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Sample records for aids related stigma

  1. Dentistry and HIV/AIDS related stigma

    PubMed Central

    Elizondo, Jesus Eduardo; Treviño, Ana Cecilia; Violant, Deborah

    2015-01-01

    OBJECTIVE To analyze HIV/AIDS positive individual’s perception and attitudes regarding dental services. METHODS One hundred and thirty-four subjects (30.0% of women and 70.0% of men) from Nuevo León, Mexico, took part in the study (2014). They filled out structured, analytical, self-administered, anonymous questionnaires. Besides the sociodemographic variables, the perception regarding public and private dental services and related professionals was evaluated, as well as the perceived stigma associated with HIV/AIDS, through a Likert-type scale. The statistical evaluation included a factorial and a non-hierarchical cluster analysis. RESULTS Social inequalities were found regarding the search for public and private dental professionals and services. Most subjects reported omitting their HIV serodiagnosis and agreed that dentists must be trained and qualified to treat patients with HIV/AIDS. The factorial analysis revealed two elements: experiences of stigma and discrimination in dental appointments and feelings of concern regarding the attitudes of professionals or their teams concerning patients’ HIV serodiagnosis. The cluster analysis identified three groups: users who have not experienced stigma or discrimination (85.0%); the ones who have not had those experiences, but feel somewhat concerned (12.7%); and the ones who underwent stigma and discrimination and feel concerned (2.3%). CONCLUSIONS We observed a low percentage of stigma and discrimination in dental appointments; however, most HIV/AIDS patients do not reveal their serodiagnosis to dentists out of fear of being rejected. Such fact implies a workplace hazard to dental professionals, but especially to the very own health of HIV/AIDS patients, as dentists will not be able to provide them a proper clinical and pharmaceutical treatment. PMID:26538100

  2. HIV/AIDS-related stigma in Kumasi, Ghana

    PubMed Central

    Ulasi, Chijioke I; Preko, Peter O; Baidoo, Joseph A.; Bayard, Budry; Ehiri, John E; Jolly, Curtis M; Jolly, Pauline E

    2009-01-01

    Objective To assess HIV/AIDS-related stigma and discrimination of people living with HIV/AIDS (PLWHA) in Kumasi, Ghana. Methods A cross-sectional survey of 104 adults from the four sub-districts in Kumasi was conducted. Results Four stigma constructs, employment-based discrimination, screening and identification of HIV positive people, revelation of HIV status and social contact stigma were determined based on reliability measures from responses to the questionnaire. Regression analysis showed that participants with higher educational attainment were more likely to favor policies denying employment to PLWHA (p<0.05), but disapproved of revealing HIV sero-status (p<0.05). Muslims were more likely than Christians to agree with identifying PLWHA (p<0.05) and more likely to advocate revealing HIV sero-status (p<0.05). Males were more likely to favor revealing HIV status (p<0.05). Employed persons were more likely to have social contact with PLWHA (p<0.05). Conclusions These findings are useful in guiding the design of interventions against HIV/AIDS-related stigma in Kumasi. PMID:18632302

  3. AIDS-Related Stigma and Health Professionals in Puerto Rico

    PubMed Central

    Ruiz-Torres, Yamilette; Cintrón-Bou, Francheska N.; Varas-Díaz, Nelson

    2009-01-01

    This study addresses an important issue in the AIDS epidemic in Puerto Rico: AIDS stigma among health professionals and health profession students. AIDS stigma has been documented among health services providers such as doctors, nurses, psychologists, and social workers. It has detrimental effects of the services provided and the lives of people living with HIV/AIDS (PLWHA). The main objective of this study was to explore AIDS stigma manifestations among a sample composed of eighty health professionals and health profession students who participated in in-depth qualitative interviews. Four thematic categories stemmed from the data analysis process. These addressed the following subjects: social manifestations of stigma, stigma manifestations in the workplace, use of sensitive information to control PLWHA, and surveillance of PLWHA. Participants manifested instances of stigmatization they had witnessed in their work and training scenarios. Furthermore, they elaborated on the need to place effective surveillance mechanism on PLWHA in order to control the epidemic. PMID:21423837

  4. Measuring HIV/AIDS-Related Stigma across South Africa: A Versatile and Multidimensional Scale

    ERIC Educational Resources Information Center

    Smith, Edward A.; Miller, Jacqueline A.; Newsome, Valerie; Sofolahan, Yewande A.; Airhihenbuwa, Collins O.

    2014-01-01

    Reducing HIV/AIDS-related stigma is critical in the fight against HIV/AIDS. Although national campaigns and prevention programs have been implemented across South Africa to address this critical concern, assessing the impact of these initiatives is difficult as it requires that measurement of HIV/AIDS-related stigma is uniform and comparable…

  5. Understanding and Addressing AIDS-Related Stigma: From Anthropological Theory to Clinical Practice in Haiti

    PubMed Central

    Castro, Arachu; Farmer, Paul

    2005-01-01

    For the past several years, diverse and often confused concepts of stigma have been invoked in discussions on AIDS. Many have argued compellingly that AIDS-related stigma acts as a barrier to voluntary counseling and testing. Less compelling are observations regarding the source of stigma or its role in decreasing interest in HIV care. We reviewed these claims as well as literature from anthropology, sociology, and public health. Preliminary data from research in rural Haiti suggest that the introduction of quality HIV care can lead to a rapid reduction in stigma, with resulting increased uptake of testing. Rather than stigma, logistic and economic barriers determine who will access such services. Implications for scale-up of integrated AIDS prevention and care are explored. PMID:15623859

  6. A systematic review of HIV/AIDS-related stigma and discrimination in India: current understanding and future needs.

    PubMed

    Bharat, Shalini

    2011-01-01

    HIV/AIDS-related stigma is recognised as a major barrier to HIV prevention efforts and an impediment to mitigating its impact on individuals and communities. This paper reviews the existing research literature on AIDS stigma in India with the objective of documenting the current status of research, highlighting major findings and identifying key gaps remaining. Thirty publications were identified through a careful search of which a majority focused on stigma assessment and very few on stigma measurement, conceptual aspects of stigma or stigma reduction interventions. A few standardised stigma measures are available but more are required to assess causes of stigma among general population and compounded and internalised stigma among positive people. Research exploring linkages between stigma and HIV services uptake or the effect of HIV care and treatment programs on stigma levels are largely missing and need to be prioritised. In addition, more research is needed to advance conceptual understanding of stigma within the cultural context of the country including research on the neglected groups such as, transgender people. Context-specific (health care, community) interventions are needed to address various forms of stigma - enacted, perceived, internalised and layered - including structural approaches besides inter-personal and information-based approaches. A major gap relates to meager research on developing and evaluating stigma reduction interventions and needs priority focus. Overall, the review recommends developing a national agenda on AIDS stigma research and interventions to help realise the government's goal of stigma reduction. PMID:23237728

  7. HIV/AIDS Related Stigma and Discrimination against PLWHA in Nigerian Population

    PubMed Central

    Bulgiba, Awang; Oche, Oche Mansur; Adekunjo, Felix Oluyemi

    2015-01-01

    Background HIV/AIDS remain a major public health concern in Nigeria. People living with HIV/AIDS (PLWHA) face not only personal medical problems but also social problems associated with the disease such as stigma and discriminatory attitudes. This study provides an insight into HIV/AIDS related stigma and discrimination against PLWHA in Nigeria. Methods The data for this study was extracted from the 2013 Nigeria Demographic and Health Survey conducted by the National Population Commission. All men and women aged 15–49 years, permanent residents and visitors of the households were eligible for the interview. Several questionnaires were used in the survey, some covering questions on HIV/AIDS. Results A total of 56 307 men and women aged 15–49 years participated in this national survey. About half of the population in Nigeria have HIV stigma. Younger persons, men, those without formal education and those within poor wealth index are more likely to have stigma towards PLWHA. In addition, married people are more likely to have stigma on PLWHA and are more likely to blame PLWHA for bringing the disease to the community. Also about half of the population discriminates against PLWHA. However, those with higher levels of education and those from higher wealth index seem to be more compassionate towards PLWHA. About 70% in the population are willing to care for relative with AIDS, even more so among those with higher level of education. Conclusion There is a high level of HIV stigma and discrimination against PLWHA in the Nigerian population. Education seems to play a major role in the society with respect to HIV stigma and discrimination against PLWHA. Educating the population with factual information on HIV/AIDS is needed to reduce stigma and discrimination towards PLWHA in the community. PMID:26658767

  8. HIV and AIDS-related stigma and discrimination: a conceptual framework and implications for action.

    PubMed

    Parker, Richard; Aggleton, Peter

    2003-07-01

    Internationally, there has been a recent resurgence of interest in HIV and AIDS-related stigma and discrimination, triggered at least in part by growing recognition that negative social responses to the epidemic remain pervasive even in seriously affected communities. Yet, rarely are existing notions of stigma and discrimination interrogated for their conceptual adequacy and their usefulness in leading to the design of effective programmes and interventions. Taking as its starting point, the classic formulation of stigma as a 'significantly discrediting' attribute, but moving beyond this to conceptualize stigma and stigmatization as intimately linked to the reproduction of social difference, this paper offers a new framework by which to understand HIV and AIDS-related stigma and its effects. It so doing, it highlights the manner in which stigma feeds upon, strengthens and reproduces existing inequalities of class, race, gender and sexuality. It highlights the limitations of individualistic modes of stigma alleviation and calls instead for new programmatic approaches in which the resistance of stigmatized individuals and communities is utilized as a resource for social change. PMID:12753813

  9. Understanding Internalized HIV/AIDS-Related Stigmas in the Dominican Republic: A Short Report

    PubMed Central

    Hampanda, Karen

    2016-01-01

    HIV/AIDS-related stigmas can become internalized, resulting in declines in physical and mental health. Pathways to internalized HIV-related stigma (IS), characterized by persistently negative, self-abasing thoughts, are not well established among women living with HIV/AIDS (WLWHA) in the Dominican Republic (DR). Identifying factors involved in self-directed shaming and blaming is important, given the high HIV prevalence in the DR’s most vulnerable populations. The present study sheds light on factors involved in negative and self-abasing thoughts in WLWHA in the DR by examining the relationship between depression, perceived HIV-related stigma from the community (PSC), perceived HIV-related stigma from family (PSF) and IS. The Internalized AIDS-Related Stigma Scale (IA-RSS), the Center for Epidemiologic Studies Short Depression Scale (CES-D 10), and an instrument designed to measure perceived HIV-related stigma from the community and family was administered to 233 WLWHA in Puerto Plata, DR. Data were analyzed using descriptive statistics and ordered multiple logistic regression. Results showed that depression (OR=1.60; p<0.05), PSC (OR=3.68; p<0.001), and PSF (OR=1.60; p<0.01) were positively associated with IS. These findings indicate that IS-reducing interventions should address HIV-related depression. Additionally, HIV-related treatment and care services should work with WLWHA to adopt healthier attitudes about how community members view people living with HIV/AIDS in the Dominican Republic. PMID:26466239

  10. Understanding internalized HIV/AIDS-related stigmas in the Dominican Republic: a short report.

    PubMed

    Rael, Christine Tagliaferri; Hampanda, Karen

    2016-03-01

    HIV/AIDS-related stigmas can become internalized, resulting in declines in physical and mental health. Pathways to internalized HIV-related stigma (IS), characterized by persistently negative, self-abasing thoughts, are not well established among women living with HIV/AIDS (WLWHA) in the Dominican Republic (DR). Identifying factors involved in self-directed shaming and blaming is important, given the high HIV prevalence in the DR's most vulnerable populations. The present study sheds light on factors involved in negative and self-abasing thoughts in WLWHA in the DR by examining the relationship between depression, perceived HIV-related stigma from the community (PSC), perceived HIV-related stigma from family (PSF), and IS. The Internalized AIDS-Related Stigma Scale (IA-RSS), the Center for Epidemiologic Studies Short Depression Scale (CES-D 10), and an instrument designed to measure perceived HIV-related stigma from the community and family was administered to 233 WLWHA in Puerto Plata, DR. Data were analyzed using descriptive statistics and ordered multiple logistic regression. Results showed that depression (OR = 1.60; p < .05), PSC (OR = 3.68; p < .001), and PSF (OR = 1.60; p < .01) were positively associated with IS. These findings indicate that IS-reducing interventions should address HIV-related depression. Additionally, HIV-related treatment and care services should work with WLWHA to adopt healthier attitudes about how community members view people living with HIV/AIDS in the DR. PMID:26466239

  11. The political context of AIDS-related stigma and knowledge in a South African township community.

    PubMed

    Forsyth, Brian; Vandormael, Alain; Kershaw, Trace; Grobbelaar, Janis

    2008-07-01

    The purpose of this study was to examine the presentation of AIDS-related stigma and knowledge within the political context of the South African government's response to the AIDS epidemic. It was during the 2000 - 2004 period that key government officials publicly challenged the orthodox views of HIV/AIDS, with the South African president, Thabo Mbeki, actively positing the primary role of poverty and other socio-economic stressors in the progression of the AIDS epidemic. This discursive position had real-time effects for AIDS policy-making and ultimately delayed the implementation of a national antiretroviral (ARV) rollout programme. Consequently this position was criticised by commentators in the media and elsewhere for contributing to an already widespread climate of AIDS stigmatization and misinformation. To shed more light on these claims we conducted a survey in 2005 in Atteridgeville, a South African township, and compared results with those of a similar survey conducted shortly after ARV medications became available in 2004. Results indicated a reduction in AIDS stigma levels across the 1-year period, and that those participants who endorsed contentious political views (such as those expressed by key government officials) were more likely to have a higher level of AIDS-related stigma than those who disagreed. Nevertheless, this study cautions against drawing a causal relationship between the South African government's position and IDS-stigmatizing attitudes, and suggests that further political and social factors be accounted for in an attempt to gain a fuller understanding of this seemingly complex relationship. PMID:18709210

  12. Reducing AIDS-related stigma in developing countries: the importance of theory- and evidence-based interventions.

    PubMed

    Bos, Arjan E R; Schaalma, Herman P; Pryor, John B

    2008-08-01

    In many developing countries persons living with HIV and AIDS experience strong stigma and discrimination, and AIDS-related stigma has an enormous negative impact on their social relationships, access to resources, and psychological well being. Moreover, AIDS-related stigma hampers HIV-related health promotion, including voluntary HIV counselling and testing. In this article, we will argue that programs to reduce AIDS-related stigma are most likely to be effective if these programs are based upon thorough needs assessments, theory- and evidence-based intervention strategies and collaborative planning. A protocol for health promotion programs design is outlined. Furthermore, psychosocial correlates of AIDS-related stigma in developing countries, social-psychological theories that might be useful in designing intervention strategies to reduce stigmatisation and successful elements of previous interventions aimed at stigma reduction are discussed. It is concluded that psychological theory does provide guidelines for the development of stigma-reducing intervention programs, but that such programs can only be effective when based upon context-specific needs assessment and collaborative planning. PMID:18825583

  13. AIDS Related Stigma in Social Relations: A Qualitative Study in Turkey

    ERIC Educational Resources Information Center

    Kasapoglu, Aytul; Saillard, Elif Kus; Kaya, Nilay; Turan, Feryal

    2011-01-01

    The actual number of HIV/AIDS cases in Turkey is higher than the number of cases reported, and People Living with HIV (PLWHIV) may refrain from acknowledging their sickness or seeking help because of the stigma associated with HIV and fear of discrimination from their close friends, workmates, and even their families. In this paper we aim to…

  14. Economic empowerment and AIDS-related stigma in rural Kenya: a double-edged sword?

    PubMed

    Gnauck, Katherine; Ruiz, Jamie; Kellett, Nicole; Sussman, Andrew; Sullivan, Mary Ann; Montoya, Maria; Levin, Nick; Tomedi, Angelo; Mwanthi, Mutuku A

    2013-01-01

    Economic empowerment, HIV risk and AIDS-related stigma appear intricately intertwined for women in Kenya. Their interaction must be understood in order to implement effective economic interventions that also decrease HIV risk and stigma. We conducted a qualitative study amongst women in a rural Kamba-speaking community of southeastern Kenya to pursue whether engagement in an economic empowerment initiative (a basket weaving cooperative) influences women's perspectives and experiences with HIV risk and AIDS-related stigma. We conducted seven women's focus groups: participants in the local basket-weaving cooperative comprised four focus groups and non-participants comprised the remaining three groups. The HIV status of the women was not known. Three dominant themes emerged from the focus groups: empowerment, pervasive vulnerability and unanticipated social paradoxes. Contradictions found in these themes suggest that economic empowerment can become a double-edged sword. Economic empowerment enhanced perceived individual, domestic and social community status. However, this enhancement was not protective of domestic violence and perceived HIV risk. Social perceptions may have paradoxically contributed barriers to HIV testing and treatment putting women at greater HIV risk. In conclusion, economic empowerment initiatives for women in developing countries in the context of the HIV epidemic should be coupled with peer mediated support and HIV-risk education. PMID:23668536

  15. "She Told Them, Oh That Bitch Got AIDS": Experiences of Multilevel HIV/AIDS-Related Stigma Among African American Women Living with HIV/AIDS in the South.

