{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T12:03:48Z","timestamp":1784289828536,"version":"3.55.0"},"reference-count":85,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2022,2,21]],"date-time":"2022-02-21T00:00:00Z","timestamp":1645401600000},"content-version":"unspecified","delay-in-days":20,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MR\/M025454\/1"],"award-info":[{"award-number":["MR\/M025454\/1"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,1,14]]},"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We studied the psychometric properties of the 12-item short version of the Berger HIV stigma scale and assessed the correlates of HIV-related stigma among adults living with HIV on the Kenyan coast.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Comprehensive Care and Research Centre in the Kilifi County Hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Adults living with HIV on combination antiretroviral therapy were recruited and interviewed between February and April 2018 (n=450).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>HIV-related stigma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>450 participants with a median age of 43 years (IQR=36\u201350) took part in the study. Of these, 356 (79.1%) were female. Scale reliability and validity were high (alpha=0.80, test\u2013retest reliability intraclass correlation coefficient=0.92). Using confirmatory factor analysis, we observed that the 12-item short version of the HIV stigma scale had a good fit for its hypothesised model (Comparative Fit Index=0.966, Tucker Lewis Index=0.955, root mean square error of approximation=0.044). Multigroup confirmatory factor analysis indicated measurement invariance across gender and age groups as \u0394CFI was \u22640.01. Multivariate linear regression established that being female (\u03b2=2.001, 95%\u2009CI: 0.21 to 3.80, p=0.029), HIV status non-disclosure (\u03b2=4.237, 95%\u2009CI: 1.27 to 7.20, p=0.005) and co-occurrence of depressive and anxiety symptoms (\u03b2=6.670, 95%\u2009CI: 3.40 to 9.94, p&lt;0.001) were significant predictors of perceived HIV-related stigma and that these variables accounted for 10.2% of the explained variability in HIV-related stigma among adults living with HIV from Kilifi.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our results indicate that the 12-item short version of the HIV stigma scale is a valid and reliable measure of HIV stigma in Kenya. Furthermore, our study indicates that interventions aimed at reducing stigma need to take into account gender to address the specific needs of women, people who have not disclosed their HIV status, and those exhibiting symptoms of depression and anxiety, thereby improving their quality of life.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-050709","type":"journal-article","created":{"date-parts":[[2022,2,22]],"date-time":"2022-02-22T12:31:33Z","timestamp":1645533093000},"page":"e050709","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Measurement characteristics and correlates of HIV-related stigma among adults living with HIV: a cross-sectional study from coastal Kenya"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1422-0162","authenticated-orcid":false,"given":"Stanley W","family":"Wanjala","sequence":"first","affiliation":[{"name":"Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences Ghent University, Ghent, Belgium"},{"name":"Department of Social Sciences, School of Humanities and Social Sciences Pwani University, Kilifi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7761-0718","authenticated-orcid":false,"given":"Moses K","family":"Nyongesa","sequence":"additional","affiliation":[{"name":"Department of Clinical Research (Neurosciences), KEMRI\/Wellcome Trust Research Programme, Centre for Geographic Medicine Research (Coast), Kilifi, Kenya"},{"name":"Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Mwangi","sequence":"additional","affiliation":[{"name":"Department of Clinical Research (Neurosciences), KEMRI\/Wellcome Trust Research Programme, Centre for Geographic Medicine Research (Coast), Kilifi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnes M","family":"Mutua","sequence":"additional","affiliation":[{"name":"Department of Clinical Research (Neurosciences), KEMRI\/Wellcome Trust Research