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008.6 The gendered influence of stigma on hiv testing behaviour: results from a population-based survey of women and men in rwanda
  1. A Stangl1,
  2. E Efronson1,
  3. K Sievwright1,
  4. S Krishnaratne2,
  5. J Hargreaves2
  1. 1The International Center for Research on Women
  2. 2The London School of Hygiene and Tropical Medicine

Abstract

Objective Stigmatisation is a multifaceted process, and distinct domains of stigma may impact HIV testing behaviour differently. We examined the relationship between two stigma domains and HIV testing behaviour among Rwandan men and women who participated in a population-based survey in 2011.

Methods We conducted multivariable logistic regression with data from 4,669 Rwandan women (N = 2613) and men (N = 2,056) aged 15 years and older to predict ‘ever tested for HIV’. Independent variables included sociodemographics, knowledge of and proximity to HIV, and two stigma domains, ‘drivers’ (fear of HIV infection through casual contact with PLHIV) and ‘manifestations’ (anticipated and perceived stigma, shame and discriminatory attitudes). All analyses were disaggregated by gender.

Results Three quarters of women and men reported ever testing for HIV. Sociodemographic variables significantly associated with HIV testing behaviour included: age, secondary (women only) and post-secondary education (both genders), complete knowledge of HIV [women only, OR: 1.52, 95% CI: 1.20–1.96], frequent trips outside the community (men only), and proximity (personally knowing a PLHIV) [women, OR: 1.66, 95% CI: 1.22–2.25; men, OR: 1.89, 95% CI: 1.36 – 2.60]. Fear of becoming infected with HIV via contact with saliva was the only stigma variable significantly associated with testing behaviour for women [OR: 0.68, 95% CI: 0.49 – 0.94]. For men, holding a discriminatory attitude was the only stigma variable significantly associated with testing behaviour [OR: 0.63, 95% CI: 0.41–0.98]. Socioeconomic status and residence were not significantly associated with HIV testing behaviour for either gender.

Conclusion These findings demonstrate that drivers and manifestations of stigma influence HIV testing behaviour differently for women and men, suggesting the need for tailored interventions, including stigma-reduction components, to increase HIV testing among both genders in Rwanda. Targeted interventions are also needed to increase testing among adolescents (15–24) and older (50+) men and women.

Disclosure of interest statement Nothing to declare.

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