Factors associated with HIV-related stigma among adults from fishing communities around Lake George, Kasese District.

Abstract

Introduction: HIV- related stigma has been identified as a key obstacle to diagnosis of HIV, linkage to care, retention in care, adherence to ART and achieving viral suppression, the UNAIDS 90-90-90 goals as well as ending the pandemic by 2030. Since stigma levels are high in most at risk populations, this study therefore aimed to assess the factors associated with HIV- related stigma among adults from fishing communities around lake George in Kasese district. Methods: A cross sectional study where interviewer administered questionnaires and data abstraction forms were used to collect data from 148 HIV positive adults from fishing communities enrolled consecutively. HIV- related stigma was assessed using the 6-item internalized AIDS related stigma scale (IARSS). Data were checked for completeness, entered to SPSS, cleaned and analysed. Univariate analysis was done using descriptive statistics while bivariate analysis was by binary logistic regression. Lastly, binary logistic regression was conducted to assess factors associated with HIV related stigma. Statistical significance was predicted by a p value of less than 0.05, the strength of association measured using odds ratios and 95% confidence interval. Findings are presented as text, tables and charts. Results: In general, 81.8% of the participants endorsed at least 1 of the six IARSS items. The average score was 2.46 with a median score of 2. Mean monthly income, self-rated health status and disclosure to a casual sexual partner were significantly associated with HIV related stigma (aOR 4.858, 7.256 and 0.157) respectively. More than six in 10 respondents did not have viral load results on file. Conclusions and recommendations: There were high levels of HIV- related stigma among the study participants which was associated with less average monthly income, poor self-rated health status and non-disclosure to a casual sexual partner. Also, most participants’ files were missing key data. Since stigma hinders all points of the HIV care continuum, stigma reduction interventions should be specifically tailored for fishing communities. In addition, there is need for other income generating activities, counselling and client education as well as harmonized viral load testing strategies