HIV/AIDS-related symbolic stigma

In the context of HIV/AIDS, symbolic stigma attitudes are based on moral judgement of people associated with HIV/AIDS. For example, in South Africa where HIV transmission is mainly through heterosexual sex, people with behaviours that are judged to be socially immoral such as promiscuity have been blamed for spreading HIV [25]. The current study assesses symbolic stigma attitudes from the general population by asking their opinion on the blameworthiness of PLWHA using the following questions: “Do you think HIV/AIDS is a punishment for sleeping around?”, “Do you think that many people who get HIV infected through sex have only themselves to blame?”. The possible responses to these questions were 1 (definitely yes), 2 (probably yes), 3 (probably no), 4 (definitely no) and 9 (Don’t know). In our analysis, the responses were reversed such that they are in increasing order of stigmatizing attitudes and the “don’t know” responses were treated as missing. HIV/AIDS-related symbolic stigma is treated as a latent variable as it is not directly measured but it is modelled as a two-item factor analysis in the model described in sections to follow.