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Metrics details. The mean total HIV-related stigma score was Peer Review reports. HIV remains a highly stigmatized illness globally [ 1 ]. Numerous studies have shown that stigma is associated with poor adherence to antiretroviral therapy ART [ 2 ], mental health disorders such as loneliness, depression and anxiety [ 3 ], non-disclosure of HIV status, and overall poor health outcomes [ 4 , 5 ].
Because stigma continues to be a major barrier to seeking HIV testing, care, and treatment services [ 6 , 7 ], it is recognized as a priority for both primary and secondary prevention of HIV and AIDS [ 8 , 9 ]. Definitions and discussion of different forms of HIV related stigma have been described previously [ 10 ]. It is widely accepted that HIV-related stigma is influenced by socio-demographic characteristics such as age, gender, marital status, educational attainment, socioeconomic status, and area of residence.
In comparison to urban areas, rural areas are more heavily affected by the HIV epidemic due to difficulty in accessing antiretroviral therapy and logistical challenges in accessing clinical care [ 11 , 12 ]. In China, A recent study conducted in individuals from the general population found that the level of stigma towards PLWHA is higher in rural areas than in urban areas [ 16 ].
The AIDS epidemic in China first established a rural foothold through illegal, unsanitary commercial plasma donation activities in the late s and early s among unknowing, heterosexual agrarian populations who were paid for plasma donations that involved receiving contaminated pooled blood products [ 19 ].
