ArticleBMC public health2023
Experiences of stigma and HIV care engagement in the context of Treat All in Rwanda: a qualitative study.
Article in BMC public health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.
- Impact of HIV-Related Stigma on Antiretroviral Therapy Adherence, Engagement and Retention in HIV Care, and Transition to Adult HIV Care in Pediatric and Young Adult Populations Living With HIV: A Literature Review.AIDS and behavior · 2025Pooled it
- Beyond knowledge deficits: social visibility, family dynamics, and delayed initiation among people living with HIV in Southwestern China-a descriptive phenomenological study.BMC public health · 2026Article
- Stigma, discrimination and associated determinants among people living with HIV/AIDS accessing Anti-Retroviral Therapy in Ikeja, Lagos state, Nigeria.Scientific reports · 2026Article
- Predictors of sustained human immunodeficiency virus viral-load suppression before and after the adoption of Treat All policy in Rwanda.World journal of virology · 2025Article
- Sustained maternal human immunodeficiency virus viral load suppression and cascade of human immunodeficiency virus testing among exposed infants in Rwanda.World journal of virology · 2025Article
- Article
- Health Workers' Responses to COVID-19 Pandemic's Impact on Service Delivery to Adolescents in HIV Treatment in Cape Town, South Africa: A Qualitative Study.Healthcare (Basel, Switzerland) · 2024Article
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Authors and funding
10 authors at 3 institutions in 2 countries.
Funding
Abstract
background'Treat All' policies recommending immediate antiretroviral therapy (ART) soon after HIV diagnosis for all people living with HIV (PLHIV) are now ubiquitous in sub-Saharan Africa. While early ART initiation and retention is effective at curtailing disease progression and transmission, evidence suggests that stigma may act as a barrier to engagement in care. This study sought to understand the relationships between HIV stigma and engagement in care for PLHIV in Rwanda in the context of Treat All.
methodsBetween September 2018 and March 2019, we conducted semi-structured, qualitative interviews with adult PLHIV receiving care at two health centers in Kigali, Rwanda. We used a grounded theory approach to data analysis to develop conceptual framework describing how stigma influences HIV care engagement in the context of early Treat All policy implementation in Rwanda.
resultsAmong 37 participants, 27 (73%) were women and the median age was 31 years. Participants described how care engagement under Treat All, including taking medications and attending appointments, increased their visibility as PLHIV. This served to normalize HIV and use of ART but also led to high levels of anticipated stigma in the health center and community at early stages of treatment. Enacted stigma from family and community members and resultant internalized stigma acted as additional barriers to care engagement. Nonetheless, participants described how psychosocial support from care providers and family members helped them cope with stigma and promoted continued engagement in care.
conclusionsTreat All policy in Rwanda has heightened the visibility of HIV at the individual and social levels, which has influenced HIV stigma, normalization, psychosocial support and care engagement in complex ways. Leveraging the individual and community support described by PLHIV to deliver evidence-based, peer or provider-delivered stigma reduction interventions may aid in attaining Treat All goals.
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