Programme, Centre for Geographic Medicine Research (Coast), Kilifi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stanley","family":"Luchters","sequence":"additional","affiliation":[{"name":"Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences Ghent University, Ghent, Belgium"},{"name":"Institute for Human Development, The Aga Khan University, Nairobi, Kenya"},{"name":"Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles R J C","family":"Newton","sequence":"additional","affiliation":[{"name":"Department of Clinical Research (Neurosciences), KEMRI\/Wellcome Trust Research Programme, Centre for Geographic Medicine Research (Coast), Kilifi, Kenya"},{"name":"Department of Psychiatry, Oxford University, Oxford, UK"},{"name":"Department of Public Health, Pwani University, Kilifi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amina","family":"Abubakar","sequence":"additional","affiliation":[{"name":"Department of Clinical Research (Neurosciences), KEMRI\/Wellcome Trust Research Programme, Centre for Geographic Medicine Research (Coast), Kilifi, Kenya"},{"name":"Institute for Human Development, The Aga Khan University, Nairobi, Kenya"},{"name":"Department of Psychiatry, Oxford University, Oxford, UK"},{"name":"Department of Public Health, Pwani University, Kilifi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,2,22]]},"reference":[{"key":"2025121221393259000_12.2.e050709.1","unstructured":"Joint United Nations Programme on HIV\/AIDS . Global HIV & AIDS statistics \u2014 2020 fact sheet. Available: https:\/\/www.unaids.org\/en\/resources\/fact-sheet [Accessed 22 Feb 2021]."},{"key":"2025121221393259000_12.2.e050709.2","unstructured":"Joint United Nations Programme on HIV\/AIDS . UNAIDS data 2020. Switzerland: UNAIDS, 2020. https:\/\/www.unaids.org\/sites\/default\/files\/media_asset\/2020_aids-data-book_en.pdf"},{"key":"2025121221393259000_12.2.e050709.3","unstructured":"National AIDS Control Council (NACC) . Kenya AIDS response progress report 2014: progress towards zero. Nairobi, Kenya: National AIDS Control Council of Kenya, 2014. https:\/\/www.unaids.org\/sites\/default\/files\/country\/documents\/KEN_narrative_report_2014.pdf"},{"key":"2025121221393259000_12.2.e050709.4","unstructured":"Stigma GE . Notes on the management of spoiled identity. New York: Simon and Shuster Inc, 1963."},{"key":"2025121221393259000_12.2.e050709.5","unstructured":"Jones EE , Farina A , Hastorf AH . Social stigma: the psychology of marked relationships. New York: W.H. Freeman, 1984."},{"key":"2025121221393259000_12.2.e050709.6","doi-asserted-by":"crossref","first-page":"766","DOI":"10.1007\/s10461-016-1476-9","article-title":"Assessing the impact of food assistance on stigma among people living with HIV in Uganda using the HIV\/AIDS stigma Instrument-PLWA (HASI-P)","volume":"21","author":"Maluccio","year":"2017","journal-title":"AIDS Behav"},{"key":"2025121221393259000_12.2.e050709.7","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0143749","article-title":"HIV\/AIDS related stigma and discrimination against PLWHA in Nigerian population","volume":"10","author":"Dahlui","year":"2015","journal-title":"PLoS One"},{"key":"2025121221393259000_12.2.e050709.8","doi-asserted-by":"crossref","first-page":"263","DOI":"10.15171\/joddd.2016.042","article-title":"HIV stigma: perceptions from HIV-positive and HIV-negative patients in a community dental clinic","volume":"10","author":"Toth","year":"2016","journal-title":"J Dent Res Dent Clin Dent Prospects"},{"key":"2025121221393259000_12.2.e050709.9","doi-asserted-by":"publisher","DOI":"10.1186\/1758-2652-12-15"},{"key":"2025121221393259000_12.2.e050709.10","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1300\/J013v38n04_04","article-title":"Stigma, disclosure, and psychological functioning among HIV-infected and non-infected African-American women","volume":"38","author":"Clark","year":"2004","journal-title":"Women & Health"},{"key":"2025121221393259000_12.2.e050709.11","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0114867","article-title":"Psychometric evaluation of the HIV stigma scale in a Swedish context","volume":"9","author":"Lindberg","year":"2014","journal-title":"PLoS