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The Impact of Community Support Initiatives on the Stigma Experienced by People Living with HIV/AIDS in South Africa

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Abstract

In the current context of human resource shortages in South Africa, various community support interventions are being implemented to provide long-term psychosocial care to persons living with HIV/AIDS (PLWHA). However, it is important to analyze the unintended social side effects of such interventions in regards to the stigma felt by PLWHA, which might threaten the successful management of life-long treatment. Latent cross-lagged modeling was used to analyze longitudinal data on 294 PLWHA from a randomized controlled trial (1) to determine whether peer adherence support (PAS) and treatment buddying influence the stigma experienced by PLWHA; and (2) to analyze the interrelationships between each support form and stigma. Results indicate that having a treatment buddy decreases felt stigma scores, while receiving PAS increases levels of felt stigma at the second follow up. However, the PAS intervention was also found to have a positive influence on having a treatment buddy at this time. Furthermore, a treatment buddy mitigates the stigmatizing effect of PAS, resulting in a small negative indirect effect on stigma. The study indicates the importance of looking beyond the intended effects of an intervention, with the goal of minimizing any adverse consequences that might threaten the successful long-term management of HIV/AIDS and maximizing the opportunities created by such support.

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  1. Information not available at Follow-up 2.

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Acknowledgments

The study team would like to express their gratitude and thanks to all respondents for their participation and openness, as well as the local study coordinators and study assistants for their continuous commitment. We are also grateful to the Free State Department of Health (FSDOH) and National Health Laboratory Service (NHLS). Alok Bhargava deserves our gratitude for the advice he provided. For their input into the design of the study, we would like to thank Mead Over from the Center for Global Development and Damien de Walque and Satoko Hashimoto from the World Bank. Finally, we would like to give special thanks to the following funding agencies: the World Bank Research Committee; the Bank-Netherlands Partnership Program; WB-DfiD “Evaluation of the Community Response to HIV and AIDS”; the Programme to Support Pro-Poor Policy Development (PSPPD), a partnership between the Presidency, Republic of South Africa and the European Union; the Health Economics and Aids Research Division (HEARD) at the University of Kwazulu-Natal; the University of the Free State (UFS); and South Africa’s National Research Foundation (NRF).

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Authors and Affiliations

  1. Department of Sociology, Research Centre for Longitudinal and Life Course Studies (CELLO), University of Antwerp, Sint Jacobsstraat 2, 2000, Antwerp, Belgium

    Caroline Masquillier, Edwin Wouters & Dimitri Mortelmans

  2. Centre for Health Systems Research and Development, University of the Free State, Bloemfontein, South Africa

    Edwin Wouters

  3. Department of Economics, University of the Free State, Bloemfontein, South Africa

    Frederik le Roux Booysen

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  1. Caroline Masquillier
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  2. Edwin Wouters
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Correspondence to Caroline Masquillier.

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Masquillier, C., Wouters, E., Mortelmans, D. et al. The Impact of Community Support Initiatives on the Stigma Experienced by People Living with HIV/AIDS in South Africa. AIDS Behav 19, 214–226 (2015). https://doi.org/10.1007/s10461-014-0865-1

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