    PubMed

    Fletcher, Faith; Ingram, Lucy Annang; Kerr, Jelani; Buchberg, Meredith; Bogdan-Lovis, Libby; Philpott-Jones, Sean

    2016-07-01

    African American women bear a disproportionate burden of HIV/AIDS in the United States. Although they constitute only 13% of the US population, African Americans account for nearly 65% of all new HIV infections among American women. In addition, this population suffers comparatively greater adverse health outcomes related to HIV status. African American women living with HIV in the South may be further burdened by HIV/AIDS stigma, which is comparatively more pronounced in this region. To further explore this burden, we used narrative data and the Social Ecological Model to explore how African American women living with HIV in the US South recount, conceptualize, and cope with HIV/AIDS stigma at interpersonal, community, and institutional levels. Our narrative analysis suggests that HIV-positive African American women living in the South are vulnerable to experiences of multilevel HIV stigma in various settings and contexts across multiple domains of life. Stigma subsequently complicated disclosure decisions and made it difficult for women to feel supported in particular social, professional and medical settings that are generally regarded as safe spaces for noninfected individuals. Findings suggest that the debilitating and compounded effect of multilevel HIV/AIDS stigma on HIV-positive African American women in the South warrants closer examination to tailor approaches that effectively address the unique needs of this population. PMID:27410498

  16. Creating social spaces to tackle AIDS-related stigma: reviewing the role of church groups in Sub-Saharan Africa.

    PubMed

    Campbell, C; Skovdal, M; Gibbs, A

    2011-08-01

    An expanding body of literature explores the role of African church groups in facilitating or hindering the support of people living with AIDS and challenging or contributing to HIV/AIDS-related stigma. Treating church groups as social spaces in which HIV/AIDS-related stigma may potentially be challenged, we systematically review this literature, identifying five themes that highlight the complex and contradictory role of the church as a potential agent of health-enhancing social change. In many ways the church perpetuates HIV/AIDS-related stigma through (i) moralistic attitudes and (ii) its reinforcement of conservative gender ideologies. However some churches have managed move towards action that makes a more positive contribution to HIV/AIDS management through (iii) promoting various forms of social control for HIV prevention, (iv) contributing to the care and support of the AIDS-affected and (v) providing social spaces for challenging stigmatising ideas and practices. We conclude that church groups, including church leadership, can play a key role in facilitating or hindering the creation of supportive social spaces to challenge stigma. Much work remains to be done in developing deeper understandings of the multi-layered factors that enable some churches, but not others, to respond effectively to HIV/AIDS. PMID:20668927

  17. Creating Social Spaces to Tackle AIDS-Related Stigma: Reviewing the Role of Church Groups in Sub-Saharan Africa

    PubMed Central

    Skovdal, M.; Gibbs, A.

    2012-01-01

    An expanding body of literature explores the role of African church groups in facilitating or hindering the support of people living with AIDS and challenging or contributing to HIV/AIDS-related stigma. Treating church groups as social spaces in which HIV/AIDS-related stigma may potentially be challenged, we systematically review this literature, identifying five themes that highlight the complex and contradictory role of the church as a potential agent of health-enhancing social change. In many ways the church perpetuates HIV/AIDS-related stigma through (i) moralistic attitudes and (ii) its reinforcement of conservative gender ideologies. However some churches have managed move towards action that makes a more positive contribution to HIV/AIDS management through (iii) promoting various forms of social control for HIV prevention, (iv) contributing to the care and support of the AIDS-affected and (v) providing social spaces for challenging stigmatising ideas and practices. We conclude that church groups, including church leadership, can play a key role in facilitating or hindering the creation of supportive social spaces to challenge stigma. Much work remains to be done in developing deeper understandings of the multi-layered factors that enable some churches, but not others, to respond effectively to HIV/AIDS. PMID:20668927

  18. Internalized HIV/AIDS-related stigma in a sample of HIV-positive people in Bangladesh.

    PubMed

    Hasan, M Tanvir; Nath, Samir Ranjan; Khan, Nabilah S; Akram, Owasim; Gomes, Tony Michael; Rashid, Sabina F

    2012-03-01

    Internalized stigma among people living with HIV/AIDS (PLHA) is prevalent in Bangladesh. A better understanding of the effects of stigma on PLHA is required to reduce this and to minimize its harmful effects. This study employed a quantitative approach by conducting a survey with an aim to know the prevalence of internalized stigma and to identify the factors associated with internalized stigma among a sample of 238 PLHA (male=152 and female=86) in Bangladesh. The findings suggest that there is a significant difference between groups with the low- and the high-internalized HIV/AIDS stigma in terms of both age and gender. The prevalence of internalized stigma varied according to the poverty status of PLHA. An exploratory factor analysis (EFA) found 10 of 15 items loaded highly on the three factors labelled self-acceptance, self-exclusion, and social withdrawal. About 68% of the PLHA felt ashamed, and 54% felt guilty because of their HIV status. More than half (87.5% male and 19.8% female) of the PLHA blamed themselves for their HIV status while many of them (38.2% male and 8.1% female) felt that they should be punished. The male PLHA more frequently chose to withdraw themselves from family and social gatherings compared to the female PLHA. They also experienced a higher level of internalized stigma compared to the female PLHA. The results suggest that the prevalence of internalized stigma is high in Bangladesh, and much needs to be done by different organizations working for and with the PLHA to reduce internalized stigma among this vulnerable group. PMID:22524116

  19. Knowledge, attitude, and practice of HIV/AIDS-related stigma and discrimination reduction among nursing students in southwest Nigeria

    PubMed Central

    Farotimi, Adekunbi A; Nwozichi, Chinomso Ugochukwu; Ojediran, Tolulope D

    2015-01-01

    Background: One of the reported obstacles to the achievement of universal access to Human Immunodeficiency Virus (HIV) prevention, treatment, care, and support programs includes stigma and discrimination from health workers, particularly nurses. Since nursing students would become future practising nurses and are most likely exposed to caring for people living with HIV/AIDS (PL WHA) during their training, it is of great importance to assess the knowledge, attitude, and practice of student nurses toward the reduction of HIV/AIDS-related stigma and discrimination. Materials and Methods: A descriptive survey research design was used. A total of 150 nursing students were selected using the simple random sampling technique of fish bowl method with replacement. Data were obtained using a self-administered (33-item) validated questionnaire to assess the knowledge, attitude, and practice of student nurses with regard to HIV/AIDS-related stigma and discrimination reduction strategies. Reliability of the tool was tested using Cronbach alpha (R) yielding a reliability value of 0.72. Data collected were analyzed with descriptive statistics of frequencies and percentages. Results: Majority (76.0%) of the respondents were females and 82.7% were married. Respondents were found to have high knowledge (94.0%) of strategies for reducing HIV/AIDS-related stigma and discrimination. Also, 64% had moderate discriminatory attitude, 74% engaged in low discriminatory practice, while 26% engaged in high discriminatory practice. Conclusions: Student nurses had adequate knowledge about strategies for reducing HIV/AIDS-related stigma and discrimination; negative discriminatory attitude toward PLWHA and some form of discriminatory practices exist in participants’ training schools. It is, therefore, recommended that an educational package on reduction of HIV/AIDS-related stigma and discrimination be developed and implemented for the participants. PMID:26793257

  20. AIDS-Related Stigma and Mental Disorders among People Living with HIV: A Cross-Sectional Study in Cambodia

    PubMed Central

    Yi, Siyan; Chhoun, Pheak; Suong, Samedy; Thin, Kouland; Brody, Carinne; Tuot, Sovannary

    2015-01-01

    Background AIDS-related stigma and mental disorders are the most common conditions in people living with HIV (PLHIV). We therefore conducted this study to examine the association of AIDS-related stigma and discrimination with mental disorders among PLHIV in Cambodia. Methods A two-stage cluster sampling method was used to select 1,003 adult PLHIV from six provinces. The People Living with HIV Stigma Index was used to measure stigma and discrimination, and a short version of general health questionnaire (GHQ-12) was used to measure mental disorders. Multivariate logistic regression analysis was conducted. Results The reported experiences of discrimination in communities in the past 12 months ranged from 0.8% for reports of being denied health services to 42.3% for being aware of being gossiped about. Internal stigma was also common ranging from 2.8% for avoiding going to a local clinic and/or hospital to 59.6% for deciding not to have (more) children. The proportions of PLHIV who reported fear of stigma and discrimination ranged from 13.9% for fear of being physically assaulted to 34.5% for fear of being gossiped about. The mean score of GHQ-12 was 3.2 (SD = 2.4). After controlling for several potential confounders, higher levels of mental disorders (GHQ-12≥ 4) remained significantly associated with higher levels of experiences of stigma and discrimination in family and communities (AOR = 1.9, 95% CI = 1.4–2.6), higher levels of internal stigma (AOR = 1.7, 95% CI = 1.2–2.3), and higher levels of fear of stigma and discrimination in family and communities (AOR = 1.5, 95% CI = 1.1–2.2). Conclusions AIDS-related stigma and discrimination among PLHIV in Cambodia are common and may have potential impacts on their mental health conditions. These findings indicate a need for community-based interventions to reduce stigma and discrimination in the general public and to help PLHIV to cope with this situation. PMID:25806534

  1. Measuring HIV- and AIDS-related stigma and discrimination in Nicaragua: results from a community-based study.

    PubMed

    Ugarte, William J; Högberg, Ulf; Valladares, Eliette C; Essén, Birgitta

    2013-04-01

    Psychometric properties of external HIV-related stigma and discrimination scales and their predictors were investigated. A cross-sectional community-based study was carried out among 520 participants using an ongoing health and demographic surveillance system in León, Nicaragua. Participants completed an 18-item HIV stigma scale and 19 HIV and AIDS discrimination-related statements. A factor analysis found that 15 of the 18 items in the stigma scale and 18 of the 19 items in the discrimination scale loaded clearly into five- and four-factor structures, respectively. Overall Cronbach's alpha of .81 for the HIV stigma scale and .91 for the HIV discrimination scale provided evidence of internal consistency. Hierarchical multiple linear regression analysis identified that females, rural residents, people with insufficient HIV-related transmission knowledge, those not tested for HIV, those reporting an elevated self-perception of HIV risk, and those unwilling to disclose their HIV status were associated with higher stigmatizing attitudes and higher discriminatory actions towards HIV-positive people. This is the first community-based study in Nicaragua that demonstrates that overall HIV stigma and discrimination scales were reliable and valid in a community-based sample comprised of men and women of reproductive age. Stigma and discrimination were reported high in the general population, especially among sub-groups. The findings in the current study suggest community-based strategies, including the monitoring of stigma and discrimination, and designing and implementing stigma reduction interventions, are greatly needed to reduce inequities and increase acceptance of persons with HIV. PMID:23514083

  2. Validity and Reliability of Persian Version of HIV/AIDS Related Stigma Scale for People Living With HIV/AIDS in Iran

    PubMed Central

    Pourmarzi, Davoud; Khoramirad, Ashraf; Ahmari Tehran, Hoda; Abedini, Zahra

    2015-01-01

    Objective: To assess the perceived HIV/AIDS related stigma a comprehensive and well developed stigma instrument is necessary. This study aimed to assess validity and reliability of the Persian version of HIV/AIDS related stigma scale which was developed by Kang et al for people living with HIV/AIDS in Iran. Materials and methods: Thescale was forward translatedby two bilingual academic members then both translations were discussed by expert team. Back-translation was done by two other bilingual translators then we carried out discussion with both of them. To evaluate understandability the scale was administered to 10 Persons Living with HIV/AIDS (PLWHA). Final Persian version was administered to 80 PLWHA in Qom, Iran in 2014. Test–retest reliability was assessed in a sample of 20 PLWHA after a week by intra-class correlation coefficient (ICC). Results: Cronbach’s alpha coefficient for overall scale was 0.85. Also Cronbach’s alpha coefficients for the five subscales were as follows: social rejection (9 items, α = 0.84), negative self-worth (4 items, α = 0.70), perceived interpersonal insecurity (2 items, α = 0.57), financial insecurity (3 items, α = 0.70), discretionary disclosure (2 items, α = 0.83). Test–retest reliability was also approved with ICC = 0.78. Correlation between items and their hypothesized subscale is greater than 0.5. Correlation between an item and its own subscale was significantly higher than its correlation with other subscales. Conclusion: This study demonstrate that the Persian version of HIV/AIDS related stigma scale is valid and reliable to assess HIV/AIDS related stigma perceived by people living whit HIV/AIDS in Iran. PMID:27047562

  3. A comparison of HIV/AIDS-related stigma in four countries: negative attitudes and perceived acts of discrimination towards people living with HIV/AIDS.

    PubMed

    Genberg, Becky L; Hlavka, Zdenek; Konda, Kelika A; Maman, Suzanne; Chariyalertsak, Suwat; Chingono, Alfred; Mbwambo, Jessie; Modiba, Precious; Van Rooyen, Heidi; Celentano, David D

    2009-06-01

    HIV/AIDS-related stigma and discrimination have a substantial impact on people living with HIV/AIDS (PLHA). The objectives of this study were: (1) to determine the associations of two constructs of HIV/AIDS-related stigma and discrimination (negative attitudes towards PLHA and perceived acts of discrimination towards PLHA) with previous history of HIV testing, knowledge of antiretroviral therapies (ARVs) and communication regarding HIV/AIDS and (2) to compare these two constructs across the five research sites with respect to differing levels of HIV prevalence and ARV coverage, using data presented from the baseline survey of U.S. National Institute of Mental Health (NIMH) Project Accept, a four-country HIV prevention trial in Sub-Saharan Africa (Tanzania, Zimbabwe and South Africa) and northern Thailand. A household probability sample of 14,203 participants completed a survey including a scale measuring HIV/AIDS-related stigma and discrimination. Logistic regression models determined the associations between negative attitudes and perceived discrimination with individual history of HIV testing, knowledge of ARVs and communication regarding HIV/AIDS. Spearman's correlation coefficients determined the relationships between negative attitudes and perceived discrimination and HIV prevalence and ARV coverage at the site-level. Negative attitudes were related to never having tested for HIV, lacking knowledge of ARVs, and never having discussed HIV/AIDS. More negative attitudes were found in sites with the lowest HIV prevalence (i.e., Tanzania and Thailand) and more perceived discrimination against PLHA was found in sites with the lowest ARV coverage (i.e., Tanzania and Zimbabwe). Programs that promote widespread HIV testing and discussion of HIV/AIDS, as well as education regarding and universal access to ARVs, may reduce HIV/AIDS-related stigma and discrimination. PMID:19427086

  4. HIV/AIDS-related stigma and information behaviour: an ethnographic study in the UK.

    PubMed

    Namuleme, Robinah Kalemeera

    2015-03-01

    This feature explores the information behaviour of people infected with or affected by HIV/AIDS. It investigates specifically the difficult issue of stigma and how this shapes the ways in which people interact with vital information. The study adopted an ethnographic whereby the researcher worked as a part-time volunteer at an HIV support centre in the North of England for over a year. This is the first time that such an approach has been reported in this feature and is interesting from this perspective alone. The very rich data which was gathered as a result of the approach is also instructive. The study formed part of a PhD thesis, which Robinah Kalemeera Namuleme completed at the University of Sheffield in March 2013. PMID:25684027

  5. Can AIDS stigma be reduced to poverty stigma? Exploring Zimbabwean children's representations of poverty and AIDS

    PubMed Central

    Campbell, C; Skovdal, M; Mupambireyi, Z; Madanhire, C; Robertson, L; Nyamukapa, C A; Gregson, S

    2012-01-01

    Objective We use children's drawings to investigate social stigmatization of AIDS-affected and poverty-affected children by their peers, in the light of suggestions that the stigmatization of AIDS-affected children might derive more from the poverty experienced by these children than from their association with AIDS. Methods A qualitative study, in rural Zimbabwe, used draw-and-write techniques to elicit children's (10–12 years) representations of AIDS-affected children (n= 30) and poverty-affected children (n= 33) in 2009 and 2010 respectively. Results Representations of children affected by AIDS and by poverty differed significantly. The main problems facing AIDS-affected children were said to be the psychosocial humiliations of AIDS stigma and children's distress about sick relatives. Contrastingly, poverty-affected children were depicted as suffering from physical and material neglect and deprivation. Children affected by AIDS were described as caregivers of parents whom illness prevented from working. This translated into admiration and respect for children's active contribution to household survival. Poverty-affected children were often portrayed as more passive victims of their guardians' inability or unwillingness to work or to prioritize their children's needs, with these children having fewer opportunities to exercise agency in response to their plight. Conclusions The nature of children's stigmatization of their AIDS-affected peers may often be quite distinct from poverty stigma, in relation to the nature of suffering (primarily psychosocial and material respectively), the opportunities for agency offered by each affliction, and the opportunities each condition offers for affected children to earn the respect of their peers and community. We conclude that the particular nature of AIDS stigma offers greater opportunities for stigma reduction than poverty stigma. PMID:21985490

  6. Professionalisation and social attitudes: a protocol for measuring changes in HIV/AIDS-related stigma among healthcare students

    PubMed Central

    Ahmadi, Keivan; Reidpath, Daniel D; Allotey, Pascale; Hassali, Mohamed Azmi Ahmad

    2013-01-01

    Introduction HIV/AIDS-related stigma affects the access and utilisation of health services. Although HIV/AIDS-related stigma in the health services has been studied, little work has attended to the relationship between professional development and stigmatising attitudes. Hence, in this study, we will extend earlier research by examining the relationship between the stage of professional development and the kinds of stigmatising attitudes held about people living with HIV/AIDS. Methods and analysis A serial cross-sectional design will be combined with a two-point in time longitudinal design to measure the levels of stigma among healthcare students from each year of undergraduate and graduate courses in Malaysia and Australia. In the absence of suitable measures, we will carry out a sequential mixed methods design to develop such a tool. The questionnaire data will be analysed using mixed effects linear models to manage the repeated measures. Ethics and dissemination We have received ethical approval from the Monash MBBS executive committee as well as the Monash University Human Research Ethics Committee. We will keep the data in a locked filing cabinet in the Monash University (Sunway campus) premises for 5 years, after which the information will be shredded and disposed of in secure bins, and digital recordings will be erased in accordance with Monash University's regulations. Only the principal investigator and the researcher will have access to the filing cabinet. We aim to present and publish the results of this study in national and international conferences and peer-reviewed journals, respectively. PMID:23793653

  7. Understanding the relationships among HIV/AIDS-related stigma, health service utilization, and HIV prevalence and incidence in Sub-Saharan Africa: a multi-level theoretical perspective.

