{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:01:55Z","timestamp":1792108915529,"version":"4.4.0"},"reference-count":85,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2022,5,28]],"date-time":"2022-05-28T00:00:00Z","timestamp":1653696000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>To date, about 37 million people are living with the human immunodeficiency virus (HIV) and an estimated 680,000 people have died from acquired immune deficiency syndrome (AIDS) related illnesses globally. While all countries have been impacted by HIV, some have been significantly more impacted than others, particularly countries in sub-Saharan Africa. The purpose of this paper was to identify progress made in HIV prevention globally, particularly in the areas of voluntary counseling and testing (VCT) uptake, access to antiretroviral therapy (ART), and HIV-related stigma. With the development of ART, a cocktail of medications for the treatment of HIV, VCT uptake increased, as it became apparent that the medication would only be prescribed after an HIV diagnosis through testing. Widely considered a critical gateway to HIV prevention and treatment, VCT is being implemented in many countries, and as a result, about 38 million people living with HIV in 2018 had access to ART. Regardless of this success, major challenges still remain. We did an electronic search of 135 articles in English related to global HIV progress and challenges indexed in PubMed, ResearchGate, Google, and other search engines from 1998 to 2021. Sixty articles met the inclusion criteria for this paper. Data on trends in ART coverage were obtained from the Joint United Nations Programme on HIV\/AIDS (UNAIDS) website. These data were used to show ART coverage globally in World Health Organization (WHO) regions. It was found that while global successes have been chalked in the areas of VCT uptake and ART coverage, HIV-related stigma has impeded greater success. This paper summarizes and discusses global successes and challenges in HIV prevention efforts in the past four decades with a focus on VCT, ART, and HIV-related stigma.<\/jats:p>","DOI":"10.3390\/ijerph19116597","type":"journal-article","created":{"date-parts":[[2022,5,29]],"date-time":"2022-05-29T08:50:51Z","timestamp":1653814251000},"page":"6597","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Voluntary Counseling and Testing, Antiretroviral Therapy Access, and HIV-Related Stigma: Global Progress and Challenges"],"prefix":"10.3390","volume":"19","author":[{"given":"Elizabeth Afibah","family":"Armstrong-Mensah","sequence":"first","affiliation":[{"name":"Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA 30303, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ato Kwamena","family":"Tetteh","sequence":"additional","affiliation":[{"name":"Laboratory Department, Metropolitan Hospital, Cape Coast P.O. Box 174, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9558-5632","authenticated-orcid":false,"given":"Emmanuel","family":"Ofori","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Komfo Anokye Teaching Hospital, Kumasi P.O. Box 1934, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osasogie","family":"Ekhosuehi","sequence":"additional","affiliation":[{"name":"Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA 30303, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,5,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"49","DOI":"10.5334\/aogh.3120","article-title":"HIV Stigma and Status Disclosure in Three Municipalities in Ghana","volume":"87","author":"Adam","year":"2021","journal-title":"Ann. Glob. Health"},{"key":"ref_2","unstructured":"Joint United Nations Program on HIV\/AIDS (UNAIDS) (2021, November 13). Fact Sheet 2021: Global HIV Statistics. Available online: https:\/\/embargo.unaids.org\/static\/files\/uploaded_files\/UNAIDS_2021_FactSheet_en_em.pdf#:~:text=FACT%20SHEET%202021%20Preliminary%20UNAIDS%202021%20epidemiological%20estimates,people%20became%20newly%20infected%20with%20HIV%20in%202020."