Population-based survey with necessary questions to ascertain respondents’ attitudes toward PLWHA.  Where data are available, the indicator can be disaggregated by sex, age group, education level, and urban/rural residence.

Data Source(s):

Population-based survey tools, such as the AIDS Indicator Survey (AIS), Demographic and Health Survey (DHS), or Multiple Indicator Cluster Survey (MICS).

Purpose:

HIV/AIDS awareness programs are designed to increase accepting attitudes toward PLWHA or those perceived to be living with HIV. This indicator provides a measure of the effectiveness of HIV awareness programs and can underscore whether more needs to be done to counter HIV-related stigma.  HIV-related stigma refers to unfavorable attitudes, beliefs, and policies directed toward PLWHA and their family members, close associates and communities. HIV-related stigma can reduce the effectiveness of programs and services designed for PLWHA and those who are affected by the disease. For example, studies have shown that some families with orphans have chosen not to receive relief services in order to avoid the stigma attached to these benefits. Other studies found that some families cut themselves off from social support networks long before an AIDS death occurs in the family in order to avoid HIV-related stigma (UNAIDS, 2008).

Issue(s):

While a low value for the indicator suggests a high level of HIV-related stigma, a high value for the indicator could be interpreted either that there is a low level of HIV-related stigma or that people know they should not discriminate and therefore report accepting attitudes. High scores may also reflect the respondent’s limited personal experience with HIV/AIDS. Another limitation of this indicator is that there is frequently not a direct relationship between attitudes and behavior. What people actually do in the face of HIV/AIDS may differ from what they say they would do when asked a hypothetical question. Some studies have found, for example, that people expressing very negative attitudes toward PLWHA actually provide supportive care for an HIV-infected relative in their own home. On the other hand, some people who deny having negative attitudes towards PLWHA may actively discriminate against them in specific settings, such as in the provision of health care (UNAIDS, 2008).

References:

PEPFAR, 2009, The President’s Emergency Plan for AIDS Relief: Next Generation Indicators Reference Guide, Washington, DC: USAID/PEPFAR.  http://pdf.usaid.gov/pdf_docs/Pcaac330.pdf