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The association between self-reported stigma and loss-to-follow-up in treatment eligible HIV positive adults in rural KwaZulu-Natal, South Africa

30 October 2013
12:30 - 13:30

Presenter: Dr. Michael Evangeli, Royal Holloway University of London
Date: 30 October 2013
Time: 12:15 for 12:30-13:30
Loss-to-follow-up (LTFU) (non-attendance at scheduled clinic visits) in HIV programmes in sub-Saharan Africa (SSA) is important among those eligible for ART, given the risk of mortality and morbidity, onward transmission and ART resistance with inconsistent medication use. A number of clinical, demographic and structural factors have been shown to relate to higher rates of LTFU in individuals on ART (or those eligible to start ART) in SSA.
Psychosocial predictors of LTFU have been assessed less frequently, perhaps due to the relative difficulty of obtaining relevant information. One psychosocial factor that may be associated with LTFU is stigma. The relationship between self-reported stigma and LTFU has not been examined quantitatively in those eligible to start ART. This study examined the relationship between self-reported stigma and LTFU in a prospective cohort study within an HIV treatment and care programme in an area of high HIV prevalence and widespread ART availability in KwaZulu-Natal, South Africa. We assessed individuals’ self-reported stigma after they had been assessed and informed of their eligibilty for ART, followed them up for a maximum of four years, and explored the associations between this factor, a range of additional psychosocial, demographic and medical factors and LTFU. 
Dr Michael Evangeli is a Clinical Psychologist and Senior Lecturer at Royal Holloway University of London. He qualified as a Clinical Psychologist in 1997 and completed a Masters in Public Health in Developing Countries at the London School of Hygiene and Tropical Medicine in 2010. In the UK,  Dr Evangeli has worked clinically with HIV positive clients, undertaken a range of HIV research (particularly with young people with perinatally acquired HIV) and has been involved in Motivational Interviewing training initiatives within HIV services (as both a trainer and a consultant). In South Africa, Dr Evangeli worked at Stellenbosch University in 2006-2007 as a visiting psychologist on behavioural aspects of HIV vaccine participation. He also carried out and evaluated a Motivational Interviewing training initiative to lay HIV counsellors in the Western Cape.  His recent work has been on loss-to-follow up in an HIV treatment and care programme in KwaZulu-Natal.

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This seminar may be attended via video conference in Pretoria, Cape Town and KwaZulu-Natal. Details as below.  

Cape Town : HSRC, 12th Floor, Plein Park Building (Opposite Revenue Office), Plein Street, Cape Town. Contact Jean Witten, Tel (021) 4668004, Fax (021) 461 0299, or

Durban :  First floor HSRC board room, 750 Francois Road, Ntuthuko Junction, Pods 5 and 6, Cato Manor, Contact Ridhwaan Khan, Tel (031) 242 5400, cell: 083 788 2786 or

Pretoria : HSRC Video Conference, 1st floor HSRC Library Human Sciences Research Council, 134 Pretorius Street, Pretoria. Arlene Grossberg, Tel: (012) 302 2811, e-mail: