Prevalence and associated factors of public stigma toward people living with HIV: a systematic review and meta-analysis.
4 affiliations
- 1School of Management, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
- 2School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
- 3School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, China. [email protected].
- 4School of Management, Chengdu University of Traditional Chinese Medicine, Chengdu, China. [email protected].
Abstract
Background
HIV-related public stigma remains a critical barrier to ending the AIDS epidemic, yet its global prevalence remains poorly quantified. Existing evidence is fragmented, with no comprehensive synthesis of temporal trends, regional patterns, or population subgroups. This systematic review and meta-analysis aimed to estimate the global prevalence of public stigma toward people living with HIV (PLHIV) in the general population and to identify factors associated with such stigma.Methods
We searched PubMed, Embase, Web of Science, and the DHS Program website, among others, from inception to June 30, 2025. We included observational studies reporting the prevalence of public stigma toward PLHIV in general populations aged 15 years or older. Two reviewers independently screened records, extracted data, and assessed study quality. The overall and subgroup prevalence estimates were pooled using a three-level mixed-effects meta-analytic model. For associated factors reported as adjusted odds ratios (AOR), we applied random- or fixed-effect models based on heterogeneity.Results
We included 59 studies comprising 171 data points and 2438150 participants. The overall pooled prevalence of public stigma was 69.09% (95% CI 60.81-76.30). In subgroup analyses, prevalence declined over time, from 71.82% (1991-2010) to 49.15% (2020-2024), and varied substantially by region, ranging from 46.04% in Eastern and Southern Africa to 92.06% in the Middle East and North Africa. Prevalence was highest in lower‑middle‑income countries (75.98%) and lowest in high‑income countries (54.68%). In analyses of factors associated with stigma, higher education (AOR 0.43, 95% CI 0.25-0.73), greater wealth (AOR 0.47, 95% CI 0.32-0.69), HIV knowledge (AOR 0.55, 95% CI 0.36-0.86), HIV testing history (AOR 0.91, 95% CI 0.85-0.98), and personal proximity to PLHIV (AOR 0.68, 95% CI 0.55-0.85) were each associated with lower odds of stigma.Conclusions
Public stigma toward PLHIV remains pervasive globally, affecting nearly seven in ten people and far exceeding the UNAIDS target of < 10%. Although modest declines in recent years offer cautious optimism, current progress is inadequate. Stigma reflects structural inequities and sociocultural norms, underscoring the need for sustained multilevel strategies beyond information campaigns. Without intensified efforts, the 2030 goal of ending AIDS will remain out of reach.Registration
PROSPERO, CRD420251055912.
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BibTeX
@article{ye2026prevalence,
title = {{Prevalence and associated factors of public stigma toward people living with HIV: a systematic review and meta-analysis.}},
author = {Zhihua Ye and Jin Peng and Jiang Yuan and Fengjun Li and Yuan Li and Yi Yang},
journal = {BMC public health},
year = {2026},
month = jul,
doi = {10.1186/s12889-026-28723-0},
url = {https://europepmc.org/article/MED/42928180},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Prevalence and associated factors of public stigma toward people living with HIV: a systematic review and meta-analysis.
AU - Zhihua Ye
AU - Jin Peng
AU - Jiang Yuan
AU - Fengjun Li
AU - Yuan Li
AU - Yi Yang
PY - 2026
DA - 2026/07/29
JO - BMC public health
DO - 10.1186/s12889-026-28723-0
UR - https://europepmc.org/article/MED/42928180
AB - Background HIV-related public stigma remains a critical barrier to ending the AIDS epidemic, yet its global prevalence remains poorly quantified. Existing evidence is fragmented, with no comprehensive synthesis of temporal trends, regional patterns, or population subgroups. This systematic review and meta-analysis aimed to estimate the global prevalence of public stigma toward people living with HIV (PLHIV) in the general population and to identify factors associated with such stigma.Methods We searched PubMed, Embase, Web of Science, and the DHS Program website, among others, from inception to June 30, 2025. We included observational studies reporting the prevalence of public stigma toward PLHIV in general populations aged 15 years or older. Two reviewers independently screened records, extracted data, and assessed study quality. The overall and subgroup prevalence estimates were pooled using a three-level mixed-effects meta-analytic model. For associated factors reported as adjusted odds ratios (AOR), we applied random- or fixed-effect models based on heterogeneity.Results We included 59 studies comprising 171 data points and 2438150 participants. The overall pooled prevalence of public stigma was 69.09% (95% CI 60.81-76.30). In subgroup analyses, prevalence declined over time, from 71.82% (1991-2010) to 49.15% (2020-2024), and varied substantially by region, ranging from 46.04% in Eastern and Southern Africa to 92.06% in the Middle East and North Africa. Prevalence was highest in lower‑middle‑income countries (75.98%) and lowest in high‑income countries (54.68%). In analyses of factors associated with stigma, higher education (AOR 0.43, 95% CI 0.25-0.73), greater wealth (AOR 0.47, 95% CI 0.32-0.69), HIV knowledge (AOR 0.55, 95% CI 0.36-0.86), HIV testing history (AOR 0.91, 95% CI 0.85-0.98), and personal proximity to PLHIV (AOR 0.68, 95% CI 0.55-0.85) were each associated with lower odds of stigma.Conclusions Public stigma toward PLHIV remains pervasive globally, affecting nearly seven in ten people and far exceeding the UNAIDS target of < 10%. Although modest declines in recent years offer cautious optimism, current progress is inadequate. Stigma reflects structural inequities and sociocultural norms, underscoring the need for sustained multilevel strategies beyond information campaigns. Without intensified efforts, the 2030 goal of ending AIDS will remain out of reach.Registration PROSPERO, CRD420251055912.
SN - 1471-2458
ER -