{"doi":"10.1111/tmi.13473","title":"Association between HIV stigma and antiretroviral therapy adherence among adults living with HIV: baseline findings from the HPTN 071 (PopART) trial in Zambia and South Africa","abstract":"OBJECTIVES: Adherence to antiretroviral therapy (ART) leads to viral suppression for people living with HIV (PLHIV) and is critical for both individual health and reducing onward HIV transmission. HIV stigma is a risk factor that can undermine adherence. We explored the association between HIV stigma and self-reported ART adherence among PLHIV in 21 communities in the HPTN 071 (PopART) trial in Zambia and the Western Cape of South Africa. METHODS: We conducted a cross-sectional analysis of baseline data collected between 2013 and 2015, before the roll-out of trial interventions. Questionnaires were conducted, and consenting participants provided a blood sample for HIV testing. Poor adherence was defined as self-report of not currently taking ART, missing pills over the previous 7 days or stopping treatment in the previous 12 months. Stigma was categorised into three domains: community, health setting and internalised stigma. Multivariable logistic regression was used for analysis. RESULTS: Among 2020 PLHIV self-reporting ever taking ART, 1888 (93%) were included in multivariable analysis. Poor ART adherence was reported by 15.8% (n = 320) of participants, and 25.7% (n = 519) reported experiencing community stigma, 21.5% (n = 434) internalised stigma, and 5.7% (n = 152) health setting stigma. PLHIV who self-reported previous experiences of community and internalised stigma more commonly reported poor ART adherence than those who did not (aOR 1.63, 95% CI 1.21 -2.19, P = 0.001 and aOR 1.31, 95% CI 0.96-1.79, P = 0.09). CONCLUSIONS: HIV stigma was associated with poor ART adherence. Roll-out of universal treatment will see an increasingly high proportion of PLHIV initiated on ART. Addressing HIV stigma could make an important contribution to supporting lifelong ART adherence.","journal":"Tropical Medicine & International Health","year":2020,"id":92950,"datarank":1.4744256968230465,"base_score":3.7376696182833684,"endowment":3.7376696182833684,"self_citation_contribution":0.5606504427425053,"citation_network_contribution":0.9137752540805412,"self_endowment_contribution":0.5606504427425053,"citer_contribution":0.9137752540805412,"corpus_percentile":null,"corpus_rank":null,"citation_count":41,"citer_count":38,"citers_with_citation_signal":25,"citers_with_endowment":25,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9658,"is_data_producer":true,"deposit_databanks":{"ClinicalTrials.gov":["NCT01900977"]},"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":257501,"name":"Sian Floyd","orcid":"0000-0002-8615-7601","position":1,"is_corresponding":false},{"id":334965,"name":"Anne Stangl","orcid":"0000-0001-9325-5077","position":2,"is_corresponding":false},{"id":334966,"name":"Virginia Bond","orcid":"0000-0002-6815-4239","position":3,"is_corresponding":false},{"id":334957,"name":"Graeme Hoddinott","orcid":"0000-0001-5915-8126","position":4,"is_corresponding":false},{"id":334956,"name":"Triantafyllos Pliakas","orcid":"0000-0002-7242-6479","position":5,"is_corresponding":false},{"id":441105,"name":"Justin Bwalya","orcid":null,"position":6,"is_corresponding":false},{"id":466293,"name":"Nomtha Mandla","orcid":null,"position":7,"is_corresponding":false},{"id":440380,"name":"Ayana Moore","orcid":"0000-0002-1216-6337","position":8,"is_corresponding":false},{"id":334960,"name":"Deborah Donnell","orcid":"0000-0002-0587-7480","position":9,"is_corresponding":false},{"id":334964,"name":"Peter Bock","orcid":"0000-0003-3211-6078","position":10,"is_corresponding":false},{"id":257500,"name":"Sarah Fidler","orcid":"0000-0003-1676-7583","position":11,"is_corresponding":false},{"id":257503,"name":"Richard Hayes","orcid":"0000-0002-1729-9892","position":12,"is_corresponding":false},{"id":257498,"name":"Helen Ayles","orcid":"0000-0003-4108-2842","position":13,"is_corresponding":false},{"id":304707,"name":"James Hargreaves","orcid":"0000-0002-3509-3572","position":14,"is_corresponding":false},{"id":466294,"name":"the HPTN 071 (PopART) Study Team","orcid":null,"position":15,"is_corresponding":false},{"id":464900,"name":"Harriet Jones","orcid":"0000-0003-4007-7144","position":0,"is_corresponding":true}],"reference_count":34,"raw_metadata":null,"created_at":"2026-07-18T22:30:54.208860Z","pmid":"32745296","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}