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Assessing the Role of HIV Stigma in HIV Prevention and Care

Concept Clearance


Cynthia Grossman, Ph.D.
HIV Treatment and Translation Science Branch, Secondary Prevention Program
Division on AIDS Research (DAR)

Susannah Allison, Ph.D.
HIV Prevention Science Branch, Prevention Program
Division on AIDS Research (DAR)


This initiative aims to expand the understanding of the role HIV-associated stigma plays in the HIV testing, care, and treatment continuum, and to examine potential effects of interventions on HIV-associated stigma.


A public health approach that enhances the continuum from HIV testing, to linkage and engagement in care, to suppression of HIV viral replication is widely considered the path that will lead to decreases in HIV incidence at the population level. Along every step of the continuum, HIV-associated stigma may act as a barrier. Over the past two decades, the field has developed reliable and valid measures of HIV-associated stigma that have been used to provide evidence of stigma as a barrier to testing, care, and treatment. However, these measures have not been employed systematically or collectively to determine a) how HIV stigma operates to impact all of the steps along the HIV testing-to-care continuum, and b) how interventions could decrease stigma, or the attitudes, beliefs, and lack of knowledge that may contribute to HIV stigma.

Therefore, this initiative aims to support research utilizing state-of-the-science techniques to:

  • Determine the magnitude of impact of HIV-associated stigma on the steps along the HIV testing-to-care continuum;
  • Determine the impact of current interventions to increase HIV testing, linkage, and retention in care on HIV-associated stigma (e.g., could include assessment of the impact of interventions designed to indirectly reduce stigma);
  • Determine the best approaches to address HIV-associated stigma as part of comprehensive prevention programs—including, but not limited to, modeling the impact of addressing HIV-associated stigma as part of scale-up of combination prevention; and,
  • Advance and refine the assessment of HIV stigma, sensitivity to change over time, and measure other intersecting stigmas (e.g., injection drug use, mental illness) and HIV.

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