One"},{"key":"2025121221393259000_12.2.e050709.12","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-009-9593-3"},{"key":"2025121221393259000_12.2.e050709.13","doi-asserted-by":"publisher","DOI":"10.1002\/nur.10011"},{"key":"2025121221393259000_12.2.e050709.14","doi-asserted-by":"crossref","DOI":"10.1186\/s12955-017-0691-z","article-title":"Development of a 12-item short version of the HIV stigma scale","volume":"15","author":"Reinius","year":"2017","journal-title":"Health Qual Life Outcomes"},{"key":"2025121221393259000_12.2.e050709.15","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2012.0403"},{"key":"2025121221393259000_12.2.e050709.16","doi-asserted-by":"crossref","DOI":"10.1186\/1477-7525-11-195","article-title":"Psychometric properties of a short version of the HIV stigma scale, adapted for children with HIV infection","volume":"11","author":"Wiklander","year":"2013","journal-title":"Health Qual Life Outcomes"},{"key":"2025121221393259000_12.2.e050709.17","doi-asserted-by":"crossref","unstructured":"Holzemer WL , Uys LR , Chirwa ML . Validation of the HIV\/AIDS stigma Instrument\u2014PLWA (HASI-P) 2007;19:1002\u201312.","DOI":"10.1080\/09540120701245999"},{"key":"2025121221393259000_12.2.e050709.18","unstructured":"Bauman L , Silver E . Camacho S Stigma among mothers with HIV\/AIDS. XIII international AIDS Conference, Durban, South Africa 2000."},{"key":"2025121221393259000_12.2.e050709.19","doi-asserted-by":"publisher","DOI":"10.2307\/2676360"},{"key":"2025121221393259000_12.2.e050709.20","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.83.4.574"},{"key":"2025121221393259000_12.2.e050709.21","doi-asserted-by":"publisher","DOI":"10.1080\/713613191"},{"key":"2025121221393259000_12.2.e050709.22","doi-asserted-by":"crossref","unstructured":"Jeyaseelan L , Kumar S , Mohanraj R . Assessing HIV\/AIDS stigma in South India: validation and abridgement of the Berger HIV stigma scale 2013;17:434\u201343.","DOI":"10.1007\/s10461-011-0128-3"},{"key":"2025121221393259000_12.2.e050709.23","doi-asserted-by":"publisher","DOI":"10.1521\/aeap.2007.19.3.198"},{"key":"2025121221393259000_12.2.e050709.24","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1080\/09540121.2014.978734","article-title":"The impact of HIV-related stigma on older and younger adults living with HIV disease: does age matter?","volume":"27","author":"Emlet","year":"2015","journal-title":"AIDS Care"},{"key":"2025121221393259000_12.2.e050709.25","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1080\/09540121.2015.1096888","article-title":"HIV-related stigma experiences: understanding gender disparities in Thailand","volume":"28","author":"Pannetier","year":"2016","journal-title":"AIDS Care"},{"key":"2025121221393259000_12.2.e050709.26","doi-asserted-by":"crossref","first-page":"935","DOI":"10.1080\/09540121.2013.869537","article-title":"Stigma in Ethiopia: association with depressive symptoms in people with HIV","volume":"26","author":"Endeshaw","year":"2014","journal-title":"AIDS Care"},{"key":"2025121221393259000_12.2.e050709.27","first-page":"VC09","article-title":"Perceived HIV related stigma among patients attending art center of a tertiary care center in rural West Bengal, India","volume":"10","author":"Datta","year":"2016","journal-title":"J Clin Diagn Res"},{"key":"2025121221393259000_12.2.e050709.28","doi-asserted-by":"publisher","DOI":"10.1080\/09540121.2010.525621"},{"key":"2025121221393259000_12.2.e050709.29","doi-asserted-by":"crossref","first-page":"1255","DOI":"10.1080\/09540121.2017.1282601","article-title":"Social-cultural factors of HIV-related stigma among the Chinese general population in Hong Kong","volume":"29","author":"Yeo","year":"2017","journal-title":"AIDS Care"},{"key":"2025121221393259000_12.2.e050709.30","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.1080\/09540121.2012.699669","article-title":"Factors associated with pregnant women\u2019s anticipations and experiences of HIV-related stigma in rural Kenya","volume":"24","author":"Cuca","year":"2012","journal-title":"AIDS Care"},{"key":"2025121221393259000_12.2.e050709.31","doi-asserted-by":"crossref","first-page":"1046","DOI":"10.1007\/s10461-013-0611-0","article-title":"Stigma against people with HIV\/AIDS in rural Ethiopia, 2005 to 2011: signs and predictors of improvement","volume":"18","author":"Girma","year":"2014","journal-title":"AIDS Behav"},{"key":"2025121221393259000_12.2.e050709.32","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1007\/s12160-013-9576-5","article-title":"The