},{"key":"ref_3","unstructured":"(2021, November 14). MDG MONITOR Millennium Development Goals\u2014MDGs. Available online: https:\/\/www.mdgmonitor.org\/millennium-development-goals\/."},{"key":"ref_4","unstructured":"United Nations (2021, November 12). The 17 Goals: Sustainable Development. Available online: https:\/\/sdgs.un.org\/goals."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"18881","DOI":"10.7448\/IAS.16.3.18881","article-title":"Global Action to Reduce HIV Stigma and Discrimination","volume":"16","author":"Grossman","year":"2013","journal-title":"J. Int. AIDS Soc."},{"key":"ref_6","unstructured":"World Health Organization (2021, October 14). HIV Testing and Counseling: The Gateway to Treatment, Care, and Support. Available online: https:\/\/www.who.int\/3by5\/publications\/briefs\/hiv_testing_counselling\/en\/."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1080\/09540120500213511","article-title":"Utilization of Voluntary Counseling and Testing Services in the Eastern Cape, South Africa","volume":"18","author":"Hutchinson","year":"2006","journal-title":"AIDS Care"},{"key":"ref_8","unstructured":"United States Agency for International Development (2021, November 12). P. S. Voluntary Counseling and Testing Rigorous Evidence\u2014Usable Results. Available online: https:\/\/www.jhsph.edu\/research\/centers-and-institutes\/research-to-prevention\/publications\/VCT.pdf#:~:text=Voluntary%20Counseling%20and%20Testing%20%28VCT%29%20allows%20individuals%20to,pre-%20and%20post-test%20counseling%20and%20an%20HIV%20test."},{"key":"ref_9","first-page":"73","article-title":"Uptake of HIV Testing: Assessing the Impact of a Community-Based Intervention in Rural Nigeria","volume":"21","author":"Onoja","year":"2020","journal-title":"Health Sci. Dis."},{"key":"ref_10","first-page":"165","article-title":"Responsiveness to HIV Education and VCT Services Among Kenyan Rural Women: A Community-Based Survey","volume":"14","author":"Karau","year":"2010","journal-title":"Afr. J. Reprod. Health"},{"key":"ref_11","first-page":"28","article-title":"Exploring the Inter Play Between VCT Service Delivery and it\u2019s Amongst Primary School Teachers in South-West Ethiopia","volume":"11","author":"Bediru","year":"2019","journal-title":"Softw. Eng. Technol."},{"key":"ref_12","unstructured":"World Health Organization (2021, December 26). Guidance on Couples HIV Testing and Counselling Including Antiretroviral Therapy for Treatment and Prevention in Serodiscordant Couples: Recommendations for a Public Health Approach. Available online: http:\/\/apps.who.int\/iris\/bitstream\/10665\/44646\/1\/9789241501972_eng.pdf."},{"key":"ref_13","unstructured":"Centers for Disease Control and Prevention (2021, December 26). Testing Together, Available online: https:\/\/www.cdc.gov\/hiv\/effective-interventions\/diagnose\/testing-together\/index.html."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1136\/sextrans-2014-051882","article-title":"Seek, Test and Disclose: Knowledge of HIV Testing and Serostatus Among High-risk Couples in a South African Township","volume":"92","author":"Doherty","year":"2016","journal-title":"Sex. Transm Infect."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1097\/QAI.0000000000000546","article-title":"Who Knows Their Partner\u2019s HIV Status? Results From a Nationally Representative Survey in Uganda","volume":"69","author":"Kenyon","year":"2015","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1097\/00002030-200303280-00012","article-title":"Sexual Behavior of HIV Discordant Couples After HIV Counseling and Testing","volume":"17","author":"Allen","year":"2003","journal-title":"AIDS"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1136\/sextrans-2016-052743","article-title":"Sustained Effect of Couples\u2019 HIV Counselling and Testing on Risk Reduction Among Zambian HIV Serodiscordant Couples","volume":"93","author":"Wall","year":"2017","journal-title":"Sex. Transm. Infect."