    PubMed

    Williams, Leslie D

    2014-03-01

    HIV-positive individuals often face community-wide discrimination or public shame and humiliation as a result of their HIV-status. In Sub-Saharan Africa, high HIV incidence coupled with unique cultural contexts make HIV-positive individuals particularly likely to experience this kind of HIV/AIDS-related (HAR) stigma. To date, there is a relatively small amount of high-quality empirical literature specific to HAR stigma in this context, supporting the notion that a better understanding of this phenomenon is needed to inform potential interventions. This paper provides a thorough review of the literature specific to HAR stigma in Sub-Saharan Africa, finding (a) qualitative support for the existence of important relationships between HAR stigma and health service utilization and barriers; (b) a need for more quantitative study of stigma and its relationships both to health service utilization and to HIV outcomes directly; and (c) a disconnect between methodological techniques used in this context-specific literature and well-known theories about stigma as a general phenomenon. This paper then draws from its empirical literature review, as well as from well-known theoretical frameworks from multiple disciplines, to propose a theoretical framework for the ecological and multilevel relationships among HAR stigma, health service utilization, and HIV outcomes in this context. PMID:24477769

  8. A comparison of HIV/AIDS-related stigma in four countries: Negative attitudes and perceived acts of discrimination towards people living with HIV/AIDS☆

    PubMed Central

    Genberg, Becky L.; Hlavka, Zdenek; Konda, Kelika A.; Maman, Suzanne; Chariyalertsak, Suwat; Chingono, Alfred; Mbwambo, Jessie; Modiba, Precious; Van Rooyen, Heidi; Celentano, David D.

    2010-01-01

    HIV/AIDS-related stigma and discrimination have a substantial impact on people living with HIV/AIDS (PLHA). The objectives of this study were: (1) to determine the associations of two constructs of HIV/AIDS-related stigma and discrimination (negative attitudes towards PLHA and perceived acts of discrimination towards PLHA) with previous history of HIV testing, knowledge of antiretroviral therapies (ARVs) and communication regarding HIV/AIDS and (2) to compare these two constructs across the five research sites with respect to differing levels of HIV prevalence and ARV coverage, using data presented from the baseline survey of U.S. National Institute of Mental Health (NIMH) Project Accept, a four-country HIV prevention trial in Sub-Saharan Africa (Tanzania, Zimbabwe and South Africa) and northern Thailand. A household probability sample of 14,203 participants completed a survey including a scale measuring HIV/AIDS-related stigma and discrimination. Logistic regression models determined the associations between negative attitudes and perceived discrimination with individual history of HIV testing, knowledge of ARVs and communication regarding HIV/AIDS. Spearman's correlation coefficients determined the relationships between negative attitudes and perceived discrimination and HIV prevalence and ARV coverage at the site-level. Negative attitudes were related to never having tested for HIV, lacking knowledge of ARVs, and never having discussed HIV/AIDS. More negative attitudes were found in sites with the lowest HIV prevalence (i.e., Tanzania and Thailand) and more perceived discrimination against PLHA was found in sites with the lowest ARV coverage (i.e., Tanzania and Zimbabwe). Programs that promote widespread HIV testing and discussion of HIV/AIDS, as well as education regarding and universal access to ARVs, may reduce HIV/AIDS-related stigma and discrimination. PMID:19427086

  9. Masculinity and the persistence of AIDS stigma

    PubMed Central

    Wyrod, Robert

    2011-01-01

    With the expansion of access to HIV testing and antiretroviral therapy in sub-Saharan Africa, questions have emerged if stigma remains a useful concept for understanding the effects of AIDS. There is, however, a paucity of research on how HIV-positive Africans—especially African men—experience living with AIDS. This paper addresses this gap and draws on findings from ethnographic fieldwork in 2004 and 2009 with a support group for HIV-positive men in Kampala, Uganda. The paper demonstrates that stigma is central to how men in this context coped with HIV and AIDS, and it provides a conceptual framework that links men’s experiences of AIDS stigma to conceptions of masculinity. In so doing, findings highlight both the possibilities and challenges of involving African men more fully in HIV prevention. PMID:21246426

  10. Masculinity and the persistence of AIDS stigma.

    PubMed

    Wyrod, Robert

    2011-04-01

    With the expansion of access to HIV testing and antiretroviral therapy in sub-Saharan Africa, questions have emerged as to whether stigma remains a useful concept for understanding the effects of AIDS. There is, however, a paucity of research on how HIV-positive Africans--especially African men--experience living with AIDS. This paper addresses this gap and draws on findings from ethnographic fieldwork in 2004 and 2009 with a support group for HIV-positive men in Kampala, Uganda. The paper demonstrates that stigma is central to how men in this context coped with HIV and AIDS and it provides a conceptual framework that links men's experiences of AIDS stigma to conceptions of masculinity. In so doing, findings highlight both the possibilities and challenges of involving African men more fully in HIV prevention. PMID:21246426

  11. Individual attitudes and perceived social norms: Reports on HIV/AIDS-related stigma among service providers in China

    PubMed Central

    Li, Li; Liang, Li-Jung; Wu, Zunyou; Lin, Chunqing; Wen, Yi

    2009-01-01

    This study examined HIV/AIDS-related stigma among Chinese service providers by comparing their personal attitudes toward people living with HIV/AIDS with their perception of social norms related to people living with HIV/AIDS. We randomly selected three provincial hospitals, four city/prefecture hospitals, 10 county hospitals, 18 township health clinics, and 54 village clinics from Yunnan, China. Doctors and nurses were randomly sampled proportionally to the doctor-nurse ratio of each hospital or clinic. Lab technicians were over-sampled in order to include an adequate representation in the analysis. A total of 1,101 service providers participated in a voluntary, anonymous survey where demographic characteristics, individual attitude and perceived social norms toward people living with HIV/AIDS, discrimination intent at work, general prejudicial attitude and knowledge on HIV/AIDS were measured. A majority of the sample demonstrated a similarity between their personal views and what they thought most people in society believe. Multiple logistic regressions revealed that participants who were younger or reported personal contact with people living with HIV/AIDS were significantly more likely to report personal attitudes toward the population that were more liberal than their perceived social norms. Holding a more liberal personal attitude toward people living with HIV/AIDS than perceived social norms was significantly and negatively related to the level of discrimination intent at work, perceived discrimination at interpersonal level and the level of general prejudicial attitude toward people living with HIV/AIDS. Results underscored the importance of understanding social norms and personal attitudes in studying HIV-related stigma and called for the incorporation of existing human capital into future HIV stigma reduction programs. Cette étude a examiné le VIH/SIDA lié à stigmatisation parmi les agences chinoises fournissant des soins en comparant leurs attitudes

  12. HIV-related stigma and self-disclosure: the mediating and moderating role of anticipated discrimination among people living with HIV/AIDS in Akure Nigeria.

    PubMed

    Olley, B O; Ogunde, M J; Oso, P O; Ishola, A

    2016-06-01

    Although links between HIV-related stigma and self-disclosure of HIV status among people living with HIV have been well established, it is unclear whether levels of perceived discrimination are differentially associated with self-disclosure. The present study using a multi-factorial survey design investigated the role of stigma and other self-related factors (e.g., anticipated discrimination, self-esteem, HIV-related factors [e.g., drug use combination; knowledge of duration of HIV diagnosis] and socio-demographic factors [e.g., multiple spouse; age, gender, educational level] and psychological distress [depression]) in self-disclosure among People living with HIV/AIDs has been added (PLWHA) on follow-up management in State Specialist Hospital Akure, Nigeria. One hundred and thirty nine HIV/AIDS patients (49 males and 90 females) participated in the study. Mean age and mean time in months since diagnosis were 39.56 ± 10.26 and 37.78 ± 48.34, respectively. Four variables: multiple spouse, anticipated discrimination, HIV-related stigma and self-esteem were related to self-disclosure at (p < .05). Product-term regression analyses demonstrated that perceived discrimination mediated the relationship between self-esteem (Sobel test: z = 2.09, Aroian = 2.06, p < .001), perceived stigma (Sobel test: z = 2.78, Aroaian = 2.75 p < .01) and self-disclosure. Interaction term analysis between HIV-related stigma t (5, 137) = 1.69, p > .05, self-esteem t (5, 137) = .59, p > .05 and anticipated discrimination were non-significant, suggesting a non-moderation effect of discrimination and disclosure. The results indicate that anticipated discrimination may impact HIV-related stigma to reduce self-disclosure among the PLWHAs in Akure, Nigeria. Interventions should incorporate anticipated discrimination in educational programs of HIV stigma in encouraging self-disclosure among PLWHAs. PMID:26882476

  13. Coping with HIV/AIDS Stigma in Five African Countries

    PubMed Central

    Makoae, Lucia N.; Greeff, Minrie; Phetlhu, René D.; Uys, Leana R.; Naidoo, Joanne R.; Kohi, Thecla W.; Dlamini, Priscilla S.; Chirwa, Maureen L.; Holzemer, William L.

    2008-01-01

    People living with HIV (PLWH) and their families are subjected to prejudice, discrimination and hostility related to the stigmatization of AIDS. This paper examines how PLWH cope with HIV-related stigma in the five southern African countries of Lesotho, Malawi, South Africa, Swaziland, and Tanzania. A descriptive, qualitative research design was used to explore the experience of HIV-related stigma of PLWH and nurses in 2004. Forty-three focus groups were conducted with 251 participants (114 nurses, 111 PLWHs and 26 volunteers). In describing incidents of stigma, respondents reported strategies used or observed to cope with those incidents of stigma. Nurse reports of coping strategies that they used as well as coping strategies they observed as used by HIV-infected patients were coded. Coping strategies used by PLWH in dealing with HIV-related stigma were coded. Seventeen different self-care strategies were identified: restructuring, seeing oneself as OK, letting go, turning to God, hoping, changing behavior, keeping oneself active, using humor, joining a support or social group, disclosing one’s HIV status, speaking to others with same problem, getting counseling, helping others to cope with the illness, educating others, learning from others, acquiring knowledge and understanding about the disease, and getting help from others. Coping appears to be self-taught and only modestly helpful in managing perceived stigma. PMID:18328964

  14. Disengagement and Engagement Coping with HIV/AIDS Stigma and Psychological Well-Being of People with HIV/AIDS

    PubMed Central

    Varni, Susan E.; Miller, Carol T.; McCuin, Tara; Solomon, Sondra E.

    2012-01-01

    The stigma associated with HIV/AIDS poses a psychological challenge to people living with HIV/AIDS. We hypothesized that that the consequences of stigma-related stressors on psychological well-being would depend on how people cope with the stress of HIV/AIDS stigma. Two hundred participants with HIV/AIDS completed a self-report measure of enacted stigma and felt stigma, a measure of how they coped with HIV/AIDS stigma, and measures of depression and anxiety, and self-esteem. In general, increases in felt stigma (concerns with public attitudes, negative self-image, and disclosure concerns) coupled with how participants reported coping with stigma (by disengaging from or engaging with the stigma stressor) predicted self-reported depression, anxiety, and self-esteem. Increases in felt stigma were associated with increases in anxiety and depression among participants who reported relatively high levels of disengagement coping compared to participants who reported relatively low levels of disengagement coping. Increases in felt stigma were associated with decreased self-esteem, but this association was attenuated among participants who reported relatively high levels of engagement control coping. The data also suggested a trend that increases in enacted stigma predicted increases in anxiety, but not depression, among participants who reported using more disengagement coping. Mental health professionals working with people who are HIV positive should consider how their clients cope with HIV/AIDS stigma and consider tailoring current therapies to address the relationship between stigma, coping, and psychological well-being. PMID:22611302

  15. Factors Associated with Perceived Stigma among People Living with HIV/AIDS in Post-Conflict Northern Uganda

    ERIC Educational Resources Information Center

    Nattabi, Barbara; Li, Jianghong; Thompson, Sandra C.; Orach, Christopher G.; Earnest, Jaya

    2011-01-01

    HIV-related stigma continues to persist in several African countries including Uganda. This study quantified the burden of stigma and examined factors associated with stigma among 476 people living with HIV (PLHTV) in Gulu, northern Uganda. Data were collected between February and May 2009 using the HIV/AIDS Stigma Instrument-PLWA. Females more…

  16. Lessons on Stigma: Teaching about HIV/AIDS

    ERIC Educational Resources Information Center

    Lichtenstein, Bronwen; DeCoster, Jamie

    2014-01-01

    Teaching about the sociology of HIV/AIDS involves teaching about the causes and effects of stigma. We describe a Sociology of HIV/AIDS course at the University of Alabama in which stigma reduction was assessed as a primary objective. The syllabus involved theory-based instruction, class visits, service learning, and student research on community…

  17. The development and validation of the HIV/AIDS Stigma Instrument - Nurse (HASI-N)

    PubMed Central

    Uys, Leana R.; Holzemer, William L.; Chirwa, Maureen L.; Dlamini, Priscilla S.; Greeff, Minrie; Kohi, Thecla W.; Makoae, Lucia N.; Stewart, Anita L.; Mullan, Joseph; Phetlhu, René D.; Wantland, Dean J.; Durrheim, Kevin L.; Cuca, Yvette P.; Naidoo, Joanne R.

    2009-01-01

    Illness-related stigma remains a serious problem in the management of HIV disease in Africa. This article describes a series of study phases conducted to develop and validate an instrument to measure HIV/AIDS-related stigma as perpetrated and experienced by nurses. Data were collected in Lesotho, Malawi, South Africa, Swaziland and Tanzania, from 2004-2006. The first phase was a qualitative study with focus group participants (n = 251) to gather emic and etic descriptions of HIV/AIDS-related stigma in the five countries. Based on the qualitative data, a 46-item instrument was developed and tested during a second phase in the same five countries (n = 244). The result of this phase was a 33-item, three-factor instrument with an average Cronbach alpha of 0.85. A third phase tested the instrument in 1474 nurses. The result was a final 19-item instrument, the HIV/AIDS Stigma Instrument - Nurse (HASI-N), comprised of two factors (Nurses Stigmatizing Patients and Nurses Being Stigmatized) with a Cronbach alpha of 0.90. Concurrent validity was tested by comparing the level of stigma with job satisfaction and quality of life. A significant negative correlation was found between stigma and job satisfaction. The HASI-N is the first inductively derived instrument measuring stigma experienced and enacted by nurses. It has the potential to be used not only to measure stigma, but also to develop stigma-reduction interventions. PMID:19229683

  18. The development and validation of the HIV/AIDS Stigma Instrument - Nurse (HASI-N).

    PubMed

    Uys, Leana R; Holzemer, William L; Chirwa, Maureen L; Dlamini, Priscilla S; Greeff, Minrie; Kohi, Thecla W; Makoae, Lucia N; Stewart, Anita L; Mullan, Joseph; Phetlhu, René D; Wantland, Dean J; Durrheim, Kevin L; Cuca, Yvette P; Naidoo, Joanne R

    2009-02-01

    Illness-related stigma remains a serious problem in the management of HIV disease in Africa. This article describes a series of study phases conducted to develop and validate an instrument to measure HIV/AIDS-related stigma as perpetrated and experienced by nurses. Data were collected in Lesotho, Malawi, South Africa, Swaziland and Tanzania, from 2004-2006. The first phase was a qualitative study with focus group participants (n=251) to gather emic and etic descriptions of HIV/AIDS-related stigma in the five countries. Based on the qualitative data, a 46-item instrument was developed and tested during a second phase in the same five countries (n=244). The result of this phase was a 33-item, three-factor instrument with an average Cronbach alpha of 0.85. A third phase tested the instrument in 1474 nurses. The result was a final 19-item instrument, the HIV/AIDS Stigma Instrument - Nurse (HASI-N), comprised of two factors (Nurses Stigmatizing Patients and Nurses Being Stigmatized) with a Cronbach alpha of 0.90. Concurrent validity was tested by comparing the level of stigma with job satisfaction and quality of life. A significant negative correlation was found between stigma and job satisfaction. The HASI-N is the first inductively derived instrument measuring stigma experienced and enacted by nurses. It has the potential to be used not only to measure stigma, but also to develop stigma-reduction interventions. PMID:19229683

  19. Examining the associations between HIV-related stigma and health outcomes in people living with HIV/AIDS: a series of meta-analyses

    PubMed Central

    Mitra, Sanjana; Chen, Shiyi; Gogolishvili, David; Globerman, Jason; Chambers, Lori; Wilson, Mike; Logie, Carmen H; Shi, Qiyun; Morassaei, Sara; Rourke, Sean B

    2016-01-01

    Objective To conduct a systematic review and series of meta-analyses on the association between HIV-related stigma and health among people living with HIV. Data sources A structured search was conducted on 6 electronic databases for journal articles reporting associations between HIV-related stigma and health-related outcomes published between 1996 and 2013. Study eligibility criteria Controlled studies, cohort studies, case-control studies and cross-sectional studies in people living with HIV were considered for inclusion. Outcome measures Mental health (depressive symptoms, emotional and mental distress, anxiety), quality of life, physical health, social support, adherence to antiretroviral therapy, access to and usage of health/social services and risk behaviours. Results 64 studies were included in our meta-analyses. We found significant associations between HIV-related stigma and higher rates of depression, lower social support and lower levels of adherence to antiretroviral medications and access to and usage of health and social services. Weaker relationships were observed between HIV-related stigma and anxiety, quality of life, physical health, emotional and mental distress and sexual risk practices. While risk of bias assessments revealed overall good quality related to how HIV stigma and health outcomes were measured on the included studies, high risk of bias among individual studies was observed in terms of appropriate control for potential confounders. Additional research should focus on elucidating the mechanisms behind the negative relationship between stigma and health to better inform interventions to reduce the impact of stigma on the health and well-being of people with HIV. Conclusions This systematic review and series of meta-analyses support the notion that HIV-related stigma has a detrimental impact on a variety of health-related outcomes in people with HIV. This review can inform the development of multifaceted, intersectoral interventions to

  20. My secret: The social meaning of HIV/AIDS stigma

    PubMed Central

    Judgeo, N.; Moalusi, K.P.

