{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T10:03:47Z","timestamp":1789380227084,"version":"build-2803163510"},"reference-count":30,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T00:00:00Z","timestamp":1783555200000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In Zambia, HIV is a serious public health concern that predominantly affects women of reproductive age. Disclosure of HIV status remains central to treatment adherence, partner notification, and prevention efforts. Yet stigma continues to constrain disclosure. However, the question remains that: are all stigma the same? How different does internalized and enacted stigma affect HIV status disclosure? To answer these questions, the study examined the association between internalized, enacted stigma, and HIV status disclosure among women in Zambia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This study analyzed the 2024 demographic and health survey data of 1037 women living with HIV in Zambia. The outcome variable was HIV status disclosure, with the key exposure variables being internalized and enacted stigma. A multivariable logistic regression was performed to assess the association. Statistical significance was set at\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 89.7% (95% CI: 87.5\u201391.5) of women reported having disclosed their HIV status. About 26.1% and 21.8% experienced internalized and enacted stigma, respectively. The findings also revealed that women living with HIV mostly disclosed their status to family members (48.2%), followed by their intimate partners (29.7%). Women who experienced internalized stigma had significantly lower odds of HIV disclosure [AOR\u2009=\u20090.52; 95% CI: 0.33\u20130.84]. However, enacted stigma showed no statistical significance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>HIV disclosure among women in Zambia is high but remains patterned by internalized stigma and HIV transmission knowledge. Integrating stigma\u2010informed counseling with targeted health education may enhance disclosure and support broader HIV prevention and care outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.72800","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T06:54:51Z","timestamp":1783666491000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["When Stigma Differs: A Cross\u2010Sectional Study of Divergent Associations of Internalized and Enacted Stigma on Human Immunodeficiency Virus Disclosure in Zambia"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4080-7522","authenticated-orcid":false,"given":"Joshua","family":"Okyere","sequence":"first","affiliation":[{"name":"School of Human and Health Sciences University of Huddersfield, Queensgate Huddersfield England UK"},{"name":"College of Health Sciences University of Ghana Accra Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mutinta","family":"Monze","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Choma General Hospital Choma Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,9]]},"reference":[{"key":"e_1_2_15_2_1","unstructured":"World Health Organization HIV and AIDS: Key Facts.2025 https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/hiv-aids."},{"key":"e_1_2_15_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-025-23121-4"},{"key":"e_1_2_15_4_1","doi-asserted-by":"publisher","DOI":"10.4102\/PHCFM.v18i1.5202"},{"key":"e_1_2_15_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000003834"},{"key":"e_1_2_15_6_1","unstructured":"UNAIDS Understanding Measures of Progress Towards the 95\u201395\u201395 HIV Testing Treatment and Viral Suppression Targets 2023 https:\/\/www.unaids.org\/sites\/default\/files\/media_asset\/progress-towards-95-95-95_en.pdf."},{"key":"e_1_2_15_7_1","volume-title":"Zambia Population\u2010Based HIV Impact Assessment (ZAMPHIA) 2021: Final Report","author":"Ministry of Health, Zambia","year":"2023"},{"key":"e_1_2_15_8_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0331919"},{"key":"e_1_2_15_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12529-024-10291-5"},{"key":"e_1_2_15_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-019-3704-1"},{"key":"e_1_2_15_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.25915"},{"key":"e_1_2_15_12_1","volume-title":"Global AIDS Strategy 2021\u20132026: End Inequalities","author":"Joint United Nations Programme on HIV\/AIDS","year":"2021"},{"key":"e_1_2_15_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.25931"},{"key":"e_1_2_15_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000001757"},{"key":"e_1_2_15_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11524-019-00390-0"},{"key":"e_1_2_15_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-023-03342-z"},{"key":"e_1_2_15_17_1","volume-title":"Zambia Demographic and Health Survey 2024","author":"Zambia Statistics Agency, Ministry of Health (MoH) [Zambia], and ICF","year":"2024"},{"key":"e_1_2_15_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41043-026-01301-1"},{"key":"e_1_2_15_19_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0211921"},{"issue":"1","key":"e_1_2_15_20_1","article-title":"Research Article HIV\u2010Positive Status Disclosure and Associated Factors Among HIV\u2010Positive Adult Patients Attending Art Clinics at Public Health Facilities of Butajira Town, Southern Ethiopia","volume":"2020","author":"Berhe T. M.","year":"2020","journal-title":"AIDS Research and Treatment"},{"key":"e_1_2_15_21_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0211967"},{"key":"e_1_2_15_22_1","doi-asserted-by":"publisher","DOI":"10.5334\/aogh.3120"},{"key":"e_1_2_15_23_1","doi-asserted-by":"publisher","DOI":"10.30442\/ahr.1004-02-253"},{"key":"e_1_2_15_24_1","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/6842957"},{"key":"e_1_2_15_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-021-10472-x"},{"key":"e_1_2_15_26_1","unstructured":"M.Chanda Prudence HIV Disclosure Patterns Among Sexually Active Adolescent Girls and Young Women Living With HIV in Urban Communities of Zambia(Stellenbosch University 2021)."},{"key":"e_1_2_15_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/JNC.0000000000000442"},{"key":"e_1_2_15_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-020-03137-0"},{"key":"e_1_2_15_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.26167"},{"key":"e_1_2_15_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-019-02478-9"},{"key":"e_1_2_15_31_1","doi-asserted-by":"publisher","DOI":"10.2989\/16085906.2018.1552879"}],"container-title":["Health Science Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hsr2.72800","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/hsr2.72800","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hsr2.72800","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T09:12:32Z","timestamp":1789377152000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/hsr2.72800"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":30,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1002\/hsr2.72800"],"URL":"https:\/\/doi.org\/10.1002\/hsr2.72800","archive":["Portico"],"relation":{},"ISSN":["2398-8835","2398-8835"],"issn-type":[{"value":"2398-8835","type":"print"},{"value":"2398-8835","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]},"assertion":[{"value":"2026-02-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-09","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e72800"}}