Stigma of People with HIV/AIDS in Sub-Saharan Africa: A Literature Review

Table 1

Characteristics of the empirical studies used.

Number	Author	Location number on reference list	Year of publication	Methods	Study objectives	Study population	Country
1	Greeff et al.	[2]	2008	Qualitative research design focus group discussion	To increase understanding of disclosure as a circumstance that is affected by HIV/AIDS stigma and discrimination	225	Five African countries (Tanzania, Lesotho, South Africa, Swaziland, and Malawi)
2	Campbell et al.	[6]	2007	Qualitative research In-depth interview including focused group discussion	Study on complex interplay of psychological and social forces that drive HIV/AIDS stigma	120	South Africa
3	Neville and Rubin	[7]	2007	Semistructured focused group discussion	Identity of typical targets of disclosure of positive sero-status, commonly used avenues for disclosure, motivations for disclosure and nondisclosure of sero-status	40	Kenya
4	Strebel et al.	[13]	2006	Interview and focus group discussion	Construction of gender identities and roles, how women and men understand gender-based violence and what they believe about links between gender relations and HIV/AIDS risk	78	South Africa
5	Simbayi et al.	[16]	2007	Quantitative study	Examination of internalized AIDS stigmas among PLWHA	1063	South Africa
6	Wood and Lambert	[17]	2008	Participant observation, semistructured interview, focused group discussions	Description of family and community responses to HIV/AIDS epidemic: use of indirect communication	152	South Africa
7	Muula	[18]	2005	Theoretical review	What should HIV/AIDS be called in Malawi?		Malawi
8	Uys et al.	[19]	2005	Focus group discussion	Identification of terminology used to talk about HIV/AIDS and PLWHA	261	Five African countries (Lesotho, South Africa, Malawi, Swaziland, and Tanzania)
9	Visser et al.	[20]	2009	Questionnaire	Assessment of stigmatizing attitudes among members of a community compared with perceived stigma within the community and the extent to which stigmatizing attitudes are affected by sociodemographic characteristics	1077	South Africa
10	Iwelunmor	[21]	2006	Focus group discussion	Family system responses to HIV and AIDS	204	South Africa
11	Ulasi et al.	[22]	2009	Questionnaire	Predictors of stigma and the perception of communities toward PLWHA	104	Ghana
12	Hartwig et al.	[23]	2006	Focused group discussion	A case study providing insights into how some local church leaders view HIV stigma, and changes some of them have made in their own church leadership behavior	15	Tanzania
13	Okoror et al.	[24]	2007	Focused group discussion	Role of food as an instrument in expressing and experiencing stigma used by HIV-positive women and their families	249	South Africa
14	Otolok-Tanga et al.	[25]	2007	Semistructured interview	Exploration of Uganda-based key decision-makers about the past, present and optimal future roles of faith-based organizations involved in HIV/AIDS work, including actions to promote or dissuade stigma and discrimination	150	Uganda
15	Chimwaza and Watkins	[26]	2004	Quantitative and interview	Focus on the caregivers’ diagnoses of the illness of their patients, the type and duration of the care they provided, the support they received from relatives and other members of the community, and the extent to which caregiving was experienced as an emotional, physical and financial burden	15	Malawi
16	Duffy	[27]	2005	Focused group discussion, interview	Perspective on HIV-related stigma	28	Zimbabwe
17	Petros et al.	[28]	2006	Focus group discussion, interview	Exploring the concept and practice of “othering’’ in relation to HIV and AIDS today	418	South Africa
18	Kalichman et al.	[29]	2005	Questionnaire	Development of a brief measure of AIDS-related stigma that could be readily used in multiple settings and contexts	1371	South Africa
19	Plummer et al.	[30]	2006	Qualitative research (participant observation)	Examination of beliefs about general illness, STI and AIDS treatment practices	Participant observation	Tanzania
20	Muyinda et al.	[31]	1997	Qualitative research (in-depth interview)	Knowledge, attitudes and practices of families caring for PLWHA in relation to stigma-related conditions	127	Uganda
21	Hatchett et al.	[32]	2004	Qualitative research (interview)	Exploration of traditional and modern health-seeking in Malawi	46	Malawi
22	Thorsen et al.	[33]	2008	Qualitative research (interview, nonparticipant observation)	Potential facilitation of stigmatization through inadvertent disclosure of HIV + status via PMTCT program components and attributes	42	Malawi
23	Daniel and Oladapo	[34]	2006	Quantitative study (questionnaire)	Assessment of acceptability of prenatal HIV screening among pregnant women attending primary healthcare centres in a suburban population	333	Nigeria