    2014-01-01

    Abstract This study uses Goffman's [1963. Stigma: Notes on the Management of Spoiled Identity, New Jersey, Prentice-Hall] theory of stigma as an intellectual scaffold to help understand the social meaning of HIV/AIDS stigma from People Living with HIV/AIDS. The study adopts a qualitative approach because of its appropriateness for unravelling subjective phenomena such as the experiences of HIV/AIDS stigma. In-depth interviews were conducted with 10 HIV-positive employees of a retailing company located in the Western Cape province of South Africa who volunteered to participate in the study. The participants with the discreditable stigma internalised society's prejudice towards those living with the virus. As a result, the participants relied on self-isolation and social withdrawal to cope with enacted stigma. Managing information about one's status and deciding whether, who, when, etc., to tell are crucial questions. The participants feared being devalued by family, friends, co-workers and the community. In concurrence with Goffman [1963. Stigma: Notes on the Management of Spoiled Identity, New Jersey, Prentice-Hall] the HIV/AIDS stigma is seen as about relationships. PMID:24980478

  1. Sexual behavior as a function of stigma and coping with stigma among people with HIV/AIDS in rural New England.

    PubMed

    Varni, Susan E; Miller, Carol T; Solomon, Sondra E

    2012-11-01

    The relationship between coping with HIV/AIDS stigma and engaging in risky sexual behavior (i.e., inconsistent condom use) was examined in HIV-positive adults living in rural areas. Participants answered questions about their experiences with HIV/AIDS prejudice and discrimination (enacted stigma) and their perceptions of felt HIV/AIDS stigma (disclosure concerns, negative self-image, and concern with public attitudes). They were also asked about how they coped with HIV/AIDS stigma, and about their sexual activity during the past 90 days. We hypothesized that using disengagement coping to manage the stress of HIV/AIDS stigma would be related to risky sexual behavior. Multinomial logistic regression results showed that using disengagement coping (avoidance, denial, and wishful thinking) coupled with high levels of enacted stigma was associated with less risky rather than more risky sexual behavior. That is, disengagement coping coupled with high stigma increased the odds of not having vaginal or anal sex versus inconsistently using condoms. Implications for people with HIV/AIDS who use disengagement coping to manage stress to deal with HIV/AIDS stigma are discussed. PMID:22782789

  2. Sexual Behavior as a Function of Stigma and Coping with Stigma Among People with HIV/AIDS in Rural New England

    PubMed Central

    Solomon, Sondra E.

    2012-01-01

    The relationship between coping with HIV/AIDS stigma and engaging in risky sexual behavior (i.e., inconsistent condom use) was examined in HIV-positive adults living in rural areas. Participants answered questions about their experiences with HIV/AIDS prejudice and discrimination (enacted stigma) and their perceptions of felt HIV/AIDS stigma (disclosure concerns, negative self-image, and concern with public attitudes). They were also asked about how they coped with HIV/AIDS stigma, and about their sexual activity during the past 90 days. We hypothesized that using disengagement coping to manage the stress of HIV/AIDS stigma would be related to risky sexual behavior. Multinomial logistic regression results showed that using disengagement coping (avoidance, denial, and wishful thinking) coupled with high levels of enacted stigma was associated with less risky rather than more risky sexual behavior. That is, disengagement coping coupled with high stigma increased the odds of not having vaginal or anal sex versus inconsistently using condoms. Implications for people with HIV/AIDS who use disengagement coping to manage stress to deal with HIV/AIDS stigma are discussed. PMID:22782789

  3. HIV/AIDS stigma: Measurement and relationships to psycho-behavioral factors in Latino gay/bisexual men and transgender women

    PubMed Central

    Molina, Y.; Ramirez-Valles, J.

    2013-01-01

    Despite the increased interest in HIV/AIDS stigma and its negative effects on the health and social support of people living with HIV/AIDS (PLWHA), little attention has been given to its assessment among Latino gay/bisexual men and transgender women (GBT) living with HIV/AIDS. The purpose of this paper is twofold: to develop a multidimensional assessment of HIV/AIDS stigma for Latino GBT living with HIV/AIDS, and to test whether such stigma is related to self-esteem, safe sex self-efficacy, social support, and alcohol and drug use. The sample included 170 HIV+ Latino GBT persons. The results revealed three dimensions of stigma: internalized, perceived, and enacted HIV/AIDS stigma. Enacted HIV/AIDS stigma comprised two domains: generalized and romantic and sexual. Generalized enacted HIV/AIDS stigma was related to most outcomes. Internalized HIV/AIDS stigma mediated the associations between generalized enacted HIV/AIDS stigma and self-esteem and safe sex self-efficacy. In addition, romantic and sexual enacted HIV/AIDS stigma significantly predicted drug use. Perceived HIV/AIDS stigma was not associated with any outcome. These findings expand the understanding of the multi-dimensionality of stigma and the manner in which various features impact marginalized PLWHA. PMID:23668809

  4. My secret: the social meaning of HIV/AIDS stigma.

    PubMed

    Judgeo, N; Moalusi, K P

    2014-01-01

    This study uses Goffman's [1963. Stigma: Notes on the Management of Spoiled Identity, New Jersey, Prentice-Hall] theory of stigma as an intellectual scaffold to help understand the social meaning of HIV/AIDS stigma from People Living with HIV/AIDS. The study adopts a qualitative approach because of its appropriateness for unravelling subjective phenomena such as the experiences of HIV/AIDS stigma. In-depth interviews were conducted with 10 HIV-positive employees of a retailing company located in the Western Cape province of South Africa who volunteered to participate in the study. The participants with the discreditable stigma internalised society's prejudice towards those living with the virus. As a result, the participants relied on self-isolation and social withdrawal to cope with enacted stigma. Managing information about one's status and deciding whether, who, when, etc., to tell are crucial questions. The participants feared being devalued by family, friends, co-workers and the community. In concurrence with Goffman [1963], the HIV/AIDS stigma is seen as about relationships. PMID:24980478

  5. Development and Assessment of Traditional and Innovative Media to Reduce Individual HIV/AIDS-Related Stigma Attitudes and Beliefs in India

    PubMed Central

    Catalani, Caricia; Castaneda, Diego; Spielberg, Freya

    2013-01-01

    Although stigma is considered a major barrier to effective response to the HIV/AIDS epidemic, there is a lack of evidence on effective interventions. This media intervention took place among key HIV-vulnerable communities in Southern India. Two HIV stigma videos were created using techniques from traditional film production and new media digital storytelling. A series of 16 focus group discussions were held in 4 rural and 4 urban sites in South India, with specific groups for sex workers, men who have sex with men, young married women, and others. Focus groups with viewers of the traditional film (8 focus groups, 80 participants) and viewers of the new media production (8 focus groups, 69 participants) revealed the mechanisms through which storyline, characters, and esthetics influence viewers’ attitudes and beliefs about stigma. A comparative pre-/post-survey showed that audiences of both videos significantly improved their stigma scores. We found that a simple illustrated video, produced on a limited budget by amateurs, and a feature film, produced with an ample budget by professionals, elicited similar responses from audiences and similar positive short-term outcomes on stigma. PMID:24350190

  6. HIV stigma among substance abusing people living with HIV/AIDS: implications for HIV treatment.

    PubMed

    Levi-Minzi, Maria A; Surratt, Hilary L

    2014-08-01

    HIV-related stigma has a major impact on quality of life and health among people living with HIV and AIDS (PLWHA). This study examines demographic, mental health, behavioral, contextual, and HIV care-related correlates of HIV stigma among 503 substance abusing PLWHA. Stigma was measured with the HIV Internalized Stigma Measure which has four subscales: stereotypes about HIV, self-acceptance, disclosure concerns, and social relationships. Severe substance dependence (55.3%) and depression (54.7%) were associated with higher HIV stigma across all domains. 49.9% of the sample reported antiretroviral (ARV) medication diversion (the unlawful sale and trading of ARV medications); diverters endorsed significantly higher stigma related to disclosure. 54.1% of the sample reported ≥95% ARV adherence; these individuals reported significantly lower stigma for self-acceptance, disclosure, and social relationships. Multivariate linear regression showed that depression and social support demonstrated significant main effects across stigma domains. Findings suggest that interventions to decrease HIV related stigma may be an important component of initiatives to increase engagement in HIV care. PMID:24983302

  7. Correlates of Stigma among Rural Indian Women Living with HIV/AIDS

    PubMed Central

    Nyamathi, Adeline; Ekstrand, Maria; Zolt-Gilburne, Jessica; Ganguly, Kalyan; Sinha, Sanjeev; Ramakrishnan, Padma; Suresh, P.; Marfisee, Mary; Leake, Barbara

    2012-01-01

    AIDS-related stigma has received increasing attention in the literature; however, little is known about the devastating impact it has on rural women living with AIDS (WLA) in India. This cross-sectional study (N = 68), analyzed from complete baseline data, identified a number of correlates of stigma among rural WLA in South India. Structured instruments were used to capture sociodemographic history, stigma, knowledge of HIV, depressive symptoms along with the recording of CD4 data. A higher level of felt stigma and more AIDS symptoms were related to avoidant coping, while fewer adherence strategies and lower support for ART adherence were also associated with avoidant coping. These findings promote the need for support and resources for rural India WLA. PMID:21915715

  8. Discrimination, stigma, and AIDS: a review of academic literature produced in Brazil (2005-2010).

    PubMed

    Monteiro, Simone; Villela, Wilza Vieira; Knauth, Daniela

    2012-01-01

    Given the implications of stigma for HIV/AIDS prevention and control of the epidemic, as emphasized by UNAIDS, this study analyzes the Brazilian academic production on health, AIDS, stigma, and discrimination, available in the SciELO database from 2005 to 2010. Brazilian research on the theme is modest as compared to the international literature, but the studies follow the same trend of focusing on individual experiences of discrimination as opposed to analysis of stigma and discrimination as social processes associated with power relations and domination (macro-social structures) and the characteristics of individuals and social groups that shape social interactions. The current study seeks to analyze the reasons for the scarcity of studies on the social perspective towards stigma and discrimination in the field of public health and the implications for the development of proposals to deal with HIV/AIDS-related discrimination. PMID:22267077

  9. EXPERIENCES OF HIV/AIDS STIGMA OF PERSONS LIVING WITH HIV/AIDS AND NURSES INVOLVED IN THEIR CARE FROM FIVE AFRICAN COUNTRIES

    PubMed Central

    Greeff, Minrie; Uys, Leana R; Holzemer, William L; Makoae, Lucia N; Dlamini, Priscilla S; Kohi, Thecla W; Chirwa, Maureen L; Naidoo, Joanne R; Phetlhu, Rene D.

    2009-01-01

    The concept of stigma has received significant attention in recent years in the HIV/AIDS literature. Although there is some change towards the positive, AIDS still remains a significantly stigmatized condition. AIDS stigma and discrimination continue to influence people living with and affected by HIV (PLWA), as well as their health-care providers. Unless stigma is conquered, the illness will not be defeated. Due to the burden that HIV/AIDS places on people living in Africa, a five-year project entitled Perceived AIDS Stigma: A Multinational African Study was undertaken. The focus of the first phase of this project was on exploring and describing the meaning and effect of stigma on PLWA from the experiences of PLWA and the nurses involved in their care in five African countries: Lesotho, Swaziland, Malawi, South Africa and Tanzania. An exploratory descriptive qualitative research design was used to explore and describe the experience of stigma through the critical incident method. Purposive voluntary sampling was utilized. Forty-three focus group discussions were held with respondents to relate incidences which they themselves observed, as well as those that they themselves experienced in the community and in families. The transcribed data was analyzed through the technique of open coding using the NVivo 2.0 analysis package. Three types of stigma (received stigma, internal stigma and associated stigma) and several dimensions for each of these types of stigma emerged from the data. Recommendations were made to pursue these findings further. PMID:20052299

  10. EXPERIENCES OF HIV/AIDS STIGMA OF PERSONS LIVING WITH HIV/AIDS AND NURSES INVOLVED IN THEIR CARE FROM FIVE AFRICAN COUNTRIES.

    PubMed

    Greeff, Minrie; Uys, Leana R; Holzemer, William L; Makoae, Lucia N; Dlamini, Priscilla S; Kohi, Thecla W; Chirwa, Maureen L; Naidoo, Joanne R; Phetlhu, Rene D

    2008-01-01

    The concept of stigma has received significant attention in recent years in the HIV/AIDS literature. Although there is some change towards the positive, AIDS still remains a significantly stigmatized condition. AIDS stigma and discrimination continue to influence people living with and affected by HIV (PLWA), as well as their health-care providers. Unless stigma is conquered, the illness will not be defeated. Due to the burden that HIV/AIDS places on people living in Africa, a five-year project entitled Perceived AIDS Stigma: A Multinational African Study was undertaken. The focus of the first phase of this project was on exploring and describing the meaning and effect of stigma on PLWA from the experiences of PLWA and the nurses involved in their care in five African countries: Lesotho, Swaziland, Malawi, South Africa and Tanzania. An exploratory descriptive qualitative research design was used to explore and describe the experience of stigma through the critical incident method. Purposive voluntary sampling was utilized. Forty-three focus group discussions were held with respondents to relate incidences which they themselves observed, as well as those that they themselves experienced in the community and in families. The transcribed data was analyzed through the technique of open coding using the NVivo 2.0 analysis package. Three types of stigma (received stigma, internal stigma and associated stigma) and several dimensions for each of these types of stigma emerged from the data. Recommendations were made to pursue these findings further. PMID:20052299

  11. Qualitative Contributions to a Randomized Controlled Trial Addressing HIV/AIDS-Stigma in Medical Students

    PubMed Central

    Marzán-Rodríguez, Melissa; Varas-Díaz, Nelson; Neilands, Torsten

    2016-01-01

    Specialized training for healthcare professionals (HCP) in order to reduce HIV/AIDS related stigma must be part of a public health model for HIV/AIDS. Tested interventions to reduce HIV/AIDS related stigma among HCP have been mostly absent from these efforts. A qualitative approach was used to assess stigma reduction within a traditional randomized controlled design in order to better understand how our current stigma intervention worked and was understood by 2nd year medical students. After conducting a quantitative follow up survey one-year post intervention we conducted 20 in-depth qualitative interviews with a subsample of our intervention group participants as part of the overall evaluation process. Once the interviews were finished, we transcribed them and used NVivo (v.8) to organized the qualitative data. In the process of analyzing the qualitative data we identified core intervention areas participants described as useful for their training and development: (1) acquiring more HIV/AIDS-related knowledge, (2) increased skills for management of high stigma situations, and (3) the ability to identify socio-structural factors that foster HIV infection among clients. The gathered information is important in order to have a deep understanding of how attitudinal change happens as part of our intervention strategies. Keywords: HIV/AIDS, Stigma, Randomized Controlled Trial, Qualitative Evaluation, Medical Students, Puerto Rico PMID:26855975

  12. Issues of expressed stigma of HIV/AIDS among professionals in Southern Sudan.

    PubMed

    Machine, Edwin M; Ross, Michael W; McCurdy, Sheryl A

    2011-08-01

    HIV-related stigma continues to be a significant barrier to HIV testing, treatment, and care. Understanding the factors that underlie this stigma could help remove barriers to HIV/AIDS intervention. We identified these factors among nurses as well as community leaders in Lui, Southern Sudan. Participants included health workers at a local hospital, a women's group, local market traders, religious leaders, and teachers. We categorized the responses generated from group interaction forums as concerns, fears, and perceptions. We found that stigma persisted not only toward people with conspicuous signs of full-blown AIDS, but also toward community programs, like voluntary counseling and testing centers. Future interventions, including delabeling the counseling and testing centers and demonstrating the efficacy of highly active antiretroviral therapy, will be critical in reducing the stigma of HIV/AIDS in communities. PMID:21149851

  13. Vicious circle of perceived stigma, enacted stigma and depressive symptoms among children affected by HIV/AIDS in China.

    PubMed

    Chi, Peilian; Li, Xiaoming; Zhao, Junfeng; Zhao, Guoxiang

    2014-06-01

    Previous research has found a deleterious impact of stigma on the mental health of children affected by HIV/AIDS. Little is known about the longitudinal relationship of stigma and children's mental health. This study explores the longitudinal reciprocal effects of depressive symptoms and stigma, specifically enacted stigma and perceived stigma, among children affected by HIV/AIDS aged 6-12. Longitudinal data were collected from 272 children orphaned by AIDS and 249 children of HIV-positive parents in rural China. Cross-lagged panel analysis was conducted in the study. Results showed that the autoregressive effects were stable for depressive symptoms, perceived stigma and enacted stigma suggesting the substantially stable individual differences over time. The cross-lagged effects indicated a vicious circle among the three variables in an order of enacted stigma → depressive symptom → perceived stigma → enacted stigma. The possibility of employing equal constraints on cross-lagged paths suggested that the cross-lagged effects were repeatable over time. The dynamic interplay of enacted stigma, perceived stigma and depressive symptoms suggests the need of a multilevel intervention in stigma reduction programming to promote mental health of children affected by HIV/AIDS. PMID:24158487

  14. Understanding HIV-related stigma among Indonesian nurses.

    PubMed

    Waluyo, Agung; Culbert, Gabriel J; Levy, Judith; Norr, Kathleen F

    2015-01-01

    Evidence indicates widespread stigmatization of persons living with HIV (PLWH) in Indonesia. Such attitudes among health care workers could impede the country's policies for effective diagnosis and medical treatment of PLWH. Nonetheless, research to guide interventions to reduce stigma in health care settings is lacking. Also, the contributions of workplace, religion, and HIV knowledge to nurses' HIV-related stigma are poorly understood. Our cross-sectional study aimed to describe factors associated with nurses' stigmatizing attitudes toward PLWH. Four hundred nurses recruited from four hospitals in Jakarta, Indonesia, were surveyed using the Nurse AIDS Attitude Scale to measure stigma. Stigmatizing attitudes were significantly predicted by education, HIV training, perceived workplace stigma, religiosity, Islamic religious identification, and affiliation with the Islamic hospital. HIV knowledge was not a significant predictor of stigmatizing attitudes. Organization changes fostering workplace diversity are likely to substantially reduce stigmatizing attitudes in nurses. PMID:24759060

  15. Understanding HIV-related stigma among Indonesian nurses

    PubMed Central

    Waluyo, Agung; Culbert, Gabriel J.; Levy, Judith; Norr, Kathleen

    2014-01-01

    Evidence indicates widespread stigmatization of persons living with HIV (PLWH) in Indonesia. Such attitudes among health care workers could impede the country’s policies for effective diagnosis and medical treatment of PLWH. Nonetheless, research to guide interventions to reduce stigma in health care settings is lacking. Also, the contributions of workplace, religion, and HIV knowledge to nurses’ HIV-related stigma are poorly understood. Our cross-sectional study aimed to describe factors associated with nurses’ stigmatizing attitudes toward PLWH. Four hundred nurses recruited from 4 hospitals in Jakarta, Indonesia, were surveyed using the Nurse AIDS Attitude Scale (NAAS) to measure stigma. Stigmatizing attitudes were significantly predicted by education, HIV training, perceived workplace stigma, religiosity, Islamic religious identification, and affiliation with the Islamic hospital. HIV knowledge was not a significant predictor of stigmatizing attitudes. Organization changes fostering workplace diversity are likely to substantially reduce stigmatizing attitudes in nurses. PMID:24759060

  16. AIDS-Related Stigmas and Safe-Sex Practices of African-American College Students: A Pilot Study.

    ERIC Educational Resources Information Center

    Chandler, Donald S., Jr.