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"5740654","DOI":"10.1155\/2020\/5740654","article-title":"Understanding the Role of Voluntary Counseling and Testing (VCT) in HIV Prevention in Nantong, China","volume":"2020","author":"Xu","year":"2020","journal-title":"BioMed Res. Int."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"520","DOI":"10.5958\/0976-5506.2019.01057.X","article-title":"Risk Factors Associated with HIV Infection among General Population in Tanah Papua: Secondary Data Analysis of IBBS in Tanah Papua, Indonesia 2013","volume":"10","author":"Hidayah","year":"2019","journal-title":"Indian J. Public Health Res. Dev."},{"key":"ref_20","unstructured":"World Health Organization (1998). The Importance of Simple\/Rapid Assays In HIV Testing. Wkly. Epidemiol. Rec., 73, 321\u2013326."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Baisley, K., Doyle, A.M., Changalucha, J., Maganja, K., Watson-Jones, D., Hayes, R., and Ross, D. (2012). Uptake of Voluntary Counselling and Testing Among Young People Participating in an HIV Prevention Trial: Comparison of Opt-out and Opt-in Strategies. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0042108"},{"key":"ref_22","first-page":"159","article-title":"Factors Hindering Acceptance of HIV\/AIDS Voluntary Counseling and Testing (VCT) among Youth in Kwara State, Nigeria","volume":"14","author":"Yahaya","year":"2010","journal-title":"Afr. J. Reprod. Health"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1007\/s10461-015-1188-6","article-title":"Mobilization for HIV Voluntary Counseling and Testing Services in Vietnam: Clients\u2019 Risk Behaviors, Attitudes and Willingness to Pay","volume":"20","author":"Nguyen","year":"2016","journal-title":"AIDS Behav."},{"key":"ref_24","unstructured":"World Health Organization (2022, March 13). Guidance on Provider-Initiated HIV Testing and Counselling in Health Facilities. Available online: https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/43688\/9789241595568_eng.pdf?sequence=1&isAllowed=y."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1447","DOI":"10.1097\/01.aids.0000233579.79714.8d","article-title":"Estimating sexual transmission of HIV from persons aware and unaware that they are infected with the virus in the USA","volume":"20","author":"Marks","year":"2006","journal-title":"AIDS"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1097\/QAI.0b013e318047df88","article-title":"Successful introduction of routine opt-out HIV testing in antenatal care in Botswana","volume":"45","author":"Creek","year":"2007","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"387","DOI":"10.3109\/13625187.2011.593660","article-title":"Provider-initiated (Opt-out) HIV testing and counselling in a group of university students in Ile-Ife, Nigeria","volume":"16","author":"Ijadunola","year":"2011","journal-title":"Eur. J. Contracept. Reprod. Health Care"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/1748-5908-5-8","article-title":"The impact of provider-initiated (opt-out) HIV testing and counseling of patients with sexually transmitted infection in Cape Town, South Africa: A controlled trial","volume":"5","author":"Leon","year":"2010","journal-title":"Implement. Sci."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"302","DOI":"10.2471\/BLT.07.042580","article-title":"Acceptability of routine HIV counselling and testing, and HIV seroprevalence in Ugandan hospitals","volume":"86","author":"Wanyenze","year":"2008","journal-title":"Bull. World Health Organ."