dynamic relationship between social support and HIV-related stigma in rural Uganda","volume":"48","author":"Takada","year":"2014","journal-title":"Ann Behav Med"},{"key":"2025121221393259000_12.2.e050709.33","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2006.20.350"},{"key":"2025121221393259000_12.2.e050709.34","doi-asserted-by":"crossref","unstructured":"Anakwa NO , Teye-Kwadjo E , Kretchy IA . Effect of HIV-related stigma and HIV-related stress on HIV disclosure concerns: a study of HIV-positive persons on antiretroviral therapy at two urban hospitals in Ghana. Applied Research in Quality of Life 2020:1\u201316.","DOI":"10.1007\/s11482-020-09813-6"},{"key":"2025121221393259000_12.2.e050709.35","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dys062"},{"key":"2025121221393259000_12.2.e050709.36","unstructured":"Ngugi E , Kipruto S , Samoei P . Exploring Kenya\u2019s inequality: iulling apart or pooling together? Kilifi County. Nairobi, Kenya: Kenya National Bureau of Statistics (KNBS) and the Society for International Development (SID), 2013."},{"key":"2025121221393259000_12.2.e050709.37","unstructured":"Commission on Revenue Allocation (CRA) . Kenya County fact sheets, 2011. Available: http:\/\/siteresources.worldbank.org\/INTAFRICA\/Resources\/257994-1335471959878\/Kenya_County_Fact_Sheets_Dec2011.pdf [Accessed 22 Aug 2018]."},{"key":"2025121221393259000_12.2.e050709.38","unstructured":"National AIDS Control Council . Kenya HIV county profiles - 2016. National AIDS Control Council, 2016: 49\u201352. http:\/\/nacc.or.ke\/wp-content\/uploads\/2016\/12\/Kenya-HIV-County-Profiles-2016.pdf"},{"key":"2025121221393259000_12.2.e050709.39","doi-asserted-by":"crossref","DOI":"10.1016\/j.jbi.2019.103208","article-title":"The REDCap consortium: building an international community of software platform partners","volume":"95","author":"Harris","year":"2019","journal-title":"J Biomed Inform"},{"key":"2025121221393259000_12.2.e050709.40","doi-asserted-by":"crossref","unstructured":"Harris PA , Taylor R , Thielke R . Research electronic data capture (REDCap)\u2014a metadata-driven methodology and workflow process for providing translational research informatics support 2009;42:377\u201381.","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"2025121221393259000_12.2.e050709.41","doi-asserted-by":"publisher","DOI":"10.1001\/jama.282.18.1737"},{"key":"2025121221393259000_12.2.e050709.42","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-008-0846-z"},{"key":"2025121221393259000_12.2.e050709.43","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.166.10.1092"},{"key":"2025121221393259000_12.2.e050709.44","doi-asserted-by":"crossref","unstructured":"Osborn TL , Venturo-Conerly KE , Wasil AR . Depression and anxiety symptoms, social support, and demographic factors among Kenyan high school students. J Child Fam Stud 2019:1\u201312.","DOI":"10.31234\/osf.io\/q5s63"},{"key":"2025121221393259000_12.2.e050709.45","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-023914"},{"key":"2025121221393259000_12.2.e050709.46","first-page":"115","article-title":"Estimating wealth effects without expenditure data\u2014or tears: an application to educational enrollments in states of India","volume":"38","author":"Filmer","year":"2001","journal-title":"J Demography"},{"key":"2025121221393259000_12.2.e050709.47","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12955-020-01421-0","article-title":"Correlates of health-related quality of life among adults receiving combination antiretroviral therapy in coastal Kenya","volume":"18","author":"Nyongesa","year":"2020","journal-title":"Health Qual Life Outcomes"},{"key":"2025121221393259000_12.2.e050709.48","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v048.i04"},{"key":"2025121221393259000_12.2.e050709.49","unstructured":"R Core Team . R: a language and environment for statistical computing. R Foundation for Statistical Computing. [computer program] 4.0.2 Vienna, Austria 2020."