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      Personal contact with HIV-positive persons is associated with reduced HIV-related stigma: cross-sectional analysis of general population surveys from 26 countries in sub-Saharan Africa

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          Abstract

          Introduction: HIV-related stigma hampers treatment and prevention efforts worldwide. Effective interventions to counter HIV-related stigma are greatly needed. Although the “contact hypothesis” suggests that personal contact with persons living with HIV (PLHIV) may reduce stigmatizing attitudes in the general population, empirical evidence in support of this hypothesis is lacking. Our aim was to estimate the association between personal contact with PLHIV and HIV-related stigma among the general population of sub-Saharan Africa.

          Methods: Social distance and anticipated stigma were operationalized using standard HIV-related stigma questions contained in the Demographic and Health Surveys and AIDS Indicator Surveys of 26 African countries between 2003 and 2008. We fitted multivariable logistic regression models with country-level fixed effects, specifying social distance as the dependent variable and personal contact with PLHIV as the primary explanatory variable of interest.

          Results: We analyzed data from 206,717 women and 91,549 men living in 26 sub-Saharan African countries. We estimated a statistically significant negative association between personal contact with PLHIV and desires for social distance (adjusted odds ratio [AOR] = 0.80; p < 0.001; 95% Confidence Interval [CI], 0.73–0.88). In a sensitivity analysis, a similar finding was obtained with a model that used a community-level variable for personal contact with PLHIV (AOR = 0.92; p < 0.001; 95% CI, 0.89–0.95).

          Conclusions: Personal contact with PLHIV was associated with reduced desires for social distance among the general population of sub-Saharan Africa. More contact interventions should be developed and tested to reduce the stigma of HIV.

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          Most cited references 51

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          Estimating wealth effects without expenditure data--or tears: an application to educational enrollments in states of India.

          Using data from India, we estimate the relationship between household wealth and children's school enrollment. We proxy wealth by constructing a linear index from asset ownership indicators, using principal-components analysis to derive weights. In Indian data this index is robust to the assets included, and produces internally coherent results. State-level results correspond well to independent data on per capita output and poverty. To validate the method and to show that the asset index predicts enrollments as accurately as expenditures, or more so, we use data sets from Indonesia, Pakistan, and Nepal that contain information on both expenditures and assets. The results show large, variable wealth gaps in children's enrollment across Indian states. On average a "rich" child is 31 percentage points more likely to be enrolled than a "poor" child, but this gap varies from only 4.6 percentage points in Kerala to 38.2 in Uttar Pradesh and 42.6 in Bihar.
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            Understanding Labeling Effects in the Area of Mental Disorders: An Assessment of the Effects of Expectations of Rejection

             Bruce G. Link (1987)
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              The Social Rejection of Former Mental Patients: Understanding Why Labels Matter

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                Author and article information

                Journal
                J Int AIDS Soc
                J Int AIDS Soc
                ZIAS
                zias20
                Journal of the International AIDS Society
                Taylor & Francis
                1758-2652
                2017
                10 January 2017
                : 20
                : 1
                Affiliations
                [ a ]Division of Infectious Diseases, Brigham and Women’s Hospital , Boston, MA, USA
                [ b ]Harvard Medical School , Boston, MA, USA
                [ c ]Chester M. Pierce, MD Division of Global Psychiatry, Massachusetts General Hospital , Boston, MA, USA
                [ d ]Mbarara University of Science and Technology , Mbarara, Uganda
                Author notes
                [ § ] Corresponding author: Brian T Chan, Brigham and Women’s Hospital , 15 Francis St, PBBA-4, Boston, MA 02115, USA, Tel: (+1) 617-732-8881; Fax: (+1) 617-732-6829 ( bchan@ 123456partners.org )
                Article
                1274533
                10.7448/IAS.20.1.21395
                5461118
                28362067
                © 2017 Chan BT and Tsai AC; licensee International AIDS Society

                This is an Open Access article distributed under the terms of the Creative Commons Attribution 3.0 Unported (CC BY 3.0) License ( http://creativecommons.org/licenses/by/3.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Page count
                Figures: 1, Tables: 2, References: 70, Pages: 8
                Product
                Funding
                Funded by: Harvard Catalyst |The Harvard Clinical and Translational Science Center 10.13039/100007299
                Award ID: KL2 TR001100
                Funded by: NIH 10.13039/100000002
                Award ID: K23MH096620
                Categories
                Article
                Research Article

                Infectious disease & Microbiology

                stigma, social distancing, contact hypothesis, africa, hiv

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