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1097\/QAI.0b013e318030ffa9","article-title":"Two and a half years of routine HIV testing in Botswana","volume":"44","author":"Steen","year":"2007","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Weigel, R., Kamthunzi, P., Mwansambo, C., Phiri, S., and Kazembe, P.N. (2009). Effect of provider-initiated testing and counselling and integration of ART services on access to HIV diagnosis and treatment for children in Lilongwe, Malawi: A pre- post comparison. BMC Pediatr., 9.","DOI":"10.1186\/1471-2431-9-80"},{"key":"ref_32","unstructured":"PEPFAR Solutions Platform (2022, March 10). Index and Partner Notificcation Testing Toolkit. 11 April 2018. Available online: https:\/\/www.pepfarsolutions.org\/resourcesandtools-2\/2018\/4\/11\/index-and-partner-notification-testing-toolkit."},{"key":"ref_33","first-page":"2","article-title":"Taking HIV Testing to Families: Designing a Family-Based Intervention to Facilitate HIV Testing, Disclosure, and Intergenerational Communication","volume":"4","author":"Rooyen","year":"2016","journal-title":"Front. Public Health"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1097\/QAI.0000000000001731","article-title":"Family Testing: An Index Case Finding Strategy to Close the Gaps in Pediatric HIV Diagnosis","volume":"15","author":"Simon","year":"2018","journal-title":"Acquir. Immune Defic. Syndr."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1016\/j.idc.2014.06.001","article-title":"Antiretroviral Therapy: Current Drugs","volume":"28","author":"Pau","year":"2014","journal-title":"Infect. Dis. Clin. N. Am."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1056\/NEJMoa1105243","article-title":"Prevention of HIV-1 Infection with Early Antiretroviral Therapy","volume":"365","author":"Cohen","year":"2011","journal-title":"N. Engl. J. Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1517\/14656566.2012.642865","article-title":"Combination Nucleoside\/Nucleotide Reverse Transcriptase Inhibitors for Treatment of HIV Infection","volume":"13","author":"Akanbi","year":"2012","journal-title":"Expert Opin. Pharmacother."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"S2","DOI":"10.1097\/01.qai.0000137001.40505.56","article-title":"Pharmacokinetic Properties Of Nucleoside\/Nucleotide Reverse Transcriptase Inhibitors","volume":"37","author":"Piliero","year":"2004","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref_39","unstructured":"Watson, S. (2021, November 22). The History of HIV Treatment: Antiretroviral Therapy and More. Available online: https:\/\/www.webmd.com\/hiv-aids\/hiv-treatment-history."},{"key":"ref_40","unstructured":"HIV.gov (2022, March 22). PEPFAR, Available online: https:\/\/www.hiv.gov\/federal-response\/pepfar-global-aids\/pepfar."},{"key":"ref_41","unstructured":"(2021, November 22). PEPFAR Reports to Congress 2005\u20132020, Available online: https:\/\/www.state.gov\/pepfar-reports-to-congress-archive\/."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1056\/NEJMp1916753","article-title":"Four Decades of HIV\/AIDS\u2014Much Accomplished, Much to Do","volume":"383","author":"Fauci","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_43","unstructured":"Rosenberg, Z. (2021, December 24). iPrEx Clinical Trial Demonstrate 44 Percent Protection Against HIV\u2014Mounting Evidence of the Power of ARVs to Prevent HIV Transmission. Available online: https:\/\/www.ipmglobal.org\/publications-media\/iprex-clinical-trial-demonstrates-44-protection-against-hiv."},{"key":"ref_44","unstructured":"HIV Prevention Trials Network 052 (2021, December 24). A Randomized Trial to Evaluate the Effectiveness of Antiretroviral Therapy Plus HIV Primary Care Versus HIV Primary Care Alone to Prevent the Sexual Transmission of HIV-1 in Serodiscordant Couples. Available online: https:\/\/www.hptn.org\/research\/studies\/hptn052."