Correlates of perceived HIV/AIDS-related stigma and discrimination among couples in Northern India: Gender differences and the moderating role of HIV/AIDS knowledge

Background: India ranks first in the world in the total number of people living with HIV/AIDS. A major socio-cultural factor attributed to the spread of the disease is perceived HIV/AIDS-related stigma and discrimination. However, no systematic study has examined potential correlates of perceived HIV/AIDS-related stigma and discrimination in the Indian context. Methods: The study analysis utilized crossectional, population-based data from a 2002, NIH-funded survey “Behavioral Dynamics of HIV/AIDS in Uttar Pradesh, India”. Information was collected on 3,385 married couples (i.e., 6,770 women and men). The study sample (n=4,704) was a subset of the total sample consisting of only men and women who had ever heard of HIV/AIDS. Based on four question items, the dependant variable was binary measuring whether or not respondents reported any perceived HIV/AIDS-related stigmatizing attitude. The key independent variables were gender and the interaction between gender and HIV/AIDS knowledge. Models were estimated by conditional logistic regression matching men and women that were couples. Results: Perceived HIV/AIDS-related stigma and discrimination attitudes were pervasive in the study sample. A third or more of men and women reported that they would not care for a HIV+ family member. Compared to wives, husbands had a significantly increased odds of reporting any perceived HIV/AIDS-related stigmatizing attitude (OR=1.56; 95% CI=1.04-2.45) and HIV/AIDS knowledge significantly moderated this relationship holding socio-demographic factors constant. Discussion: In order to reduce HIV/AIDS-related stigma and discrimination in India, the study demonstrates the importance of differentially targeting married men and women while concomitantly increasing HIV/AIDS knowledge in programming efforts.