Reducing stigma and increasing HIV testing with a health information intervention:

a cluster-randomized trial from Malawi

Poster: MOPDC0102

L. Derksen, A. Muula, A. Matengeni, M. van Lettow, S. D. Sodhi, J. J. van Oosterhout

Disclosure

We gratefully acknowledge funding received from the Suntory and Toyota International Centre for Economics and Related Disciplines (STICERD) and the Russell Sage Foundation

Motivation: HIV testing is surprisingly low

Over 1 million AIDS deaths per year in sub-Saharan Africa•ART is often free and effective•Half the population has never been tested

Stigma between sexual partners may be a barrier•A person seen getting tested or treated is viewed as a risky partner

“It's better to receive drugs from the hospital of some areas [...] because many people can discover fast that I have virus of AIDS, and some ladies

can disagree me so it can be painful in my everyday life.”Malawi Journals Project

Intervention to reduce stigma and increase testing

Idea: inform public that ART reduces transmission by 96% (HPTN052)•A person who gets tested is a safer partner

Cluster-RCT: community health meetings in 122 villages in Malawi

Results

Shift in beliefs about effect of ART on transmission (after 5 months):•Average belief is 70% in intervention villages vs. 18% in control

Less stigma between sexual partners in intervention villages •More prefer a partner on ART to an untested partner (p=0.000)•More believe a person on ART might find a new partner (p=0.002)

HIV testing rate 60% higher in intervention villages (p=0.035)•Based on data from 18 health facilities•Ages 15-49, non-pregnant•Controlling for village-level covariates•3 months post-intervention•Similar for men and women