AIDS Education and Prevention, 29(6), 540–553, 2017 © 2017 The Guilford Press 540 Ezer Kang is affiliated with Howard University, Washington, D.C. Darcie A. P. Delzell is affiliated with the Department of Psychology, Wheaton College, Wheaton, Illinois. Christophe Mbonyingabo is affiliated with Christian Action for Reconciliation and Social Assistance (CARSA), Kigali, Rwanda. We are grateful to the respondents for their willingness to remember and entrust us with their stories. We thank the committed staff at CARSA for coordinating the translation of instruments and assisting with data management, and the interviewers who conducted the interviews with exceptional sensitivity and compassion. This research was funded by Wheaton College, Graduate Psychology Department. Address correspondence to Ezer Kang, PhD, Department of Psychology, Howard University, 2041 Geor- gia Ave., NW, Washington, DC 20059. E-mail: ezer.kang@howard.edu HIV TRANSMISSION AND ILLNESS STIGMA KANG ET AL. UNDERSTANDING HIV TRANSMISSION AND ILLNESS STIGMA: A RELATIONSHIP REVISITED IN RURAL RWANDA Ezer Kang, Darcie A. P. Delzell, and Christophe Mbonyingabo Integrating an understanding of HIV transmission with structural-behavior- al prevention approaches remains a priority in low prevalence rural regions in Africa. Many national indicators use categorical survey responses which do not capture the cultural nuances of HIV transmission knowledge that potentially reify stigmatizing treatment of persons living with HIV (PL- HIV). We examined the relationship between quantitative and qualitative measures of HIV knowledge and four forms of stigma (individual attitudes, felt normative, social distance, and stigma perceived by PLHIV) among 200 rural residents in Rwanda. Forty-two percent qualitatively reported concurrent accurate and partial knowledge of HIV transmission. Being more knowledgeable about HIV transmission was associated with less de- sire for social distancing from PLHIV. Our findings highlight the continued importance of reinforcing an accurate understanding of HIV transmission and correcting misinformation by drawing on quantitative and qualitative assessments of HIV knowledge as critical arms of HIV stigma reduction programs in low prevalence rural regions. On the cusp of renewed optimism to reduce the number persons newly infected with HIV by 2020 (United Nations Programme on HIV/AIDS [UNAIDS], 2016) a com- bination prevention paradigm that integrates behavioral, structural, and biomedical approaches has gained increased attention and outpaced efforts to primarily ad- dress knowledge about HIV prevention and treatment especially in low-income and middle-income countries (LMIC; Parker et al., 2016). This is not surprising given that knowledge about sexual transmission of HIV has improved markedly in ur- ban regions of Africa. However, many national HIV knowledge indicators assessed biomedical knowledge of HIV by using categorical response scales such as yes, no, or don’t know to survey items (e.g., “Coughing and sneezing do not spread HIV”),