In the current study, the researchers sought to examine the impact of treatment access on HIV stigma in Botswana three years after the introduction of a national universal antiretroviral treatment program.

Prevalence and correlates of HIV stigma were studied using a population-based survey of 1,268 adults in 2004. Multivariate logistic regression was employed to assess correlates of stigmatizing attitudes and a new measure, anticipated HIV stigma.

Of participants, 38 percent reported at least one stigmatizing attitude: 23 percent would not purchase food from a shopkeeper with HIV, while 5 percent would not care for an HIV-infected relative. Seventy percent reported at least one measure of anticipated stigma: 54 percent anticipated ostracism after testing HIV-positive, and 31 percent anticipated mistreatment at work. Perceived access to antiretroviral therapy was strongly and independently associated with decreased odds of holding stigmatizing attitudes (adjusted odds ratio=0.42, 95 percent confidence interval=0.24-0.74) and of anticipated stigma (AOR=0.09; 95 percent CI=0.03, 0.30).

"Our findings suggest that antiretroviral therapy access may be a factor in reducing HIV stigma," the researchers concluded. "Nevertheless, the persistence of stigmatizing attitudes and significant anticipated stigma suggest that HIV stigma must be a target for ongoing intervention."

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