Perceived stigma among patients receiving antiretroviral treatment: a prospective randomised trial comparing an m-DOT strategy with standard-of-care in Kenya

SAHARA J. 2010 Aug;7(2):62-70. doi: 10.1080/17290376.2010.9724958.


HIV and AIDS remain highly stigmatised. Modified directly observed therapy (m-DOT) supports antiretroviral treatment (ART) adherence but little is known about its association with perceived stigma in resource-constrained settings. In 2003, 234 HIV-infected adults enrolled in a two-arm randomised trial comparing a health centre-based m-DOT strategy with standard self-administration of ART. Data on perceived stigma were collected using Berger's HIV stigma scale prior to starting ART and after 12 months. This was a secondary analysis to examine whether perceived stigma was related to treatment delivery. Perceived stigma scores declined after 12 months of treatment from a mean of 44.9 (sd=7.6) to a mean of 41.4 (sd=7.7), (t=6.14, P<0.001). No differences were found between the mean scores of participants in both study arms. Also, no difference in scores was detected using GLM, controlling for socio-demographic characteristics and baseline scores. Findings indicate that a well managed clinic-based m-DOT does not increase perceived HIV-related stigma.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Acquired Immunodeficiency Syndrome / drug therapy
  • Adolescent
  • Adult
  • Ambulatory Care Facilities
  • Anti-HIV Agents / administration & dosage
  • Anti-HIV Agents / therapeutic use*
  • Directly Observed Therapy* / methods
  • Female
  • HIV / isolation & purification
  • HIV Infections / diagnosis
  • HIV Infections / drug therapy*
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Kenya
  • Male
  • Medication Adherence
  • Outpatient Clinics, Hospital
  • Perception
  • Prospective Studies
  • Self Administration / methods
  • Stereotyping*
  • Surveys and Questionnaires


  • Anti-HIV Agents