},{"key":"2025121221393259000_12.2.e050709.50","doi-asserted-by":"crossref","unstructured":"Blunch N . Introduction to structural equation modeling using IBM SPSS statistics and AMOS. Sage, 2012.","DOI":"10.4135\/9781526402257"},{"key":"2025121221393259000_12.2.e050709.51","doi-asserted-by":"publisher","DOI":"10.1080\/17405629.2012.686740"},{"key":"2025121221393259000_12.2.e050709.52","doi-asserted-by":"publisher","DOI":"10.1177\/0022022100031002003"},{"key":"2025121221393259000_12.2.e050709.53","doi-asserted-by":"crossref","unstructured":"Ware Jr JE , BJJoce G . Methods for testing data quality, scaling assumptions, and reliability: the IQOLA project approach 1998;51:945\u201352.","DOI":"10.1016\/S0895-4356(98)00085-7"},{"key":"2025121221393259000_12.2.e050709.54","unstructured":"Cohen J . Statistical power analysis for the behavioural sciences. 2nd edn. Hillsdale, NJ: L. Erlbaum Associates, 1988."},{"key":"2025121221393259000_12.2.e050709.55","unstructured":"Tabachnik B , Fidell L . Using multivariate statistics. 6th edn. Boston, \u00c9.-U. U: Pearson, 2013."},{"key":"2025121221393259000_12.2.e050709.56","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2006.03.012"},{"key":"2025121221393259000_12.2.e050709.57","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1177\/070674379303800214","article-title":"A checklist for evaluating the usefulness of rating scales","volume":"38","author":"Streiner","year":"1993","journal-title":"Can J Psychiatry"},{"key":"2025121221393259000_12.2.e050709.58","unstructured":"StataCorp LP . Stata statistical software: release 14. [computer program] College Station, TX; StataCorp LP 2015."},{"key":"2025121221393259000_12.2.e050709.59","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1080\/09540121.2013.764385","article-title":"Sensitivity and specificity of clinician administered screening instruments in detecting depression among HIV-positive individuals in Uganda","volume":"25","author":"Akena","year":"2013","journal-title":"AIDS Care"},{"key":"2025121221393259000_12.2.e050709.60","first-page":"1","article-title":"Estimating ordinal reliability for Likert-type and ordinal item response data: a conceptual, empirical, and practical guide","volume":"17","author":"Gadermann","year":"2012","journal-title":"P Ass, Re & Evalu"},{"key":"2025121221393259000_12.2.e050709.61","unstructured":"Gonz\u00e1lez J , MJRP P . C\u00e1lculo E interpretaci\u00f3n del alfa de C\u00e1lculo E interpretaci\u00f3n del alfa de Cronbach para El caso de validaci\u00f3n de la consistencia interna de un cuestionario, Con DOS posibles escalas tipo Likert 2015;2:62\u201377."},{"key":"2025121221393259000_12.2.e050709.62","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1007\/s10461-011-0128-3","article-title":"Assessing HIV\/AIDS stigma in South India: validation and abridgement of the Berger HIV stigma scale","volume":"17","author":"Jeyaseelan","year":"2013","journal-title":"AIDS Behav"},{"key":"2025121221393259000_12.2.e050709.63","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1521\/aeap.2011.23.3.193","article-title":"Factors associated with perceived stigma among people living with HIV\/AIDS in post-conflict Northern Uganda","volume":"23","author":"Nattabi","year":"2011","journal-title":"AIDS Educ Prev"},{"key":"2025121221393259000_12.2.e050709.64","doi-asserted-by":"publisher","DOI":"10.1037\/0278-6133.25.4.501"},{"key":"2025121221393259000_12.2.e050709.65","doi-asserted-by":"publisher","DOI":"10.1080\/07399332.2014.895367"},{"key":"2025121221393259000_12.2.e050709.66","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1080\/09540121.2013.808733","article-title":"Gender differences in HIV-related stigma in Kenya","volume":"26","author":"Mugoya","year":"2014","journal-title":"AIDS Care"},{"key":"2025121221393259000_12.2.e050709.67","doi-asserted-by":"crossref","DOI":"10.1155\/2009\/145891","article-title":"Stigma of people with HIV\/AIDS in sub-Saharan Africa: a literature review","volume":"2009","author":"Mbonu","year":"2009","journal-title":"J Trop Med"},{"key":"2025121221393259000_12.2.e050709.68","doi-asserted-by":"publisher","DOI":"10.1080\/09540120601114618"},{"key":"2025121221393259000_12.2.e050709.69","doi-asserted-by":"crossref","unstructured":"Muyinda H , Seeley J , Pickering H . Social aspects of AIDS-related stigma in rural Uganda 1997;3:143\u20137.","DOI":"10.1016\/S1353-8292(97)00010-5"},{"key":"2025121221393259000_12.2.e050709.70","doi-asserted-by":"publisher","DOI":"10.1080\/02664763.2012.755320"},{"key":"2025121221393259000_12.2.e050709.71","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s10461-016-1453-3","article-title":"HIV