HIV/AIDS stigma-reduction on VCT uptake: An adapted systematic review

Both qualitative and quantitative studies have shown that stigma and discrimination impact people's decisions to access voluntary counseling and testing, (VCT) and treatment services. This systematic review attempts to answer the research question: What is the impact of HIV/AIDS-related stigma reduction interventions on VCT uptake in the developing world? This study used a systematic review. Data was collected from five major databases during 2000 – 2011, and four studies which involved 6.651 participants. The studies were assessed using the Effective Public Health Practice Project (EPHPP) quality assessment tool which addressed selection bias, study design, confounders, blinding, data collection, and withdrawals and drop-outs. One study had a 'Strong' Global rating; one had a 'Weak' Global rating. Two had a 'Moderate' Global rating. Other results revealed that lack of stigma, HIV-related knowledge, and self-efficacy were positively related to HIV testing. Also, stigma was found to be a significant barrier to HIV testing and disclosure. In addition, reduced stigma had significant correlations to VCT use, knowing where to get tested, and willingness to disclose test results. Very importantly, positive correlations were found between exposure to a radio serial drama program (intervention) and reduced stigma as well as greater intention to obtain HIV testing. It would appear that revising the existing knowledge about the effectiveness of stigma interventions in reducing stigma is critical to appreciate the effects of reducing HIV/AIDS stigma on VCT uptake in the developing world. More exploratory studies, similar to the study which had a ‘Strong’ Global rating, should be conducted.