Understanding stigma among HIV care providers, both government health care workers and community lay workers, is essential for ensuring effective delivery of care and improving the fight against HIV. The Role of HIV-related stigma in the Delivery of Universal test and Treatment for HIV Prevention or the HPTN 071/a or Stigma Ancillary Study, is a 3-year (2014-2017) sub-study to the HPTN 071/PopART trial that will examine how healthcare worker experiences of HIV stigma, attitudes to key population groups and levels of burn-out and stress, influence the delivery of HIV services and the uptake of the PopART study intervention. The data will be combined with other qualitative and social epidemiological data collected in PopART from the community and People Living with HIV to understand the role of HIV stigma experiences in HIV services in the context of Universal test and Treatment (UTT).

The main component of the study is a self-administered survey using a structured questionnaire and Personal Digital Assistants (PDAs). All government health facility staff, all CHiPs staff and other lay community health volunteers working through the key health facilities in the PopART study community sites are being approached.  In total, the aim is have at least 700 research participants across the 12 community sites are being approached. In total, the aim is to have at least 700 research participants across the 12 PopART community sites (in Zambia) who take part who take part in three rounds of the survey between 2014 and 2017.  Qualitative research will include documentation and observations of stigma reduction efforts, in-depth interviews with a small number of health facility staff and CHiPs and exploratory research with key and marginal population groups.

The survey has just started in one PopART site. Despite their busy schedules, health care workers and community lay workers have made time for responding to the questionnaire. Although some find the questionnaire long, many participants enjoy mastering the PDA and others have said the questions made them reflect on stigma.

The potential benefits of this study are that information provided could help researchers improve the understanding of how HIV testing is influenced by the working conditions of health care workers and their experiences of HIV-related stigma and marginalised groups. It could also help improve programmes and future research.

The stigma ancillary study is funded by the National Institutes of Mental health (NIMH) in the United States and is being carried out in Zambia and South Africa.