},{"key":"ref_45","unstructured":"HIV Prevention Trials Network 084 (2021, December 24). HPTN 084 Study Demonstrate Superiority of CAB LA to Oral TDF\/FTC for the Prevention of HIV. Available online: https:\/\/www.hptn.org\/news-and-events\/press-releases\/hptn-084-study-demonstrates-superiority-of-cab-la-to-oral-tdfftc-for."},{"key":"ref_46","unstructured":"(2022, March 24). US Food and Drug Administration, Available online: https:\/\/www.fda.gov\/news-events\/press-announcements\/fda-approves-first-injectable-treatment-hiv-pre-exposure-prevention."},{"key":"ref_47","unstructured":"(2022, March 24). International Association of Providers of AIDS Care. Available online: https:\/\/www.iapac.org\/fact-sheet\/dapivirine-vaginal-ring\/#:~:text=The%20dapivirine%20ring%20marks%20the,to%20reduce%20their%20HIV%20risk."},{"key":"ref_48","unstructured":"International Partnership for Microbicides (2022, March 24). South Africa Approves Dapivirine Vaginal Ring for Use by Women. Available online: https:\/\/www.ipmglobal.org\/content\/south-africa-approves-dapivirine-vaginal-ring-use-women#:~:text=(March%2011%2C%202022)%E2%80%94,to%20reduce%20their%20HIV%20risk."},{"key":"ref_49","unstructured":"(2022, March 24). Avert, 2019. Treatment as Prevention (TASP) for HIV. Available online: https:\/\/www.avert.org\/professionals\/hiv-programming\/prevention\/treatment-as-prevention."},{"key":"ref_50","unstructured":"World Health Organization (2021, November 22). Latest HIV Estimates and Updates on HIV Policies Uptake, July 2020. Available online: https:\/\/www.who.int\/docs\/default-source\/hiv-hq\/presentation-international-aids-conference-2020.pdf?sfvrsn=cbd9bbc_4."},{"key":"ref_51","unstructured":"(2021, September 20). Joint United Nations Programme on HIV\/AIDS (UNAIDS) Estimate The World Bank Data. Available online: https:\/\/data.worldbank.org\/indicator\/SH.HIV.ARTC.ZS?end=2020&start=2000&view=chart."},{"key":"ref_52","unstructured":"Centers for Disease Control and Prevention (2021, November 22). HIV Stigma and Discrimination, Available online: https:\/\/www.cdc.gov\/hiv\/basics\/hiv-stigma\/index.html."},{"key":"ref_53","unstructured":"(2021, September 23). People Living with HIV Stigma Index (October 10, 2021). Available online: http:\/\/www.stigmaindex.org\/news\/oct-2015\/we-are-change-dealing-self-stigma-and-hivaids-experience-zimbabwe."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Ngangue, P., Gagnon, M.P., and Bedard, E. (2017). Challenges in the Delivery of Public HIV Testing and Counselling (HTC) in Douala, Cameroon: Providers Perspectives and Implications on Quality of HTC Services. BMC Int. Health Hum. Rights, 17.","DOI":"10.1186\/s12914-017-0118-2"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"S93","DOI":"10.1097\/QAD.0000000000000253","article-title":"Developing the 2013 WHO Consolidated Antiretroviral Guidelines","volume":"28","author":"Easterbrook","year":"2014","journal-title":"AIDS"},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Haskew, J., Turner, K., R\u00f8, G., Ho, A., Kimanga, D., and Sharif, S. (2015). Stage of HIV Presentation at Initial Clinic Visit Following a Community-Based HIV Testing Campaign in Rural Kenya. BMC Public Health, 15.","DOI":"10.1186\/s12889-015-1367-4"},{"key":"ref_57","unstructured":"Central Statistical Agency (CSA) [Ethiopia] and ICF 2017 (2021, October 08). 2016 Ethiopia Demographic and Health Survey. Available online: https:\/\/dhsprogram.com\/pubs\/pdf\/SR241\/SR241.pdf."},{"key":"ref_58","unstructured":"Stangl, A.L., Brady, L., and Fritz, K. (2021, October 08). Measuring HIV Stigma and Discrimination. Available online: http:\/\/strive.lshtm.ac.uk\/system\/files\/attachments\/STRIVE%20stigma%20measurement.pdf."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1016\/S2352-3018(20)30359-3","article-title":"The Impact of the COVID-19 Lockdown on HIV Care in 65 South African Primary Care Clinics: An Interrupted Time Series Analysis","volume":"8","author":"Dorward","year":"2021","journal-title":"Lancet HIV"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"S77","DOI":"10.1086\/651477","article-title":"Integrating HIV screening into routine health care in resource-limited settings","volume":"50","author":"Bassett","year":"2010","journal-title":"Clin. Infect. Dis."