    This study examined the safe-sex practices of African-American colleges students in light of culturally-specific beliefs that stigmatize Acquired Immune Deficiency Syndrome (AIDS) in the African-American community. A total of 21 self-selected, sexually-active African-American students (15 females and 6 males) aged 18-22 completed the AIDS…

  17. Gender differences in HIV-related stigma in Kenya.

    PubMed

    Mugoya, George C T; Ernst, Kacey

    2014-02-01

    Stigma associated with HIV/AIDS directly and indirectly drives HIV transmission. We examined how factors associated with HIV-related stigma differed by gender, using data from the 2008-2009 Kenya Demographic and Health Survey (KDHS). Descriptive, bivariate and multinomial logistic regression analyses were conducted on selected HIV-related stigma indicators for men and women. Bivariate analyses showed significant gender differences in the overall HIV Stigma index with a higher proportion of women than men presented at the highest stigma level (4.9% vs 2.7%, p < 0.01). Women were more likely to express higher stigmatic attitudes for all components of stigma measured than men. Multivariate analyses showed that HIV-related knowledge had significant inverse dose-response for both men and women. For instance, compared to women in the first HIV-related knowledge quartile, a 1 unit increase in HIV-related knowledge among women at the third HIV-related knowledge quartile was expected to lead to a 63.8% decrease in HIV-related stigma (95% CI [0.21, 0.63]) for women with high stigma, 57.8% decrease for similar women with medium stigma (95% CI [0.33, 0.55]) and 28.4% decrease for those with low stigma (95% CI [0.57, 0.90]). Acceptance with the statement "a husband is justified to hit or beat his wife if she refuses to have sex with him" was a significant risk factor for expression of stigmatising attitudes at all levels for women (High: OR = 1.49, 95% CI [1.02, 2.17]), Medium: OR = 1.47, 95% CI [1.18, 1.82], Low: OR = 1.38, 95% CI [1.10, 1.73]) and men at medium stigma (OR = 2.02, 95% CI [1.38, 2.95]). Other notable gender differences were found in employment, marital status, ethnicity, region of residence, wealth and media exposure. Our results showed that women in the general Kenyan population had higher stigmatic attitudes than men. This was associated with differences in risk factor profile and confirmed previous literature on complexity of social-cultural factors

  18. Religion and HIV/AIDS stigma: Implications for health professionals in Puerto Rico

    PubMed Central

    Varas-Díaz, N.; Neilands, T.B.; Malavé Rivera, S.; Betancourt, E.

    2009-01-01

    HIV/AIDS stigma continues to be a barrier for prevention efforts. Its detrimental effects have been documented among people living with HIV/AIDS and encompass loss of social support and depression. When it is manifested by health professionals, it can lead to suboptimal services. Although strides have been made to document the effects of HIV/AIDS stigma, much needs to be done in order to understand the structural factors that can foster it. Such is the case of religion’s role on HIV/AIDS stigma in Puerto Rico. The Caribbean Island has a Judeo-Christian based culture due to years of Spanish colonisation. This religious influence continued under Protestantism as part of the Island’s integration as a non-incorporated territory of the USA. The main objective of this study was to explore the role of religion in HIV/AIDS stigma manifested by Puerto Rican health professionals in practice and in training. Through a mixed method approach, 501 health professionals completed qualitative interviews (n=80) and self-administered questionnaires (n=421). Results show that religion plays some role in conceptualisations of health and illness among participants in the study. Furthermore, the importance placed on religion and participation in such activities was related to higher levels of HIV/AIDS stigma. PMID:20087809

  19. Raising Awareness of HIV-Related Stigma and Its Associated Prejudice and Discrimination

    ERIC Educational Resources Information Center

    Francis, D.; Francis, E.

    2006-01-01

    HIV/AIDS will remain a problem for a long time. Many people with HIV/AIDS still live in fear of discovery because of the prevalent stigma and its associated prejudice and discrimination. This article examines how HIV-related stigma and its associated prejudice and discrimination can be addressed in a classroom--in the field of education. (Contains…

  20. An exploratory survey measuring stigma and discrimination experienced by people living with HIV/AIDS in South Africa: the People Living with HIV Stigma Index

    PubMed Central

    2014-01-01

    Background The continued presence of stigma and its persistence even in areas where HIV prevalence is high makes it an extraordinarily important, yet difficult, issue to eradicate. The study aimed to assess current and emerging HIV/AIDS stigma and discrimination trends in South Africa as experienced by people living with HIV/AIDS (PLHIV). Methods The PLHIV Stigma Index, a questionnaire that measures and detects changing trends in relation to stigma and discrimination experienced by PLHIV, was used as the survey tool. The study was conducted in 10 clinics in four provinces supported by the Foundation for Professional Development (FPD), with an interview total of 486 PLHIV. A cross-sectional design was implemented in the study, and both descriptive and inferential analysis was conducted on the data. Results Findings suggest that PLHIV in this population experience significant levels of stigma and discrimination that negatively impact on their health, working and family life, as well as their access to health services. Internalised stigma was prominent, with many participants blaming themselves for their status. Conclusion The findings can be used to develop and inform programmes and interventions to reduce stigma experienced by PLHIV. The current measures for dealing with stigma should be expanded to incorporate the issues related to health, education and discrimination experienced in the workplace, that were highlighted by the study. PMID:24461042

  1. HIV-related stigma among African-American youth in the Northeast and Southeast US.

    PubMed

    Kerr, Jelani C; Valois, Robert F; Diclemente, Ralph J; Fletcher, Faith; Carey, Michael P; Romer, Daniel; Vanable, Peter A; Farber, Naomi

    2014-06-01

    HIV-related stigma inhibits optimal HIV prevention and treatment among African-Americans. Regional differences in HIV/AIDS prevalence may be related to stigma among young African-Americans. Baseline data (N = 1,606) from an HIV prevention intervention were used to investigate regional differences in HIV-related stigma and knowledge among African-American adolescents in four midsized cities in the Northeastern and Southeastern US. Analyses indicated greater HIV-related stigma among adolescents from the Southeast relative to adolescents from the Northeast (F = 22.23; p < 0.0001). Linear regression indicated a negative relationship between HIV stigma and HIV knowledge (b = -0.65; p < 0.0001). Addressing HIV/AIDS in high prevalence locales should include efforts to reduce HIV-related stigma. PMID:24402690

  2. Levels and Functions of HIV/AIDS Stigma within the Iranian Community Living in the Sydney Metropolitan Area

    ERIC Educational Resources Information Center

    Hosseinzadeh, Hassan; Hossain, Syeda Zakia; Niknami, Shamsaddin

    2012-01-01

    Objective: This study examines the levels of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) related stigma among the Iranian population and the factors that contribute to the formation of stigma within the study population. Design: A quantitative research design was used in this research whereby participants completed…

  3. Emotional, physical and financial burdens of stigma against people living with HIV/AIDS in China

    PubMed Central

    Zhang, Chen; Li, Xiaoming; Liu, Yu; Qiao, Shan; Zhang, Liying; Zhou, Yuejiao; Shen, Zhiyong; Tang, Zhengzhu

    2016-01-01

    ABSTRACT Numerous researches have shown pernicious effects of stigma against people living with HIV/AIDS (PLWHA). However, no available studies have reported these negative effects including emotional, physical to financial burdens to PLWHA. In the current study, we aim to explore different types of stigma (e.g., perceived, internalized and enacted) and the relevant consequences among PLWHA in China. A cross-sectional study was conducted from 2012 to 2013 in the Guangxi Autonomous Region in China. The validated Berger HIV Stigma Scale was used to measure various types of stigma. We employed a series of linear, logistic and polytomous regression models to assess the association between stigma and different consequences while accounting for potential confounders for each specific model. Of the total sample, 2987 PLWHA provided valid responses with 63% being male and having an average age of 42.9 years. Perceived, internalized and enacted HIV stigma were prevalent among participants, and resulted in various burdens with different magnitudes in their life contexts. Specially, PLWHA who reported higher perceived and internalized stigma were more likely to be imposed on emotional and physical burdens (p < .05). People who reported higher enacted stigma had heavier financial burden compared to their peers (p < .05). Our findings revealed that devastating consequences of HIV-related stigma in China. The prevalent stigmatizing attitudes have pushed PLWHA to the fringes of society and affected them at multiple aspects in their life context. We call for tailored efforts to overcome stigma and discrimination against PLWHA. PMID:26886415

  4. Emotional, physical and financial burdens of stigma against people living with HIV/AIDS in China.

    PubMed

    Zhang, Chen; Li, Xiaoming; Liu, Yu; Qiao, Shan; Zhang, Liying; Zhou, Yuejiao; Shen, Zhiyong; Tang, Zhengzhu

    2016-01-01

    Numerous researches have shown pernicious effects of stigma against people living with HIV/AIDS (PLWHA). However, no available studies have reported these negative effects including emotional, physical to financial burdens to PLWHA. In the current study, we aim to explore different types of stigma (e.g., perceived, internalized and enacted) and the relevant consequences among PLWHA in China. A cross-sectional study was conducted from 2012 to 2013 in the Guangxi Autonomous Region in China. The validated Berger HIV Stigma Scale was used to measure various types of stigma. We employed a series of linear, logistic and polytomous regression models to assess the association between stigma and different consequences while accounting for potential confounders for each specific model. Of the total sample, 2987 PLWHA provided valid responses with 63% being male and having an average age of 42.9 years. Perceived, internalized and enacted HIV stigma were prevalent among participants, and resulted in various burdens with different magnitudes in their life contexts. Specially, PLWHA who reported higher perceived and internalized stigma were more likely to be imposed on emotional and physical burdens (p < .05). People who reported higher enacted stigma had heavier financial burden compared to their peers (p < .05). Our findings revealed that devastating consequences of HIV-related stigma in China. The prevalent stigmatizing attitudes have pushed PLWHA to the fringes of society and affected them at multiple aspects in their life context. We call for tailored efforts to overcome stigma and discrimination against PLWHA. PMID:26886415

  5. Coping with HIV-related stigma in five African countries.

    PubMed

    Makoae, Lucia N; Greeff, Minrie; Phetlhu, René D; Uys, Leana R; Naidoo, Joanne R; Kohi, Thecla W; Dlamini, Priscilla S; Chirwa, Maureen L; Holzemer, William L

    2008-01-01

    People living with HIV (PLWH) and their families are subjected to prejudice, discrimination, and hostility related to the stigmatization of AIDS. This report examines how PLWH cope with HIV-related stigma in the five southern African countries of Lesotho, Malawi, South Africa, Swaziland, and Tanzania. A descriptive qualitative research design was used to explore the experience of HIV-related stigma of PLWH and nurses in 2004. A total of 43 focus groups were conducted with 251 participants (114 nurses, 111 PLWH, and 26 volunteers). In describing incidents of stigma, respondents reported strategies used or observed to cope with those incidents. Nurse reports of coping strategies that they used as well as observed in HIV-infected patients were coded. Coping strategies used by PLWH in dealing with HIV-related stigma were coded. A total of 17 different self-care strategies were identified: restructuring, seeing oneself as OK, letting go, turning to God, hoping, changing behavior, keeping oneself active, using humor, joining a support or social group, disclosing one's HIV status, speaking to others with same problem, getting counseling, helping others to cope with the illness, educating others, learning from others, acquiring knowledge and understanding about the disease, and getting help from others. Coping appears to be self-taught and only modestly helpful in managing perceived stigma. PMID:18328964

  6. Perspectives on HIV/AIDS Stigma and Discrimination: Voices of Some Young People in Ghana

    ERIC Educational Resources Information Center

    Oduro, Georgina Yaa; Otsin, Mercy

    2013-01-01

    This paper examines Ghanaian young people's perceptions of the determinants of HIV- and AIDS-related stigma and discrimination, and how these perceptions may influence the de-stigmatisation process. Drawing on findings from an in-depth, multi-method qualitative study involving 104 school and street young people aged between 14 and 19 years,…

  7. Exploring diabetes type 1-related stigma

    PubMed Central

    Abdoli, Samereh; Abazari, Parvaneh; Mardanian, Leila

    2013-01-01

    Background: Empowerment of people with diabetes means integrating diabetes with identity. However, others’ stigmatization can influence it. Although diabetes is so prevalent among Iranians, there is little knowledge about diabetes-related stigma in Iran. The present study explored diabetes-related stigma in people living with type 1 diabetes in Isfahan. Materials and Methods: A conventional content analysis was used with in-depth interview with 26 people with and without diabetes from November 2011 to July 2012. Results: A person with type 1 diabetes was stigmatized as a miserable human (always sick and unable, death reminder, and intolerable burden), rejected marriage candidate (busy spouse, high-risk pregnant), and deprived of a normal life [prisoner of (to must), deprived of pleasure]. Although, young adults with diabetes undergo all aspects of the social diabetes-related stigma; in their opinion they were just deprived of a normal life Conclusion: It seems that in Isfahan, diabetes-related stigma is of great importance. In this way, conducting an appropriate intervention is necessary to improve the empowerment process in people with type 1 diabetes in order to reduce the stigma in the context. PMID:23983731

  8. Perceived discrimination and stigma toward children affected by HIV/AIDS and their HIV-positive caregivers in central Haiti.

    PubMed

    Surkan, Pamela J; Mukherjee, Joia S; Williams, David R; Eustache, Eddy; Louis, Ermaze; Jean-Paul, Thierry; Lambert, Wesler; Scanlan, Fiona C; Oswald, Catherine M; Fawzi, Mary Smith

    2010-07-01

    In many settings worldwide, HIV-positive individuals have experienced a significant level of stigma and discrimination. This discrimination may also impact other family members affected by the disease, including children. The aim of our study was to identify factors associated with stigma and/or discrimination among HIV-affected youth and their HIV-positive caregivers in central Haiti. Recruitment of HIV-positive patients with children aged 10-17 years was conducted in 2006-2007. Data on HIV-related stigma and/or discrimination were based on interviews with 451 youth and 292 caregivers. Thirty-two percent of caregivers reported that children were discriminated against because of HIV/AIDS. Commune of residence was associated with discrimination against children affected by HIV/AIDS and HIV-related stigma among HIV-positive caregivers, suggesting variability across communities. Multivariable regression models showed that lacking social support, being an orphan, and caregiver HIV-related stigma were associated with discrimination in HIV-affected children. Caregiver HIV-related stigma demonstrated a strong association with depressive symptoms. The results could inform strategies for potential interventions to reduce HIV-related stigma and discrimination. These may include increasing social and caregiver support of children affected by HIV, enhancing support of caregivers to reduce burden of depressive symptoms, and promoting reduction of HIV-related stigma and discrimination at the community-level. PMID:20635244

  9. Perceived discrimination and stigma toward children affected by HIV/AIDS and their HIV-positive caregivers in central Haiti

    PubMed Central

    Surkan, Pamela J.; Mukherjee, Joia S.; Williams, David R.; Eustache, Eddy; Louis, Ermaze; Jean-Paul, Thierry; Lambert, Wesler; Scanlan, Fiona C.; Oswald, Catherine M.; Fawzi, Mary C. Smith

    2010-01-01

    In many settings worldwide, HIV-positive individuals have experienced a significant level of stigma and discrimination. This discrimination may also impact other family members affected by the disease, including children. The aim of our study was to identify factors associated with stigma and/or discrimination among HIV-affected youth and their HIV-positive caregivers in central Haiti. Recruitment of HIV-positive patients with children aged 10–17 years was conducted in 2006–2007. Data on HIV-related stigma and/or discrimination were based on interviews with 451 youth and 292 caregivers. Thirty-two percent of caregivers reported that children were discriminated against because of HIV/AIDS. Commune of residence was associated with discrimination against children affected by HIV/AIDS and HIV-related stigma among HIV-positive caregivers, suggesting variability across communities. Multivariable regression models showed that lacking social support, being an orphan, and caregiver HIV-related stigma were associated with discrimination in HIV-affected children. Caregiver HIV-related stigma demonstrated a strong association with depressive symptoms. The results could inform strategies for potential interventions to reduce HIV-related stigma and discrimination. These may include increasing social and caregiver support of children affected by HIV, enhancing support of caregivers to reduce burden of depressive symptoms, and promoting reduction of HIV-related stigma and discrimination at the community-level. PMID:20635244

