
    Saunders JB, Aasland OG, Babor TF, de la Fuente JR, Grant M. Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption—II. Addiction. 1993;88(6):791–804.PubMedCrossRefGoogle Scholar
  23. 23.
    Meneses-Gaya C, Zuardi AW, Loureiro SR, et al. Is the full version of the AUDIT really necessary? Study of the validity and internal construct of its abbreviated versions. Alcohol Clin Exp Res. 2010;34(8):1417–1424.PubMedGoogle Scholar
  24. 24.
    Catania JA, Gibson DR, Chitwood DD, Coates TJ. Methodological problems in AIDS behavioral research: Influences on measurement error and participation bias in studies of sexual behavior. Psychol Bull. 1990;108(3):339–362.PubMedCrossRefGoogle Scholar
  25. 25.
    Napper LE, Fisher DG, Reynolds GL, Johnson ME. HIV risk behavior self-report reliability at different recall periods. AIDS Behav. 2010;14(1):152–161.PubMedCrossRefGoogle Scholar

Copyright information

© The Society of Behavioral Medicine 2012

Authors and Affiliations

  • Eileen V. Pitpitan
    • 1
    • 4
  • Seth C. Kalichman
    • 1
  • Lisa A. Eaton
    • 1
  • Demetria Cain
    • 1
  • Kathleen J. Sikkema
    • 2
  • Donald Skinner
    • 3
  • Melissa H. Watt
    • 2
  • Desiree Pieterse
    • 3
  1. 1.University of ConnecticutStorrsUSA
  2. 2.Duke UniversityDurhamUSA
  3. 3.Stellenbosch UniversityCape TownSouth Africa
  4. 4.Center for Health, Intervention and PreventionUniversity of ConnecticutStorrsUSA

Personalised recommendations