Socioeconomic and socioecological determinants of AIDS stigma and the mediating role of AIDS knowledge and media use

© Taylor & Francis 2016. Background: Stigmatic attitudes toward people with HIV impede prevention efforts; it is important to understand determinants of AIDS stigma. Previous research has shown that AIDS stigma is associated with socioeconomic and socioecological factors. However, little research has investigated the mechanisms that underlie these associations. In this study, we hypothesized a mediation model and tested the role of AIDS knowledge and HIV/ AIDS-related media use in explaining the link between educational level and urban versus rural residence, on the one hand, and AIDS stigma, on the other. Methods: Cross-sectional data were gathered from 977 urban and rural residents of northwest Ethiopia. Kalichman et al.’s nine-item scale was used to measure AIDS stigma. Structural equation modeling, using the maximum likelihood method, was employed to test the hypothesized mediation model. Results: Thirty-five percent of respondents endorsed at least one of the nine AIDS stigma items. Although AIDS stigma was found to be generally low, disparities were discerned between population sub-groups. Mediation analysis showed that whereas education and urban residence are positively associated with HIV/AIDS-related media use and AIDS knowledge, only AIDS knowledge is negatively associated with AIDS stigma. Conclusions: AIDS knowledge is not only a factor that is negatively and significantly associated with AIDS stigma, but can also explain the links between AIDS stigma and its antecedents. This underscores the need to leverage ongoing HIV/ AIDS awareness raising and education programs in the region, and the importance of mass media to counteract AIDS stigma in general and the gaps in such attitudes between population sub-groups.status: publishe