HIV testing and antiretroviral therapy (ART) remain critical for curbing the spread of HIV/AIDS, but stigma can impede access to these services. Using data from the Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI), we used a multivariable logistic regression to examine the correlation between HIV-related stigma, HIV testing and ART uptake in older adults. We used four questions to measure stigma, with three assessing social stigma (reflecting social distancing preferences) and one assessing anticipated stigma (disclosure concern). We combined the three social stigma questions to generate a social stigma score ranging from 0 to 3, with higher scores indicating higher stigma. Anticipated stigma was prevalent 85% (95% CI 0.84–0.86), and social stigma was also frequent 25% (95% CI 0.24–0.27). Higher social stigma scores correlated with decreased HIV testing for all participants with social stigma. Compared to those with a score of 0, odds of testing decreased with higher stigma scores (OR = 0.66, 95% CI 0.53–0.81, p = 0.000) for a score of 1 and (OR = 0.56, 95% CI 0.38–0.83, p = 0.004) for a score of 3. ART uptake also decreased with higher social stigma scores among people living with HIV (PLWH), although it was significant for those with a score of 2 (OR = 0.41, 95% CI 0.19–0.87, p = 0.020). These findings emphasize that HIV-related stigma hampers testing and ART uptake among older adults in rural South Africa. Addressing stigma is crucial for improving testing rates, early diagnosis, and treatment initiation among the older population and achieving UNAIDS 95–95–95 targets.

HIV 检测和抗逆转录病毒治疗 (ART) 对于遏制 HIV/艾滋病的传播仍然至关重要，但耻辱可能会阻碍获得这些服务。利用非洲健康与老龄化：南非 INDEPTH 社区的纵向研究 (HAALSI) 的数据，我们使用多变量逻辑回归来研究老年人中与 HIV 相关的耻辱、HIV 检测和 ART 接受之间的相关性。我们使用四个问题来衡量耻辱，其中三个评估社会耻辱（反映社会疏远偏好），一个评估预期耻辱（披露问题）。我们将三个社会耻辱问题结合起来，生成一个范围从 0 到 3 的社会耻辱分数，分数越高表明耻辱程度越高。预期耻辱的发生率高达 85% (95% CI 0.84–0.86)，社会耻辱的发生率也高达 25% (95% CI 0.24–0.27)。对于所有有社会耻辱的参与者来说，较高的社会耻辱得分与艾滋病毒检测的减少相关。与得分为 0 的人相比，测试的几率随着污名得分的升高而降低（OR = 0.66，95% CI 0.53–0.81，p = 0.000），得分为 1 和（OR = 0.56，95% CI 0.38–0.83） ，p = 0.004），得分为 3。随着 HIV 感染者 (PLWH) 社会耻辱得分的升高，ART 的接受率也随之下降，尽管对于得分为 2 的人来说这一点很显着（OR = 0.41，95% CI 0.19– 0.87，p = 0.020）。这些发现强调，与艾滋病毒相关的耻辱阻碍了南非农村老年人的检测和抗逆转录病毒治疗的采用。解决耻辱问题对于提高老年人口的检测率、早期诊断和治疗启动以及实现联合国艾滋病规划署 95-95-95 目标至关重要。