disclosure anxiety: a systematic review and theoretical synthesis","volume":"21","author":"Evangeli","year":"2017","journal-title":"AIDS Behav"},{"key":"2025121221393259000_12.2.e050709.72","doi-asserted-by":"crossref","DOI":"10.1186\/s12888-019-2339-5","article-title":"Prevalence and correlates of depressive symptoms among adults living with HIV in rural Kilifi, Kenya","volume":"19","author":"Nyongesa","year":"2019","journal-title":"BMC Psychiatry"},{"key":"2025121221393259000_12.2.e050709.73","doi-asserted-by":"crossref","unstructured":"Charles B , Jeyaseelan L , Pandian AK . Association between stigma, depression and quality of life of people living with HIV\/AIDS (PLHA) in South India\u2013a community based cross sectional study 2012;12:463.","DOI":"10.1186\/1471-2458-12-463"},{"key":"2025121221393259000_12.2.e050709.74","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0121461","article-title":"AIDS-related stigma and mental disorders among people living with HIV: a cross-sectional study in Cambodia","volume":"10","author":"Yi","year":"2015","journal-title":"PLoS One"},{"key":"2025121221393259000_12.2.e050709.75","unstructured":"Liu Y , Gong H , Yang G . Perceived stigma, mental health and unsafe sexual behaviors of people living with HIV\/AIDS 2014;39:658\u201363."},{"key":"2025121221393259000_12.2.e050709.76","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1080\/09540121.2013.844761","article-title":"HIV and depression in Eastern Nigeria: the role of HIV-related stigma","volume":"26","author":"Onyebuchi-Iwudibia","year":"2014","journal-title":"AIDS Care"},{"key":"2025121221393259000_12.2.e050709.77","doi-asserted-by":"crossref","DOI":"10.1177\/2050312119869109","article-title":"Assessment of HIV-related stigma and determinants among people living with HIV\/AIDS in Abeokuta, Nigeria: a cross-sectional study","volume":"7","author":"Oke","year":"2019","journal-title":"SAGE Open Med"},{"key":"2025121221393259000_12.2.e050709.78","doi-asserted-by":"crossref","unstructured":"Galvan FH , Davis EM , Banks D . HIV stigma and social support among African Americans 2008;22:423\u201336.","DOI":"10.1089\/apc.2007.0169"},{"key":"2025121221393259000_12.2.e050709.79","doi-asserted-by":"publisher","DOI":"10.1080\/09540120802290365"},{"key":"2025121221393259000_12.2.e050709.80","doi-asserted-by":"crossref","first-page":"2392","DOI":"10.1111\/jocn.12792","article-title":"Predictors of HIV enacted stigma among Chilean women","volume":"24","author":"Cianelli","year":"2015","journal-title":"J Clin Nurs"},{"key":"2025121221393259000_12.2.e050709.81","doi-asserted-by":"crossref","DOI":"10.1186\/s12913-018-3245-0","article-title":"HIV-related stigma among people living with HIV\/AIDS in rural Central China","volume":"18","author":"Li","year":"2018","journal-title":"BMC Health Serv Res"},{"key":"2025121221393259000_12.2.e050709.82","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2015.302716"},{"key":"2025121221393259000_12.2.e050709.83","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2007.122044"},{"key":"2025121221393259000_12.2.e050709.84","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.socscimed.2013.01.011","article-title":"Effects of home-based voluntary counselling and testing on HIV-related stigma: findings from a cluster-randomized trial in Zambia","volume":"81","author":"J\u00fcrgensen","year":"2013","journal-title":"Soc Sci Med"},{"key":"2025121221393259000_12.2.e050709.85","doi-asserted-by":"crossref","unstructured":"Kemp CG , Lipira L , Huh D , et al . HIV stigma and viral load among African-American women receiving treatment for HIV. 2019;33:1511\u20139.doi:10.1097\/QAD.0000000000002212","DOI":"10.1097\/QAD.0000000000002212"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2021-050709","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T05:39:44Z","timestamp":1765604384000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2021-050709"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2]]},"references-count":85,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022,2,22]]},"published-print":{"date-parts":[[2022,2]]}},"alternative-id":["10.1136\/bmjopen-2021-050709"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2021-050709","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2]]}}}