  10. Situating experiences of HIV-related stigma in Swaziland.

    PubMed

    Root, R

    2010-01-01

    With the world's highest antenatal HIV prevalence rate (39.2%), Swaziland has also been described as among the most stigmatising. Yet, only recently was an anti-HIV stigma and discrimination (S&D) platform included in the government's National Multisectoral HIV and AIDS Policy. This study draws on a medical anthropological project in rural Swaziland to examine experiences of stigma among people living with HIV/AIDS (PLWH). Qualitative methods included a semi-structured questionnaire and interviews (n=40) to identify patterns of stigma across three domains: verbal, physical and social. Key informant interviews (n=5) were conducted with health personnel and support group leaders. Descriptive statistics were situated within a thematic analysis of open-ended content. Among the findings, participants reported extensive HIV-related rumouring (36.4%) and pejorative name-calling (37.5%). Nearly one in five (18.2%) could no longer partake of family meals. Homesteads, which are an organising principle of Swazi life, were often markedly stigmatising environments. In contrast to documented discrimination in health care settings, the health centre emerged as a space where PLWH could share information and support. Given the UNAIDS call for national partners to 'know your epidemic' by tracking the prevalence of HIV-related S&D, results from this study suggested that unless 'knowing your epidemic' includes the lived experiences of HIV stigma that blister into discernible patterns, effectiveness of national initiatives is likely to be limited. Multidisciplinary and locale-specific studies are especially well suited in examining the cultural dynamics of HIV stigma and in providing grounded data that deepen the impact of comprehensive HIV/AIDS policies and programming. PMID:19787517

  11. AIDS Knowledge and HIV Stigma among Children Affected by HIV/AIDS in Rural China

    ERIC Educational Resources Information Center

    Zhao, Qun; Li, Xiaoming; Zhao, Guoxiang; Zhao, Junfeng; Fang, Xiaoyi; Lin, Xiuyun; Stanton, Bonita

    2011-01-01

    The current study was designed to assess the level of AIDS knowledge and its relationship with personal stigma toward people living with HIV/AIDS (PLWHA) among children living in communities of high HIV prevalence in rural China. The data were collected in 2009 from 118 orphanage orphans (children who had lost both of their parents to HIV and…

  12. Social Determinants of HIV-Related Stigma in Faith-Based Organizations

    PubMed Central

    Tate, Allan D.; Gaddist, Bambi; White, Jacob

    2016-01-01

    Objectives. To examine the association between social factors in faith-based settings (including religiosity and proximity to people living with HIV/AIDS) and HIV stigma. Methods. A total of 1747 congregants from primarily African American faith-based organizations of Project FAITH (Fostering AIDS Initiatives That Heal), a South Carolina statewide initiative to address HIV-related stigma, completed a survey. Results. Female gender (P = .001), higher education (P < .001), knowing someone with HIV/AIDS (P = .01), and knowing someone who is gay (P < .001), but not religiosity, were associated with lower levels of stigma and with lower odds of stigmatizing attitudes (P < .05). Conclusions. Opportunities for connection with people living with HIV/AIDS tailored to the social characteristics of faith-based organizations may address HIV stigma in African American communities. PMID:26794158

  13. Expressions of HIV-related stigma among rural-to-urban migrants in China.

    PubMed

    Hong, Yan; Li, Xiaoming; Stanton, Bonita; Fang, Xiaoyi; Lin, Danhua; Wang, Jing; Mao, Rong; Yang, Hongmei

    2008-10-01

    In China, HIV-related stigma is considered as a formidable barrier in the combat against the HIV epidemic. There have been few qualitative investigations on HIV-related stigma in China, especially among a vulnerable population of rural-to-urban migrants. Based on 90 in-depth interviews conducted in 2002-2003 with rural-to-urban migrants in Beijing and Nanjing, China, this study examines the forms and expressions of HIV-related stigma from migrants' perspectives regarding HIV infection and individuals at risk of HIV infection. Consistent with the general framework on stigma, Chinese rural-to-urban migrants' attitudes toward HIV infected individuals take forms of denial, indifference, labeling, separation, rejection, status loss, shame, hopelessness, and fear. These stigmatizing attitudes were mainly derived from fears of AIDS contagion and its negative consequences, fears of being associated with the diseases, and culturally relevant moral judgments. In addition to universal AIDS stigma, both traditional Chinese culture and socially marginalized position of rural migrant population have contributed to culturally unique aspects of stigmatizing attitudes among rural-to-urban migrants. These multifaceted manifestations of HIV-related stigma suggest that HIV stigma reduction intervention needs to address multiple aspects of HIV stigma and stigmatization including personal, cultural, institutional, and structural factors. PMID:18847389

  14. Expressions of HIV-Related Stigma among Rural-to-Urban Migrants in China

    PubMed Central

    Hong, Yan; Stanton, Bonita; Fang, Xiaoyi; Lin, Danhua; Wang, Jing; Mao, Rong; Yang, Hongmei

    2008-01-01

    Abstract In China, HIV-related stigma is considered as a formidable barrier in the combat against the HIV epidemic. There have been few qualitative investigations on HIV-related stigma in China, especially among a vulnerable population of rural-to-urban migrants. Based on 90 in-depth interviews conducted in 2002–2003 with rural-to-urban migrants in Beijing and Nanjing, China, this study examines the forms and expressions of HIV-related stigma from migrants' perspectives regarding HIV infection and individuals at risk of HIV infection. Consistent with the general framework on stigma, Chinese rural-to-urban migrants' attitudes toward HIV infected individuals take forms of denial, indifference, labeling, separation, rejection, status loss, shame, hopelessness, and fear. These stigmatizing attitudes were mainly derived from fears of AIDS contagion and its negative consequences, fears of being associated with the diseases, and culturally relevant moral judgments. In addition to universal AIDS stigma, both traditional Chinese culture and socially marginalized position of rural migrant population have contributed to culturally unique aspects of stigmatizing attitudes among rural-to-urban migrants. These multifaceted manifestations of HIV-related stigma suggest that HIV stigma reduction intervention needs to address multiple aspects of HIV stigma and stigmatization including personal, cultural, institutional, and structural factors. PMID:18847389

  15. The stigma of being named "AIDS carriers" on Haitian-American women.

    PubMed

    Santana, M A; Dancy, B L

    2000-01-01

    AIDS-related stigma has impacted the lives of many individuals, including Haitians. Little, however, is known about the long-term effects AIDS-stigmatization has had on Haitian women living in the United States. A pilot study was conducted to explore Haitian-American women's perceptions of the impact of the AIDS epidemic on their lives. The long-term effects of AIDS-stigmatization fell into five categories: rejection by the dominant society, self-doubt, effect on self-esteem, effect on intimate relationships, and rejection by Haitians within their community. More extensive research is needed to explore the long-term effects of the AIDS epidemic on Haitian women. Additionally, to counter the negative effects of the AIDS epidemic, intervention strategies need to be developed and tested. PMID:11111463

  16. Stigma, HIV and AIDS: An Exploration and Elaboration of the Illness Trajectory Surrounding HIV Infection and AIDS.

    ERIC Educational Resources Information Center

    Alonzo, Angelo A.; Reynolds, Nancy R.

    In this paper, human immunodeficiency virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) are analyzed in terms of stigma and illness trajectory. The primary purpose is to conceptualize how individuals with HIV/AIDS experience stigma and to demonstrate how these experiences are affected by the social and biophysical dimensions of the…

  17. Development of an instrument to measure internalized stigma in those with HIV/AIDS.

    PubMed

    Phillips, Kenneth D; Moneyham, Linda; Tavakoli, Abbas

    2011-01-01

    Stigma has grave consequences for persons living with HIV/AIDS. Stigma hampers prevention of HIV transmission to sexual partners and to unborn babies, diagnosis, and early treatment, and negatively affects mental and physical health, quality of life, and life satisfaction. Internalized stigma of HIV/AIDS may have even more severe consequences than perceived or enacted stigma. The purpose of this study was to develop an instrument to measure internalized stigma in those with HIV/AIDS. Data were drawn from the Rural Women's Health Project. Research assistants administered structured interviews at baseline, 3 months, and 6 months. Instruments used in these analyses included a demographic data form, the Centers for Epidemiological Studies Depression Scale (CES-D), the Perceived Stigma Scale (PSS), and the Internalized Stigma of AIDS Tool (ISAT). Exploratory factor analysis confirmed that the ten items of the ISAT measure a single factor that explains 88% of the variance in the construct. Internal consistency was demonstrated by a Cronbach's alpha of .91 (Time 1), .92 (Time 2), and .92 (Time 3). Convergent validity was supported with significant positive correlations with the CES-D (rho = 0.33, p < 0.0001) and the PSS (rho = 0.56, < 0.0001). The Internalized Stigma of AIDS Tool appears to be a reliable and valid instrument to measure internalization of the stigma of HIV/AIDS. It may be of value in research and clinical assessment. PMID:21692574

  18. Relative importance of various measures of HIV-related stigma in predicting psychological outcomes among children affected by HIV.

    PubMed

    Zhao, Guoxiang; Li, Xiaoming; Zhao, Junfeng; Zhang, Liying; Stanton, Bonita

    2012-06-01

    To assess the relative importance of four different measures of HIV-related stigma in predicting psychological problems among children affected by HIV in rural China. Cross-sectional data were collected from 755 orphans (i.e., children who lost one or both of their parents to HIV), 466 vulnerable children (children who were living with HIV-infected parents), and 404 comparison children who were from the same community and did not have HIV-related illness or death in their families. Four HIV-related stigma measures include perceived public stigma against people living with HIV/AIDS (PLWHA), perceived public stigma against children affected by HIV (orphans and vulnerable children), personal stigmatizing attitudes against PLWHA, and enacted stigma among children affected by HIV. Psychological problems included depression and adjustment problems. Various measures of HIV-related stigma independently and differentially contribute to children's psychological problems. Enacted stigma and children's perceived public stigma against PLWHA or children affected by HIV are generally stronger predictors of psychological problems than their own feelings or attitudes towards PLWHA. Various aspects of HIV-related stigma are important for us to understand the perception, attitudes, and experience of children affected by HIV, including both children experiencing HIV-related parental illness and death in their own family and children who were living in the communities hardly hit by HIV. Future health promotion and psychological care efforts for children affected by HIV need to consider the effect of various forms of HIV-related stigma on these children's psychosocial well-being and mobilize the community resources to mitigate the negative effect of HIV-related stigma on PLWHA and their children. PMID:21681458

  19. “MY MOTHER TOLD ME I MUST NOT COOK ANYMORE”—FOOD, CULTURE, AND THE CONTEXT OF HIV- AND AIDS-RELATED STIGMA IN THREE COMMUNITIES IN SOUTH AFRICA*

    PubMed Central

    OKOROR, T. A.; AIRHIHENBUWA, C. O.; ZUNGU, M.; MAKOFANI, D.; BROWN, D. C.; IWELUNMOR, J.

    2012-01-01

    The purpose of this study was to examine the role of food as an instrument in expressing and experiencing HIV/AIDS stigma by HIV-positive women and their families, with the goal of reducing discrimination. It goes beyond willingness to share utensils, which has been identified in HIV/AIDS research. As part of an ongoing capacity-building HIV/AIDS stigma project in South Africa, 25 focus groups and 15 key informant interviews were conducted among 195 women and 54 men in three Black communities. Participants were asked to discuss how they were treated in the family as women living with HIV and AIDS, and data was organized using the PEN-3 model. Findings highlight both the positive and negative experiences HIV-positive women encounter. Women would not disclose their HIV status to avoid being isolated from participating in the socio-cultural aspects of food preparation, while others that have disclosed their status have experienced alienation. The symbolic meanings of food should be a major consideration when addressing the elimination of HIV/AIDS stigma in South Africa. PMID:19095587

  20. The Blame Game: Stigma and HIV/AIDS in an African Metropolis

    PubMed Central

    Akande, WA; Tserere, MM; Adewuyi, MF; Akande, E Titilola; Adetoun, BE

    2011-01-01

    Background: The purpose of the present study was to explore further the cross-cultural validity, consistency, and replicability of FAIDSS among students when assessing HIV/AIDS-related stigma and fear of people living with HIV/AIDS (PLWHA) in Lagos metropolis. Methods: Using a purposive method, participants in Lagos Metropolis were surveyed using a questionnaire and conceptualization derived from the work of Ross and Hunter (1992) to measure a variety of HIV-related attitudinal and behavioural items. Quantitative data analyzed employing factor analysis using maximum-likelihood extraction followed by oblique rotation (direct oblimin, delta= 0). Results: On the factor scale measuring having fear of sex with a particular person, younger respondents especially females significantly more likely to report greater fear than for any other groups. Our findings further suggest that levels of fear of outsiders are high among males and need urgent action and intervention at both individual and societal levels. Conclusion: It is argued that messages and interventions must be targeted to promote a positive social environment for those living with or affected by HIV/AIDS, and to be useful in understanding stigma, fear and prejudice more fully and in reducing them. A crosscurrent behavioral change that can transform AIDS from an inevitably fatal pandemic to a chronic and manageable disease is the answer. PMID:23113052

  1. Is HIV/AIDS Stigma Dividing the Gay Community? Perceptions of HIV-Positive Men Who Have Sex with Men

    ERIC Educational Resources Information Center

    Courtenay-Quirk, Cari; Wolitski, Richard J.; Parsons, Jeffrey T.; Gomez, Cynthia A.

    2006-01-01

    Stigma surrounding HIV/AIDS has existed since the beginning of the epidemic, but little is known about HIV/AIDS stigma within the gay community and how it affects men who have sex with men (MSM) living with HIV. A better understanding of the effects of stigma on this population is needed to reduce it and its harmful effects. Our study used…

  2. The role of emotions in the reduction of HIV/AIDS stigma among physicians in training

    PubMed Central

    Varas-Díaz, Nelson; Neilands, Torsten B.; Rodríguez-Madera, Sheilla L.; Padilla, Mark

    2016-01-01

    Scientific literature has systematically documented the negative effects of social stigma for people living with HIV/AIDS (PLWHA). HIV/AIDS stigma has the potential to negatively impact self-care strategies for those already affected, and simultaneously hinder prevention efforts to deter the emergence of new infections. When health professionals manifest these negative attitudes access to quality health-care and prevention strategies can be seriously affected. Scientifically tested interventions to reduce HIV/AIDS stigma among health professionals are still scarce. Although the number of tested interventions has increased over the past decade, few of them target Latino health professionals or Spanish-speaking populations. Furthermore, although some of those interventions have been reported as effective for stigma reduction, more work is needed to better understand the underlying variables that account for the reduction of stigma attitudes in those efforts. The SPACES intervention has been documented as an effective HIV/AIDS stigma-reduction intervention focusing on health-care professionals in training. The intervention, which is delivered in Spanish, has been previously tested with medical students in Puerto Rico and shown significant results in addressing negative attitudes toward PLWHA. The main objective of this study was to document the underlying variables that fostered reduction of HIV/AIDS stigma due to participation in the SPACES intervention. Results evidence that health professionals in training who participated in the intervention (n = 507) had less stigmatizing attitudes toward PLWHA due to an increase in their positive emotions toward this population. In light of these results, we discuss the importance of engaging health professionals in HIV/AIDS stigma-reduction interventions that go beyond the provision of information and skills for interacting with PLWHA, and address the emotional component of HIV/AIDS stigma. PMID:26444133

  3. Stigma of People with HIV/AIDS in Sub-Saharan Africa: A Literature Review

    PubMed Central

    Mbonu, Ngozi C.; van den Borne, Bart; De Vries, Nanne K.

    2009-01-01

    The aim of this literature review is to elucidate what is known about HIV/AIDS and stigma in Sub-Saharan Africa. Literature about HIV/AIDS and stigma in Sub-Saharan Africa was systematically searched in Pubmed, Medscape, and Psycinfo up to March 31, 2009. No starting date limit was specified. The material was analyzed using Gilmore and Somerville's (1994) four processes of stigmatizing responses: the definition of the problem HIV/AIDS, identification of people living with HIV/AIDS (PLWHA), linking HIV/AIDS to immorality and other negative characteristics, and finally behavioural consequences of stigma (distancing, isolation, discrimination in care). It was found that the cultural construction of HIV/AIDS, based on beliefs about contamination, sexuality, and religion, plays a crucial role and contributes to the strength of distancing reactions and discrimination in society. Stigma prevents the delivery of effective social and medical care (including taking antiretroviral therapy) and also enhances the number of HIV infections. More qualitative studies on HIV/AIDS stigma including stigma in health care institutions in Sub-Saharan Africa are recommended. PMID:20309417

  4. Religion and HIV/AIDS Stigma: Considerations for the Nursing Profession

    PubMed Central

    Reyes-Estrada, Marcos; Varas-Díaz, Nelson; Martínez-Sarson, Miluska T.