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"d7031","DOI":"10.1136\/bmj.d7031","article-title":"The financial cost of doctors emigrating from sub- Saharan Africa: Human capital analysis","volume":"343","author":"Mills","year":"2011","journal-title":"BMJ"},{"key":"ref_62","first-page":"1047","article-title":"Brain drain among health professionals in Kenya: A case of poor working conditions?\u2014A critical review of the causes and effects","volume":"3","author":"Machayo","year":"2013","journal-title":"Prime J. Bus. Adm. Manag."},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Sibanda, E.L., Hatzold, K., Mugurungi, O., Ncube, G., Dupwa, B., Siraha, P., Madyira, L.K., Mangwira, A., Bhattacharya, G., and Cowan, F.M. (2012). An assessment of the Zimbabwe ministry of health and child welfare provider initiated HIV testing and counselling programme. BMC Health Serv. Res., 12.","DOI":"10.1186\/1472-6963-12-131"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1186\/1758-2652-15-8","article-title":"Family model of HIV care and treatment: A retrospective study in Kenya","volume":"15","author":"Kulzer","year":"2012","journal-title":"J. Int. AIDS Soc."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"321","DOI":"10.2190\/IQ.27.4.d","article-title":"Family Systems and HIV\/AIDS in South Africa","volume":"27","author":"Lwelunmor","year":"2007","journal-title":"Int. Q. Community Health Educ."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1111","DOI":"10.1007\/s10461-010-9798-5","article-title":"HIV\/AIDS Stigma and Refusal of HIV Testing Among Pregnant Women in Rural Kenya: Results from the MAMAS Study","volume":"15","author":"Turan","year":"2011","journal-title":"AIDS Behav."},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Gyamfi, E., and Okyere, P. (2017). Enoch, A.; Appiah-Brempong, E. Prevalence of, and barriers to the disclosure of HIV status to infected children and adolescents in a district of Ghana. BMC Int. Health Hum. Rights, 17.","DOI":"10.1186\/s12914-017-0114-6"},{"key":"ref_68","doi-asserted-by":"crossref","unstructured":"Ampofo, E.A., Tetteh, I.C., Adu-Gyamfi, R., Enyan, N.I.E., Agyare, E., Addo, S.A., and Obiri-Yeboah, D. (2021). Family-Based Index testing for HIV; a qualitative study of acceptance, barriers\/challenges and facilitators among clients in Cape Coast, Ghana. AIDS Care, 1\u20136.","DOI":"10.21203\/rs.3.rs-35726\/v1"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1007\/s10461-015-1022-1","article-title":"The \u2018fears\u2019 of disclosing HIV status to sexual partners: A mixed Methods study in a counseling setting in Ghana","volume":"20","author":"Baidoo","year":"2016","journal-title":"AIDS Behav."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/S0140-6736(04)16597-5","article-title":"Scaling Up Access to Antiretroviral Treatment in Southern Africa: Who Will Do the Job?","volume":"364","author":"Kober","year":"2004","journal-title":"Lancet"},{"key":"ref_71","first-page":"1","article-title":"Factors Affecting Adherence to Antiretroviral Therapy Among HIV\/AIDS Patients in Cape Coast Metropolis, Ghana","volume":"4","author":"Prah","year":"2018","journal-title":"J. HIV AIDS"},{"key":"ref_72","unstructured":"Harrington-Edmans, F. (2021, October 14). People in Poorer Countries in Latin America and the Caribbean Adhere Better to HIV Treatment. Available online: https:\/\/www.avert.org\/news\/people-poorer-countries-latin-america-and-caribbean-adhere-better-hiv-treatment."