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Background <p>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.</p> Methods <p>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&#xa0;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.</p> Results <p>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.</p> Conclusions <p>Public stigma toward PLHIV remains pervasive globally, affecting nearly seven in ten people and far exceeding the UNAIDS target of &lt; 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.</p> Registration <p>PROSPERO, CRD420251055912.</p>

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Prevalence and associated factors of public stigma toward people living with HIV: a systematic review and meta-analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月29日

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  • Zhihua Ye,
  • Jin Peng,
  • Jiang Yuan,
  • Fengjun Li,
  • Yuan Li,
  • Yi Yang

摘要

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.