Stigma Reduction Framework for Improving Community Uptake of Infectious Disease and HIV Diagnostic Services

Stigma continues to pose a significant barrier to the utilization of infectious disease and HIV diagnostic services, particularly in low- and middle-income communities. Social, cultural, and structural stigmas can discourage individuals from seeking testing, impede disclosure of risk behaviors, and reduce adherence to follow-up care, ultimately undermining public health efforts to control disease transmission. Developing effective interventions to mitigate stigma is therefore critical to improving community engagement with diagnostic services and achieving equitable health outcomes. This abstract presents a conceptual framework for stigma reduction aimed at enhancing uptake of infectious disease and HIV testing at the community level. The framework integrates multi-level strategies that address individual, interpersonal, and societal dimensions of stigma. At the individual level, interventions focus on increasing health literacy, correcting misconceptions about disease transmission, and fostering positive attitudes toward testing through targeted educational campaigns. At the interpersonal level, the framework emphasizes peer-led support groups, community champions, and social network engagement to normalize health-seeking behaviors and reduce fear of discrimination. Structural and societal components include policy advocacy, health system sensitization, confidentiality safeguards, and integration of anti-stigma messaging into public health programs. By addressing stigma holistically across these levels, the framework seeks to create enabling environments that encourage voluntary testing, timely diagnosis, and linkage to care. Additionally, the framework incorporates continuous monitoring and evaluation to assess intervention effectiveness and inform iterative improvements. Metrics include changes in knowledge, attitudes, and behaviors related to stigma, as well as measurable increases in testing uptake and follow-up adherence. The use of community-based participatory approaches ensures that interventions are culturally sensitive, contextually relevant, and co-designed with local stakeholders, enhancing acceptability and sustainability. The proposed stigma reduction framework provides a structured, evidence-informed approach to overcoming barriers to infectious disease and HIV diagnostic service utilization. By combining educational, social, and structural interventions with robust evaluation and community engagement, the framework aims to improve early detection, promote health equity, and strengthen overall public health outcomes.