Interventions to reduce HIV-related stigma among older people living with HIV in sub-Saharan Africa: a scoping review

Abstract

HIV-related stigma remains a major barrier to testing, treatment, and quality of life, especially for the growing population of older people living with HIV (OPLWH, aged 50+). Such stigma intersects with age-related and other stigmas, compounding health vulnerabilities. Research on this issue remains limited, particularly in sub-Saharan Africa (SSA). This review thus sought to explore stigma-reduction interventions for OPLWH in SSA to inform future efforts. Guided by Joanna Briggs Institute and PRISMA-ScR standards, studies published between 2004 and 2024 including OPLWH in SSA and reporting stigma-reduction interventions were reviewed. A search of seven databases produced 709 articles, with 21 manually sought manually. Eight studies were included, five of which were from Kenya. Five were qualitative, and only one quantitative study included follow-up data. Three explicitly targeted stigma, and one intersectional stigma. Various features (e.g., education) were targeted, mostly at individual or interpersonal levels. Few operated at higher levels and age reporting was inconsistent. There is an evident lack of stigma-reduction interventions for OPLWH in SSA. Future efforts should consider age-related dynamics and intersecting stigmas. Social support (formal and informal) showed particular promise, alongside economic and nutrition-based strategies. Broader, higher-level efforts addressing social and institutional drivers of stigma are also needed.