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1111\/hiv.12347","article-title":"European AIDS Clinical Society Standard of Care Meeting on HIV and Related Coinfections: The Rome Statements","volume":"17","author":"Mussini","year":"2016","journal-title":"HIV Med."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"e84","DOI":"10.1016\/S2468-2667(18)30265-2","article-title":"HIV Crisis in The Philippines: Urgent Actions Needed","volume":"4","author":"Gangcuangco","year":"2019","journal-title":"Lancet Public Health"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"20004","DOI":"10.7448\/IAS.18.1.20004","article-title":"The Funding Landscape for HIV in Asia and the Pacific","volume":"18","author":"Stuart","year":"2015","journal-title":"J. Int. AIDS Soc."},{"key":"ref_76","unstructured":"Avert (2021, December 24). Pre-Exposure Prophylaxis (PrEP) for Hiv Prevention. Available online: https:\/\/www.avert.org\/professionals\/hiv-programming\/prevention\/pre-exposure-prophylaxis."},{"key":"ref_77","unstructured":"United Nations Programme on HIV\/AIDS (2021, December 24). Ending AIDS\u2014Progress Towards the 90-90-90 Targets. Available online: https:\/\/www.unaids.org\/sites\/default\/files\/media_asset\/Global_AIDS_update_2017_en.pdf."},{"key":"ref_78","unstructured":"Winter, S. (2021, December 24). Lost in Transition: Transgender People. Rights and HIV Vulnerability in the Asia-Pacific Region. Available online: https:\/\/www.undp.org\/sites\/g\/files\/zskgke326\/files\/publications\/UNDP_HIV_Transgender_report_Lost_in_Transition_May_2012.pdf."},{"key":"ref_79","unstructured":"European Centre for Disease Prevention and Control Special Report (2021, September 15). The Status of the HIV Response in the European Union\/European Economic Area. Available online: https:\/\/www.ecdc.europa.eu\/sites\/default\/files\/media\/en\/publications\/Publications\/Status-of-HIV-response-in-EU-EEA-2016-30-jan-2017.pdf."},{"key":"ref_80","unstructured":"(2021, August 12). World Health Organization Global HIV\/AIDS Response: Epidemic Update and Health Sector Progress Towards Uni-Versal Access: Progress Report 2011. Available online: https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/44787\/9789241502986_eng.pdf?sequence=1."},{"key":"ref_81","unstructured":"The Well Project (2021, October 12). Stigma and Discrimination against Women Living with HIV. Available online: https:\/\/www.thewellproject.org\/hiv-information\/stigma-and-discrimination-against-women-living-hiv."},{"key":"ref_82","unstructured":"Bernard, E.J., and Cameron, S. (2021, October 15). Advancing HIV Justice 2: Building Momentum in Global Advocacy against HIV Criminalisation. Available online: https:\/\/www.hivjustice.net\/wp-content\/uploads\/2016\/05\/AHJ2.final2_.10May2016.pdf."},{"key":"ref_83","unstructured":"Joint United Nations Programme on HIV\/AIDS (UNAIDS) (2021, November 23). Global Report: UNAIDS Report on the Global AIDS Epidemic 2010. Available online: https:\/\/www.unaids.org\/globalreport\/Global_report.htm."},{"key":"ref_84","unstructured":"Human Rights Watch (2021, October 12). \u201cSwept Away\u201d: Abuses against Sex Workers in China. Available online: https:\/\/www.hrw.org\/report\/2013\/05\/14\/swept-away\/abuses-against-sex-workers-china#."},{"key":"ref_85","unstructured":"Centers for Disease Control and Prevention (2021, November 23). HIV Criminalization and Ending the HIV Epidemic, Available online: https:\/\/www.cdc.gov\/hiv\/policies\/law\/criminalization-ehe.html."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/11\/6597\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:20:34Z","timestamp":1760138434000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/11\/6597"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,28]]},"references-count":85,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2022,6]]}},"alternative-id":["ijerph19116597"],"URL":"https:\/\/doi.org\/10.3390\/ijerph19116597","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,28]]}}}