    2016-01-01

    Nurses’ stigmatization of people living with HIV/AIDS hinders effective health care provisions for this sector of the population. Scientific literature on HIV/AIDS stigma has emphasized cognitive, individual, and interpersonal factors that are relevant to the understanding of the stigmatization process among health care professionals (e.g. a health care professional’s accuracy in knowledge of the workings of the virus, effectiveness of emotion management, degree of proximity to the stigmatized group, etc.). However, researchers have also examined the socio-structural factors underlying stigma, and religion has consequently emerged as a social phenomenon that may foster it. The role of religion among professional nurses who specifically service people living with HIV/AIDS remains understudied. Focusing on evidence-based literature, we discuss the relationship between religion and HIV/AIDS stigma, explore potential implications of this relationship for the nursing profession, and make recommendations for stigma-reducing interventions. PMID:26858806

  5. HIV-related stigma among African, Caribbean, and Black youth in Windsor, Ontario.

    PubMed

    Mihan, Robert; Kerr, Jelani; Maticka-Tyndale, Eleanor

    2016-01-01

    HIV-related stigma has been shown to undermine prevention, care, treatment, and the well-being of people living with HIV. A disproportion burden of HIV infection, as well as elevated levels of HIV-related stigma, is evidenced in sub-Saharan African (SSA) and African-diasporic populations. This study explores factors that influence HIV-related stigma among 16- to 25-year-old youth residing in a Canadian city who identify as African, Caribbean, or Black. Stigma, as rooted in cultural norms and beliefs and related social institutions, combined with insights from research on stigma in SSA and African-diasporic populations, guided the development of a path analytic structural equation model predicting levels of HIV-related stigmatizing attitudes. The model was tested using survey responses of 510 youth to estimate the direct and indirect influences of ethno-religious identity, religious service attendance, time in Canada, HIV/AIDS knowledge, HIV-testing history, sexual health service contact, and gender on HIV-related stigma. Statistically significant negative associations were found between levels of stigma and knowledge and HIV-testing history. Ethno-religious identity and gender had both direct and indirect effects on stigma. African-Muslim participants had higher levels of stigma, lower knowledge, and were less likely to have been tested for HIV infection than other ethno-religious groups. Male participants had higher levels of stigma and lower knowledge than women. Time in Canada had only indirect effects on stigma, with participants in Canada for longer periods having higher knowledge and less likely to have been tested than more recent arrivals. While the strength of the effect of knowledge on stigmatizing attitudes in this research is consistent with other research on stigma and evaluations of stigma-reduction programs, the path analytic results provide additional information about how knowledge and HIV-testing function as mediators of non

  6. Perception of Patients With HIV/AIDS From Stigma and Discrimination

    PubMed Central

    Saki, Mandana; Mohammad Khan Kermanshahi, Sima; Mohammadi, Eesa; Mohraz, Minoo

    2015-01-01

    Background: Stigma and discrimination among patients with HIV/AIDS cause various problems for the patients and their health systems. Objectives: The purpose of this study was to explain the perceived experiences of the patients from stigma and discrimination and their roles on health-seeking services among patients. Patients and Methods: This was a qualitative research using content analysis approach and semi-structured interviews, conducted on patients living with HIV/ADS, during 2013 - 2014 in Iran. Sampling started purposefully and continued in a snowball. Results: The experiences of patients with HIV/AIDS from stigma and discrimination led to exploring three main themes and nine subthemes. The main themes were multidimensional stigma, rejection, and insult and discrimination in receiving health services. Conclusions: Stigma and discrimination play an important role in patients' lives and hinder them from accessing the treatment. The patients' responses to this event by secrecy strategy can be an important factor in the disease prevalence. PMID:26290751

  7. Exploring the Concept of HIV-Related Stigma

    PubMed Central

    Florom-Smith, Aubrey L.; De Santis, Joseph P.

    2013-01-01

    BACKGROUND HIV infection is a chronic, manageable illness. Despite advances in the care and treatment of people living with HIV infection, HIV-related stigma remains a challenge to HIV testing, care, and prevention. Numerous studies have documented the impact of HIV-related stigma among various groups of people living with HIV infection, but the concept of HIV-related stigma remains unclear. PURPOSE Concept exploration of HIV-related stigma via an integrative literature review was conducted in order to examine the existing knowledge base of this concept. METHODS Search engines were employed to review the existing knowledge base of this concept. CONCLUSION After the integrative literature review, an analysis of HIV-related stigma emerged. Implications for future concept analysis, research, and practice are included. PMID:22861652

  8. Measuring HIV-related stigma among Chinese service providers: confirmatory factor analysis of a multidimensional scale.

    PubMed

    Stein, Judith A; Li, Li

    2008-09-01

    An HIV-related stigma scale for health care workers needs to be multidimensional in that it should encompass attitudes that might be experienced by the general public about people living with HIV/AIDS (PLWHA) (e.g., fear, shame, blame) and, further, specifically capture perceptions of appropriate professional care and medical responsibilities regarding PLWHA. A 17-item, 5-factor multidimensional HIV-related stigma scale was developed and validated using both exploratory and confirmatory factor analysis among 1,101 service providers in China. The sample was divided into a development sample (N = 551) and a validation sample (N = 550). The fit of the final confirmatory factor model with five hypothesized subscales was excellent in both samples. The final stigma subscales included: Discrimination Intent at Work, Opinion about Health Care for HIV/AIDS Patients, Prejudiced Attitudes, Internalized Shame, and Fear of PLWHA. PMID:18064554

  9. Socio-economic status and HIV/AIDS stigma in Tanzania.

    PubMed

    Amuri, Mbaraka; Mitchell, Steve; Cockcroft, Anne; Andersson, Neil

    2011-03-01

    Tanzania has a generalised AIDS epidemic but the estimated adult HIV prevalence of 6% is much lower than in many countries in Southern Africa. HIV infection rates are reportedly higher in urban areas, among women and among those with more education. Stigma has been found to be more common in poorer, less-educated people, and those in rural areas. We examined associations between poverty and other variables and a stigmatising attitude (belief that HIV/AIDS is punishment for sinning). The variables we examined in a multivariate model included: food sufficiency (as an indicator of poverty), age, sex, marital status, education, experience of intimate partner violence, condom-related choice disability, discussion about HIV/AIDS, sources of information about HIV/AIDS and urban or rural residence. Of the 1,130 men and 1,803 women interviewed, more than half (58%) did not disagree that "HIV/AIDS is punishment for sinning". Taking other variables into account, people from the poorest households (without enough food in the last week) were more likely to believe HIV/AIDS is punishment for sinning (Odds Ratio [OR] 1.29, 95% confidence intervals [CI] 1.06-1.59). Others factors independently associated with this stigmatising attitude were: having less than primary education (OR 1.29, 95% CI 1.03-1.62); having experienced intimate partner violence in the last year (OR 1.40, 95% CI 1.12-1.75); being choice disabled for condom use (OR 1.36, 95% CI 1.08-1.71); and living in rural areas (OR 1.76, 95% CI 1.06-2.90). The level of HIV and AIDS stigma in Tanzania is high with independent associations with several disadvantages: poverty, less education and living in rural areas. Other vulnerable groups, such as survivors of intimate partner violence, are also more likely to have a stigmatising attitude. HIV prevention programmes should take account of stigma, especially among the disadvantaged, and take care not to increase it. PMID:21347901

  10. Generalizing a model of health behaviour change and AIDS stigma for use with sexually transmitted infection clinic patients in Cape Town, South Africa.

    PubMed

    Kalichman, Seth C; Simbayi, Leickness C; Cain, Demetria; Jooste, Sean; Skinner, Donald; Cherry, Charsey

    2006-04-01

    We tested the Information-Motivation-Behavioural Skills (IMB) model of AIDS preventive behaviour in South Africa. Prospective path analyses were performed on measures collected from 131 men and 60 women with sexually transmitted infections (STI) in Cape Town. Results showed that IMB constructs collected at baseline predicted risk reduction behaviour 3 months later. Risk reduction intentions were positively associated with risk reduction self-efficacy and self-efficacy was in turn positively associated with protective behaviour 3 months later. In a second model, AIDS-related stigmas correlated inversely with AIDS knowledge and there was a trend toward AIDS stigmas correlating inversely with behavioural intentions. Accounting for AIDS-related stigmas did not improve model fit. These findings parallel similar tests of the IMB model in US samples and suggest that the IMB model may generalize to South Africa and may therefore be useful in guiding HIV risk reduction interventions. PMID:16546776

  11. Children's attitudes toward people with AIDS in Puerto Rico: exploring stigma through drawings and stories.

    PubMed

    González-Rivera, Milagritos; Bauermeister, José A

    2007-02-01

    AIDS stigma refers to prejudice and discrimination directed at people or groups perceived to have HIV/AIDS (Herek, 1999). Although AIDS stigma has been found in adolescent and adult populations, few researchers have explored it among children. Misconceptions about people with AIDS (PWA) might lead to negative attitudes toward PWA and obstruct HIV prevention efforts. The authors assessed 110 Puerto Rican children's attitudes toward PWA using drawings (n=65) and stories (n=45). Although participants held stigmatizing attitudes toward PWA across both methods, the approaches captured different beliefs and attitudes. Drawings depicted PWA as physically deteriorated and performing socially condemned behaviors, whereas stories describing PWA highlighted children's fear of contagion and death. Stigma toward PWA was more pronounced than toward other illnesses (e.g., cancer). The study highlights the importance of assessing children's attitudes through creative data collection procedures. PMID:17220395

  12. Impact of Asha Intervention on Stigma among Rural Indian Women with AIDS

    PubMed Central

    Nyamathi, Adeline; Ekstrand, Maria; Salem, Benissa; Sinha, Sanjeev; Ganguly, Kalyan; Leake, Barbara; Marfisee, Mary

    2013-01-01

    Rural women living with HIV/AIDS (WLA) in India face multifarious challenges which affect access to antiretroviral regimens and management of HIV/AIDS. The purpose of this pilot study, using cluster randomization, is to compare the effectiveness of the Asha-Life (AL) intervention, delivered by HIV-trained village woman, Asha (Accredited Social Health Activist), with a Usual Care (UC) group on reduction of internalized stigma and avoidant coping among 68 women living with AIDS (WLA) in rural India over a six-month period. The findings demonstrated that participation in the AL intervention was associated with significant reductions in internalized stigma and the use of avoidant coping strategies at follow-up. The findings of our study are promising in terms of the role rural village women (Asha) may play in reducing internalized stigma and avoidant coping in the lives of rural women living with AIDS in India. PMID:23539322

  13. Cumulative risk and AIDS-orphanhood: interactions of stigma, bullying and poverty on child mental health in South Africa.

    PubMed

    Cluver, Lucie; Orkin, Mark

    2009-10-01

    Research shows that AIDS-orphaned children are more likely to experience clinical-range psychological problems. Little is known about possible interactions between factors mediating these high distress levels. We assessed how food insecurity, bullying, and AIDS-related stigma interacted with each other and with likelihood of experiencing clinical-range disorder. In South Africa, 1025 adolescents completed standardised measures of depression, anxiety and post-traumatic stress. 52 potential mediators were measured, including AIDS-orphanhood status. Logistic regressions and hierarchical log-linear modelling were used to identify interactions among significant risk factors. Food insecurity, stigma and bullying all independently increased likelihood of disorder. Poverty and stigma were found to interact strongly, and with both present, likelihood of disorder rose from 19% to 83%. Similarly, bullying interacted with AIDS-orphanhood status, and with both present, likelihood of disorder rose from 12% to 76%. Approaches to alleviating psychological distress amongst AIDS-affected children must address cumulative risk effects. PMID:19713022

  14. Understanding and mitigating HIV-related resource-based stigma in the era of antiretroviral therapy.

    PubMed

    Holmes, Kathleen; Winskell, Kate

    2013-01-01

    The perception in low-resource settings that investment of resources in people living with HIV (PLHIV) is wasted because AIDS is both an incurable and deadly disease is known as resource-based stigma. In this paper, we draw on in-depth interviews (IDI), focus group discussions (FGD), and key informant interviews (KII) with 77 HIV-positive microfinance participants and nongovernmental organization leaders to examine resource-based stigma in the context of increased access to antiretroviral therapy (ART) at an individual, household, and community level in Côte d'Ivoire. The purpose of this exploratory paper is to examine: (1) resource-based stigmatization in the era of ART and (2) the relationship among microfinance, a poverty-reduction intervention, and HIV stigmatization. The frequency with which resource-based stigma was discussed by respondents suggests that it is an important component of HIV-related stigma in this setting. It affected PLHIV's access to material as well as social resources, leading to economic discrimination and social devaluation. Participation in village savings and loans groups, however, mitigated resource-based HIV stigma, suggesting that in the era of increased access to antiretroviral therapy, economic programs should be considered as one possible HIV stigma-reduction intervention. PMID:23394104

  15. Reducing HIV-related stigma among health-care professionals: a game-based experiential approach.

    PubMed

    Mak, Winnie W S; Cheng, Shannon S Y; Law, Rita W; Cheng, Winnie W L; Chan, Fei

    2015-01-01

    Stigmatizing attitudes from health professionals toward people living with HIV (PLHIV) constitute a key barrier to HIV care. Despite considerable progress in HIV stigma-reduction research, we are still searching for effective strategies that can be implemented on a larger scale. To narrow this research gap, the present study investigated a novel cost-effective approach to reducing HIV-related stigma among health professionals. Interactive experiential games were used to help participants gain first-hand experience of potential stressors that PLHIV might encounter. The effectiveness of this game-based experiential approach was compared with that of in vivo contact in reducing HIV-related stigma among students in the health-care fields. Eighty-eight students of health-related programs in Hong Kong were randomly assigned to either the game-based or in vivo contact program. They completed measures of stigmatizing attitudes and HIV/AIDS-related knowledge at pre-program, post-program, and one-month follow-up. Findings showed that the effectiveness of the game-based experiential approach in reducing HIV-related stigma was similar to that of in vivo contact both at post-program and one-month follow-up. Further research is needed to explore the potential value of the game-based approach in reducing HIV stigma among health professionals. PMID:25671591

  16. Validation of the HIV/AIDS Stigma Instrument - PLWA (HASI-P).

    PubMed

    Holzemer, William L; Uys, Leana R; Chirwa, Maureen L; Greeff, Minrie; Makoae, Lucia N; Kohi, Thecla W; Dlamini, Priscilla S; Stewart, Anita L; Mullan, Joseph; Phetlhu, René D; Wantland, Dean; Durrheim, Kevin

    2007-09-01

    This article describes the development and testing of a quantitative measure of HIV/AIDS stigma as experienced by people living with HIV/AIDS. This instrument is designed to measure perceived stigma, create a baseline from which to measure changes in stigma over time, and track potential progress towards reducing stigma. It was developed in three phases from 2003-2006: generating items based on results of focus group discussions; pilot testing and reducing the original list of items; and validating the instrument. Data for all phases were collected from five African countries: Lesotho, Malawi, South Africa, Swaziland and Tanzania. The instrument was validated with a sample of 1,477 persons living with HIV/AIDS from all of the five countries. The sample had a mean age of 36.1 years and 74.1% was female. The participants reported they knew they were HIV positive for an average of 3.4 years and 46% of the sample was taking antiretroviral medications. A six factor solution with 33 items explained 60.72% of the variance. Scale alpha reliabilities were examined and items that did not contribute to scale reliability were dropped. The factors included: Verbal Abuse (8 items, alpha=0.886); Negative Self-Perception (5 items, alpha=0.906); Health Care Neglect (7 items, alpha=0.832); Social Isolation (5 items, alpha=0.890); Fear of Contagion (6 items, alpha=0.795); and Workplace Stigma (2 items, alpha=0.758). This article reports on the development and validation of a new measure of stigma, HIV/AIDS Stigma Instrument - PLWA (HASI-P) providing evidence that supports adequate content and construct validity, modest concurrent validity, and acceptable internal consistency reliability for each of the six subscales and total score. The scale is available is several African languages. PMID:17851997

  17. HIV/AIDS and the gendering of stigma in Tamil Nadu, South India.

    PubMed

    Van Hollen, Cecilia

    2010-12-01

    Drawing on the seminal theoretical work on stigma by Goffman, this article analyzes stigma through the lens of Parker and Aggleton, who call for the joining of Goffman and Foucault to better grasp relationships among stigma, power and social inequality. Studies on the social impact of HIV/AIDS globally have demonstrated that women tend to be blamed for the spread of HIV/AIDS, and as a result, HIV-positive women face greater stigma and discrimination than HIV-positive men. Based on ethnographic research among 50 HIV-positive women in South India in 2002-2003 and 2004, my research supports this standard argument. However, my findings suggest that the gendering of stigma and discrimination is more complex and context specific. The gendering of stigma varies depending on the social context of private versus public spheres. The tendency to stigmatize women is due in part to cultural constructions of gendered bodies and not only to a gendered double standard of sexual morality, as has been previously reported. Even when a cultural argument about women's wayward sexuality is evoked, this rhetoric must be understood in part as a strategy to mask economically motivated responses, rather simply being attributed to sexist ideology per se. PMID:20842521

  18. Stigma, social reciprocity and exclusion of HIV/AIDS patients with illicit drug histories: A study of Thai nurses' attitudes

    PubMed Central

    Chan, Kit Yee; Stoové, Mark A; Reidpath, Daniel D

    2008-01-01

    Background Stigma is a key barrier for the delivery of care to patients living with HIV/AIDS (PLWHA). In the Asia region, the HIV/AIDS epidemic has disproportionately affected socially marginalised groups, in particular, injecting drug users. The effect of the stigmatising attitudes towards injecting drug users on perceptions of PLWHA within the health care contexts has not been thoroughly explored, and typically neglected in terms of stigma intervention. Methods Semi-structured interviews were conducted with a group of twenty Thai trainee and qualified nurses. Drawing upon the idea of 'social reciprocity', this paper examines the constructions of injecting drug users and PLWHA by a group of Thai nurses. Narratives were explored with a focus on how participants' views concerning the high-risk behaviour of injecting drug use might influence their attitudes towards PLWHA. Results The analysis shows that active efforts were made by participants to separate their views of patients living with HIV/AIDS from injecting drug users. While the former were depicted as patients worthy of social support and inclusion, the latter were excluded on the basis that they were perceived as irresponsible 'social cheaters' who pose severe social and economic harm to the community. Absent in the narratives were references to wider socio-political and epidemiological factors related to drug use and needle sharing that expose injecting drug users to risk; these behaviours were constructed as individual choices, allowing HIV positive drug users to be blamed for their seropositive status. These attitudes could potentially have indirect negative implications on the nurses' opinions of patients living with HIV/AIDS more generally. Conclusion Decreasing the stigma associated with illicit drugs might play crucial role in improving attitudes towards patients living with HIV/AIDS. Providing health workers with a broader understanding of risk behaviours and redirecting government injecting drug

