Reducing HIV stigma: Effect of an HIV education program among adolescents in China

Background: HIV/AIDS related stigma has become the critical public health issue worldwide, including China, the world's most populous country which is experiencing a rapid expansion of AIDS epidemic in the recent decade. HIV/AIDS related stigma is a significant barrier to effective prevention, care and treatment of HIV and AIDS.

Methods: To explore the potential intervention effect on stigma reduction among Chinese adolescents, six high schools in Nanjing city were randomly selected. Three schools (140 students) were assigned to intervention group receiving a culturally adapted HIV risk prevention curriculum, while other three schools (164 students) were assigned to control group. Both HIV transmission knowledge and stigmatizing attitude toward people living with HIV/AIDS were measured at baseline and 6-month post-intervention with a follow-up rate of 94.4% (287/304). Stigma is measured by a question (”If I know someone who has HIV/AIDS, I will stay far away from him/her”) with a 4-point response option (“strongly disagree” to “Strongly agree”).

Results: Multivariate regression analysis results show a significantly intervention effect in increasing HIV knowledge and reducing stigma at 6-month post-intervention, controlling for key demographic factors (age, gender, average grade in the last year, living with both parents, parents' education, and family average monthly income). Mediation analysis indicated that knowledge of HIV transmission mediated the effect of intervention on stigma reduction.

Conclusion: Findings from this study suggest that it is feasible to reduce the stigmatizing attitude towards people living with HIV/AIDS by increasing the accurate HIV transmission knowledge among adolescents in China.