24	Hutchinson and Mahlalela	[35]	2006	Quantitative (survey data using questionnaire)	Examination of patterns and determinants of use of VCT services	3374	South Africa
25	Nyblade et al.	[36]	2001	Quantitative (questionnaire), laboratory and counselling data	Assessment of self-selection in those who chose to participate in VCT and those who chose not to participate in the start-up phase of a long-term VCT program	10 950	Uganda
26	Maedot et al.	[37]	2007	Case control study	Identification of factors that determine VCT uptake among pregnant women attending ANC services	402	Ethiopia
27	Kalichman and Simbayi	[38]	2003	Quantitative research (venue intercept study)	Examination of the relationship between HIV testing, history, attitudes toward testing and AIDS stigma	500	South Africa
28	Nachega et al.	[39]	2005	Quantitative research (questionnaire)	Investigation of knowledge, attitudes, beliefs and practices of PLWHA regarding HIV/AIDS and ART in an HIV outpatient clinic	105	South Africa
29	Turan et al.	[40]	2008	Qualitative research (in-depth interview)	How HIV-related fears may affect where women deliver and the difficulties maternity workers face caring for HIV-positive women with unknown HIV status	37	Kenya
30	Orner et al.	[41]	2008	Qualitative research (focused group discussion, in-depth interview)	Exploration of perceptions and experiences of PLWHA of reproductive age in relation to HIV/AIDS care and treatment	8	South Africa
31	Akani and Erhabor	[42]	2006	Quantitative research (questionnaire)	Evaluation of rate, patterns, barriers to HIV sero-status disclosure	187	Nigeria
32	Blackstock	[43]	2005	Narrative case study	Curing stigma—the limits of antiretroviral access	1	Ghana
33	Kayombo et al.	[44]	2005	Qualitative research (interview)	Role of traditional healers in supporting orphans, how they get the orphans, the basic needs they can provide, techniques used for psychosocial support and problems encountered when taking the orphans	25	Tanzania
34	Mshana et al.	[45]	2006	Qualitative research (focused group discussion, interview)	Identify and mitigate barriers to seek ART between the stages of testing for HIV and enrolling in the new government ART program	18	Tanzania
35	Campbell et al.	[46]	2005	Qualitative research (focused group discussion, interview)	Identification of forms taken by stigma and its effects; identification of material, symbolic and contexts associated with stigmatisation of PLWHA	99	South Africa
36	Thomas	[47]	2006	Qualitative research (interview, diaries)	Exploration of how illness, the daily and long-term duties of caring amongst a sample of households in the Caprivi region	12	Namibia
37	Skinner and Mfecane	[48]	2004	Qualitative research (focused group discussion, interviews)			South Africa
38	Amuyunzu-Nyamongo et al.	[49]	2007	Quantitative (survey) and qualitative (in-depth interview)	Examination of complex relationship between gender, poverty, susceptibility to HIV and vulnerability to AIDS through drawing on the lived experiences of infected women and exploring the coping strategies they adopt; how the specific conditions of informal settlements influence these challenges and support mechanisms	390 (survey) 20 (interview)	Kenya
39	Mill	[50]	2003	Qualitative research (in-depth interview, focused group discussion)	Findings related to breaking the news of HIV infection to women and their maintenance of secrecy following diagnosis	56	Ghana
40	Antelman et al.	[51]	2001	Quantitative research	Examination of sociodemographic and behavioral factors predictive of an HIV-positive test result	1078	Tanzania
41	Maman et al.	[52]	2001	Qualitative research (interview)	Presentation of individual, relational and environmental factors that influence the decision to test for HIV-1 and to share test results with partners	62	Tanzania
42	Ndinya-Achola et al.	[53]	1995	Quantitative research	The right not to know HIV test result after being tested	5274	Kenya
43	Sanjobo et al.	[54]	2008	Qualitative research (interview, focus group discussion)	Exploration of patients’ and health care professionals’ perceived barriers to and facilitation of patients’ adherence to ART	72	Zambia
44	Ncama et al.	[55]	2008	Quantitative research	Examination of characteristics related to social support and antiretroviral medication adherence	149	South Africa
45	Weiser et al.	[56]	2006	Quantitative research	Assessment of knowledge of and attitudes toward routine testing in Botswana with a focus on human rights concerns related to policy; factors associated with whether respondents had heard of routine testing and had positive attitudes toward the policy; the prevalence and correlations of HIV testing, barriers to and facilitation of testing and reported experiences of testing 11 months after introduction of routine testing	1268	Botswana