Table 2 Practical recommendations that emerged from the present study

Community-level stigma reduction approaches

 Conduct multi-component community-level interventions in HRA to reduce stigma

Changes needed to organizations and systems IR-HRA encounter

 Provide high-quality HIV education in schools and other settings IR-HRA may encounter

 Design the physical layout, and look and feel, of health care settings to minimize stigma

Locating the population for HIV testing

Conduct peer-to-peer active outreach approaches in HRA to engage IR-HRA in testing

Aspects of the HIV testing experience

 Provide reassurance that confidentiality will be protected

 Provide compensation for HIV testing

 Provide HIV counseling/testing approaches tailored to heterosexuals at high-risk for HIV

 As part of testing, highlight the provision of linkages to HIV care, and the availability of support during the process of adapting to a new diagnosis

Specific health messages to combat stigma and motivate testing

 Highlight the community-enhancing nature of HIV testing, to harness altruism

 Provide health education on HIV, its psychosocial consequences, and treatments

 Provide exposure to culturally similar peers living with HIV who are thriving

 Incorporate messages into HIV counseling that fill gaps in knowledge and address fears, including:

  HIV testing is free, voluntary, and confidential

  HIV is not a death sentence

  HIV medications are available, effective, and highly tolerable

  One can live a long and healthy life with HIV

  HIV does not mean the end of sexual and romantic relationships