Ouner Jerry John, Thompson Rachel G A, Dey Nutifafa E Y, Alhassan Robert Kaba, Gyamerah Akua O
Department of Family Health Care Nursing, School of Nursing, University of California San Francisco, San Francisco, CA, USA.
Language Centre, College of Humanities, University of Ghana, legon, Accra, Ghana.
BMC Public Health. 2025 Jan 27;25(1):342. doi: 10.1186/s12889-025-21500-5.
HIV-related stigma is a major public health concern compromising the rights and health outcomes of many people living with HIV (PLWH). Its reduction is said to be critical in strengthening the continuous efforts targeted at preventing and controlling HIV, as it directly impacts antiretroviral treatment adherence. This study examines the association between HIV-related stigma and adherence to antiretroviral therapy (ART) among PLWH in one of the 16 administrative regions of Ghana, Africa.
This descriptive cross-sectional study employed a survey to assess the factors affecting the utilization of ART among PLWH (n = 155) in the Volta region. The Center for Support Evaluation adherence index and internalized stigma of AIDS Tool were used to collect data on medication adherence and stigma, respectively. Data was analyzed using R statistical analysis software. Logistic regression models were performed to ascertain the predictors of ART utilization among PLWH.
A greater proportion (70%) of the study's participants reported adherence to ART. We found a positive association between HIV-related internalized stigma and medication adherence such that reporting high levels of stigma on average was associated with high levels of medication adherence [OR = 1.08, 95% CI:1.01, 1.15]. Older age was related to higher adherence while reporting more depressive symptoms was associated with low medication adherence.
Our findings show that stigma may serve as a facilitator instead of a barrier to adhering to antiretroviral medication. Although this contradicts common narratives about stigma's destructive effect, it is possible to promote good health-seeking behavior when the fear component of stigma is considered. To encourage medication adherence towards meeting UNAIDS' 95-95-95 agenda and better understand stigma's role, further research is required.
与艾滋病病毒相关的污名化是一个重大的公共卫生问题，它损害了许多艾滋病病毒感染者（PLWH）的权利和健康状况。据说减少这种污名化对于加强预防和控制艾滋病病毒的持续努力至关重要，因为它直接影响抗逆转录病毒治疗的依从性。本研究考察了非洲加纳16个行政区之一的艾滋病病毒感染者中与艾滋病病毒相关的污名化和抗逆转录病毒疗法（ART）依从性之间的关联。
这项描述性横断面研究采用一项调查来评估影响沃尔特地区艾滋病病毒感染者（n = 155）抗逆转录病毒疗法使用情况的因素。分别使用支持评估依从性指数中心和艾滋病内化污名工具来收集关于药物依从性和污名化的数据。使用R统计分析软件对数据进行分析。进行逻辑回归模型以确定艾滋病病毒感染者中抗逆转录病毒疗法使用情况的预测因素。
该研究中较大比例（70%）的参与者报告坚持接受抗逆转录病毒疗法。我们发现与艾滋病病毒相关的内化污名和药物依从性之间存在正相关，即平均报告高水平污名与高水平药物依从性相关[比值比（OR）= 1.08，95%置信区间：1.01，1.15]。年龄较大与较高的依从性相关，而报告更多抑郁症状与较低的药物依从性相关。
我们的研究结果表明，污名化可能是坚持抗逆转录病毒药物治疗的促进因素而非障碍。尽管这与关于污名化破坏作用的常见说法相矛盾，但当考虑到污名化的恐惧成分时，有可能促进良好的求医行为。为鼓励坚持药物治疗以实现联合国艾滋病规划署的95-95-95议程并更好地理解污名化的作用，还需要进一步研究。