  19. Stigma- and non-stigma-related treatment barriers to mental healthcare reported by service users and caregivers.

    PubMed

    Dockery, Lisa; Jeffery, Debra; Schauman, Oliver; Williams, Paul; Farrelly, Simone; Bonnington, Oliver; Gabbidon, Jheanell; Lassman, Francesca; Szmukler, George; Thornicroft, Graham; Clement, Sarah

    2015-08-30

    Delayed treatment seeking for people experiencing symptoms of mental illness is common despite available mental healthcare. Poor outcomes are associated with untreated mental illness and caregivers may eventually need to seek help on the service user's behalf. More attention has recently focused on the role of stigma in delayed treatment seeking. This study aimed to establish the frequency of stigma- and non-stigma-related treatment barriers reported by 202 service users and 80 caregivers; to compare treatment barriers reported by service users and caregivers; and to investigate demographic predictors of reporting stigma-related treatment barriers. The profile of treatment barriers differed between service users and caregivers. Service users were more likely to report stigma-related treatment barriers than caregivers across all stigma-related items. Service users who were female, had a diagnosis of schizophrenia or with GCSEs (UK qualifications usually obtained at age 16) were significantly more likely to report stigma-related treatment barriers. Caregivers who were female or of Black ethnicities were significantly more likely to report stigma-related treatment barriers. Multifaceted approaches are needed to reduce barriers to treatment seeking for both service users and caregivers, with anti-stigma interventions being of particular importance for the former group. PMID:26115840

  20. Actor and partner effects of perceived HIV stigma on social network components among people living with HIV/AIDS and their caregivers

    PubMed Central

    Hao, Chun; Liu, Hongjie

    2014-01-01

    Background Few studies have investigated the relationship between HIV stigma and social network components at the dyadic level. The objective of this study was to examine the actor and partner effects of perceived HIV stigma by people living with HIV/AIDS (PLWHAs) and their caregivers on social network variables at the dyadic level. Method An egocentric social network study was conducted among 147 dyads consisting of one PLWHA and one caregiver (294 participants) in Nanning, China. The actor-partner interdependence model (APIM) was used to analyze the relationships between perceived HIV stigma and social network components (network relations, network structures, and network functions) at the dyadic level. Results We found in this dyadic analysis that: (1) social network components were similar between PLWHAs and their caregivers; (2) HIV stigma perceived by PLWHAs influenced their own social network components, whereas this influence did not exist between caregivers' perceived HIV stigma and their own social network components; (3) a few significant partner effects were observed between HIV stigma and social network components among both PLWHAs and caregivers. Conclusion The interrelationships between HIV stigma and social network components were complex at the dyadic level. Future interventions programs targeting HIV stigma should focus on the interpersonal relationship at the dyadic level, beyond the intrapersonal factors. PMID:25085478

  1. HIV-related stigma: Impact on healthcare workers in Vietnam.

    PubMed

    Ha, Pham Nguyen; Chuc, Nguyen Thi Kim; Hien, Ho Thi; Larsson, Mattias; Pharris, Anastasia

    2013-01-01

    Stigma has been identified as a major barrier to HIV response. While much is known about stigma directed towards people living with HIV (PLHIV), less is known about stigma experienced by health workers who treat PLHIV. This study aims to explore the perceptions and experiences of health workers regarding how stigma influences their work with HIV-positive patients. The study employed a qualitative design involving individual semi-structured in-depth interviews with 14 health workers, purposively selected from hospitals and detention centres for people who use drugs and sex workers in Hanoi, Vietnam. Findings showed that the stigma experienced by health workers may be organised around several themes: (1) lack of social prestige associated with HIV work; (2) fear of infection expressed by family members; (3) feelings of being devalued within the healthcare field; and (4) work-related stress and burnout, especially for staff working in detention centres for drug users and female sex workers. Efforts are needed to improve the public image of HIV work, scale up stigma reduction, enhance stress management and create a safe and supportive working environment for health workers. PMID:23738991

  2. HIV/AIDS knowledge and stigma among women of reproductive age in Ethiopia.

    PubMed

    Gurmu, Eshetu; Etana, Dula

    2015-01-01

    HIV/AIDS stigma is one of the major public health challenges in Ethiopia. This study examined knowledge about HIV/AIDS and factors behind stigmatisation towards people living with the virus based on demographic and health survey data collected in 2011 from women in the age group 15-49 years. The result shows that 49.3% of rural women had adequate knowledge about HIV/AIDS compared with 74.7% of urban women. About three-fourths (72.1%) of the rural women had stigmatising attitudes towards PLWHA whilst the proportion in urban areas was only about a third (34.2%). The likelihood of having adequate knowledge about HIV/AIDS was significantly higher among educated women but lower among those living in Afar, Somali, and Gambella regions and Dire Dawa City. Women with higher levels of education and frequent access to media had a lower tendency to stigmatise people living with the virus. Adequate knowledge about HIV/AIDS was also significantly associated with lower likelihood of stigmatisation. The results generally indicate that HIV/AIDS stigma in Ethiopia is partly explained by people's knowledge about HIV/AIDS and by socio-cultural factors that shape their perception of the epidemic. Awareness-raising efforts should thus consider the socio-cultural contexts in which stigma occurs to tackle discrimination against people living with HIV/AIDS. PMID:26285101

  3. Validation of 2 Spanish-Language Scales to Assess HIV-Related Stigma in Communities.

    PubMed

    Franke, Molly F; Nelson, Adrianne K; Muñoz, Maribel; Cruz, Janeth Santa; Atwood, Sidney; Lecca, Leonid; Shin, Sonya S

    2015-01-01

    We report the psychometric properties of 2 Spanish-language scales designed to measure (1) opinions about HIV in the community and particularly among health care workers and (2) observed acts of stigma toward people living with HIV/AIDS (PLWHA) by health care workers. The Opinions about HIV Scale included 3 components (policy, avoidance, and empathy) and 9 items, while an adapted version of the HIV/AIDS Stigma Instrument-Nurse, designed to capture acts of stigma, included 2 components (discrimination related to clinical care and refusal to share or exchange food/gifts). Scales demonstrated good reliability and construct validity. Relative to community health workers, treatment supporters were more likely to have stigmatizing opinions related to avoidance and empathy. We offer 2 Spanish-language scales that could be used to identify populations with high levels of stigmatizing opinions and behaviors toward PLWHA. Formal training of health care workers, especially treatment supporters, may raise awareness and reduce stigma toward HIV. PMID:25294853

  4. HIV/AIDS stigma at the workplace: exploratory findings from Pakistan.

    PubMed

    Bashir, Sajid

    2011-01-01

    People living with HIV/AIDS (PLHA) are stigmatised socially. They are devalued and considered like outcasts by having lesser opportunities for education, treatment and housing, and in an organisational context they get reduced opportunities of selection, promotion and income. The phenomena have been extensively researched in developed countries but limited literature addresses the situation in underdeveloped countries like Pakistan, which is also facing spread of the HIV/AIDS epidemic. There are a number of groups who are carrying the disease but the problems being faced by PLHA employed in different organisations have rarely been analysed. Stigma at the workplace can generate a number of negative outcomes. The present study considers two such outcomes among stigmatised PLHA. These outcomes are organisational cynicism and breach of psychological contract. A questionnaire was used to collect data from a sample of 174 PLHA, having a work experience after identification of the epidemic, working in different organisations across Pakistan. These PLHA were identified and recruited through a scattered record available with some government/non-government organisations operating in Pakistan to control HIV/AIDS. Findings of the study extend the knowledge about HIV/AIDS stigma indicating that PLHA are subjected to stigma, which is significantly associated with a breach of psychological contract and organisational cynicism. There is a need at governmental and organisational level as well to increase awareness about the disease and formulate policies to reduce stigma against PLHA working in different organisations. PMID:23237730

  5. 'Face' and the embodiment of stigma in China: the cases of schizophrenia and AIDS.

    PubMed

    Yang, Lawrence Hsin; Kleinman, Arthur

    2008-08-01

    The majority of theoretical models have defined stigma as occurring psychologically and limit its negative effects to individual processes. This paper, via an analysis of how 'face' is embodied in China, deepens an articulation of how the social aspects of stigma might incorporate the moral standing of both individual and collective actors defined within a local context. We illustrate (1) how one's moral standing is lodged within a local social world; (2) how one's status as a 'moral' community member is contingent upon upholding intrapersonal and social-transactional obligations; and (3) how loss of face and fears of moral contamination might lead to a 'social death'. We first draw from Chinese ethnographies that describe the process of human cultivation before one can achieve fully 'moral' status in society. We integrate findings from empirical studies describing how social-exchange networks in China are strictly organized based on the reciprocation of favors, moral positioning, and 'face'. We further ground these Chinese constructs within a theoretical framework of different forms of capital, and discuss the severe social consequences that loss of face entails. By utilizing the examples of schizophrenia and AIDS to illustrate how loss of moral standing and stigma is interwoven in China, we propose a model highlighting changes in moral status to describe how stigma operates. We suggest that symbolic restoration of moral status for stigmatized groups takes place as local-level stigma interventions. By analyzing the moral aspects of 'face', we propose that across cultures, stigma is embedded in the moral experience of participants, whereby stigma is conceived as a fundamentally moral issue: stigmatized conditions threaten what matters most for those in a local world. We further propose that stigma jeopardizes an actor's ability to mobilize social capital to attain essential social statuses. PMID:18420325

  6. ‘Face’ and the Embodiment of Stigma in China: The Cases of Schizophrenia and AIDS

    PubMed Central

    Yang, Lawrence Hsin; Kleinman, Arthur

    2008-01-01

    The majority of theoretical models have defined stigma as occurring psychologically and limit its negative effects to individual processes. This paper, via an analysis of how ‘face’ is embodied in China, deepens an articulation of how the social aspects of stigma might incorporate the moral standing of both individual and collective actors defined within a local context. We illustrate: 1) how one’s moral standing is lodged within a local social world; 2) how one’s status as a ‘moral’ community member is contingent upon upholding intrapersonal and social-transactional obligations; and 3) how loss of face and fears of moral contamination might lead to a ‘social death’. We first draw from Chinese ethnographies that describe the process of human cultivation before one can achieve fully ‘moral’ status in society. We integrate findings from empirical studies describing how social exchange networks in China are strictly organized based on the reciprocation of favors, moral positioning, and ‘face’. We further ground these Chinese constructs within a theoretical framework of different forms of capital, and discuss the severe social consequences that loss of face entails. By utilizing the examples of schizophrenia and AIDS to illustrate how loss of moral standing and stigma are interwoven in China, we propose a model highlighting changes in moral status to describe how stigma operates. We suggest that symbolic restoration of moral status for stigmatized groups takes place as local-level stigma interventions. By analyzing the moral aspects of ‘face’, we propose that across cultures, stigma is embedded in the moral experience of participants, whereby stigma is conceived as a fundamentally moral issue: stigmatized conditions threaten what matters most for those in a local world. We further propose that stigma jeopardizes an actor’s ability to mobilize social capital to attain essential social statuses. PMID:18420325

  7. Applying social marketing principles to understand the effects of the radio diaries program in reducing HIV/AIDS stigma in Malawi.

    PubMed

    Rimal, Rajiv N; Creel, Alisha H

    2008-01-01

    Relatively little is known about the extent to which health campaigns can play a constructive role in reducing HIV/AIDS-related stigma. The Malawi Radio Diaries is a program in which HIV-positive men and women openly discuss day-to-day events in their lives with the goal of reducing stigma in the population. Adopting a social marketing perspective, we analyze the various components of the Radio Diaries program in terms of three of the "Four P's": product (stigma reduction), place (radio), and promotion (the program itself). We first investigated the important dimensions of stigma and then developed a model to test the demographic and psychosocial correlates of these dimensions. A midterm household survey was then used to determine the relationship between exposure to the Radio Diaries program and stigma. In multivariate analyses, lower education and knowledge were associated with stronger beliefs that persons living with HIV should be isolated from others. Exposure to the Radio Diaries program did not have a main-effect on stigma, but there was a significant interaction between exposure and efficacy to reduce number of partners such that there was little difference in stigma by exposure level for those with low efficacy, but a significant difference by exposure level for those with high efficacy. Findings are discussed in terms of social marketing principles. PMID:18935882

  8. Modelling level, trend and geographical variations in stigma and discrimination against people living with HIV/AIDS in Nigeria.

    PubMed

    Adebayo, Samson B; Fakolade, Richard; Anyanti, Jennifer; Ekweremadu, Bright; Ladipo, Olaronke; Ankomah, Augustine

    2011-01-01

    People living with HIV and AIDS (PLHA) often face stigma and discrimination. Stigma is a powerful tool for social control and PLHA are to varying degrees stigmatised against. Consequences of stigma and discrimination against PLHA may result in low turn-out for HIV counselling and testing, identity crises, isolation, loneliness, low self-esteem and lack of interest in containing the disease. To achieve the millennium development goal on HIV reduction, efforts should be targeted at measuring impact of HIV preventive interventions. In this paper, effort was made to explore geographical variations in addition to level and trend of accepting attitude towards PLHA using 2003 - 2007 population-based household survey data. Inferences are based on Markov Chain Monte Carlo techniques, while model selection was based on Deviance Information Criteria. Findings revealed significant positive trend and spatial variations on level of accepting attitude towards PLHA. Level of exposure to HIV prevention interventions and perceptions about social support received on HIV are significantly associated with accepting attitude towards PLHA. Findings provide policy makers with tools to discern states where prevention efforts on HIV-related stigma and discrimination should be intensified. This in turn, can enhance an effective utilization of scarce resources that is paramount in developing countries. PMID:23237726

  9. Stigma, discrimination, and sexual (dis)satisfaction among people living with HIV: results from the "AIDES et toi" survey.

    PubMed

    Rojas Castro, D; Le Gall, J M; Andreo, C; Spire, B

    2010-08-01

    The effects of HIV-related stigma and discrimination have been studied in several areas, such as access to testing, quality of care quality, and access to work. Nevertheless, the effects of stigma and discrimination on the sexual life of people living with HIV/AIDS (PLWHA) have not been studied enough. AIDES, a French community-based organization, has developed a biannual survey which assesses several socioeconomical and psychosocial dimensions of the people in contact with this organization. A focus on the results concerning sexual (dis)satisfaction and the factors associated are presented here. A convenience sample of 521 HIV-positive men having sex with men, heterosexual men and women was analyzed. A logistic regression was performed to examine which factors were significantly associated with sexual dissatisfaction. Results showed that being older, not having a full-time job, not having a steady sexual partner, lower frequency of sexual intercourse, discrimination in the sexual relationship setting, and the perception of loneliness were independently associated with sexual dissatisfaction. A quality health approach must include the aspects linked to sexual life and sexual satisfaction. Given the potentially harmful effects that HIV-related stigma and discrimination have on PLWHA's well-being, more specific actions and advocacy in this direction should be developed and implemented. PMID:20552468

  10. Positive coping strategies and HIV-related stigma in south India.

    PubMed

    Kumar, Shuba; Mohanraj, Rani; Rao, Deepa; Murray, Katherine R; Manhart, Lisa E

    2015-03-01

    Whether perceived or enacted, HIV-related stigma is widespread in India, and has had a crippling effect on People Living with HIV/AIDS (PLHA). Research has shown that a positive attitude towards the illness sets a proactive framework for the individual to cope with his or her infection; therefore, healthy coping mechanisms are essential to combat HIV-related stigma. This qualitative study involving in-depth interviews and focus group discussions with PLHA affiliated with HIV support groups in South India explored positive coping strategies employed by PLHA to deal with HIV-related stigma. Interviews and focus group discussions were translated, transcribed, and analyzed for consistent themes. Taboos surrounding modes of transmission, perceiving sex workers as responsible for the spread of HIV, and avoiding associating with PLHA provided the context of HIV-related stigma. Despite these challenges, PLHA used several positive strategies, classified as Clear Knowledge and Understanding of HIV, Social Support and Family Well-Being, Selective Disclosure, Employment Building Confidence, and Participation in Positive Networks. Poor understanding of HIV and fears of being labeled immoral undermined healthy coping behavior, while improved understanding, affiliation with support groups, family support, presence of children, and financial independence enhanced PLHA confidence. Such positive coping behaviours could inform culturally relevant interventions. PMID:25612135

  11. Positive Coping Strategies and HIV-Related Stigma in South India

    PubMed Central

    Kumar, Shuba; Mohanraj, Rani; Rao, Deepa; Murray, Katherine R.

    2015-01-01

    Abstract Whether perceived or enacted, HIV-related stigma is widespread in India, and has had a crippling effect on People Living with HIV/AIDS (PLHA). Research has shown that a positive attitude towards the illness sets a proactive framework for the individual to cope with his or her infection; therefore, healthy coping mechanisms are essential to combat HIV-related stigma. This qualitative study involving in-depth interviews and focus group discussions with PLHA affiliated with HIV support groups in South India explored positive coping strategies employed by PLHA to deal with HIV-related stigma. Interviews and focus group discussions were translated, transcribed, and analyzed for consistent themes. Taboos surrounding modes of transmission, perceiving sex workers as responsible for the spread of HIV, and avoiding associating with PLHA provided the context of HIV-related stigma. Despite these challenges, PLHA used several positive strategies, classified as Clear Knowledge and Understanding of HIV, Social Support and Family Well-Being, Selective Disclosure, Employment Building Confidence, and Participation in Positive Networks. Poor understanding of HIV and fears of being labeled immoral undermined healthy coping behavior, while improved understanding, affiliation with support groups, family support, presence of children, and financial independence enhanced PLHA confidence. Such positive coping behaviours could inform culturally relevant interventions. PMID:25612135

  12. HIV-related stigma and NGO-isation in India: an historico-empirical analysis

    PubMed Central

    Nambiar, Devaki

    2011-01-01

    In response to World Bank critiques in 2007, the Indian Ministry of Health and Family Welfare declared that HIV-related stigma was a barrier to the participation of Non-Governmental Organisations (NGOs) in the implementation of HIV prevention Targeted Interventions. Taking a deeper view of HIV-related stigma as an historically inflected process of devaluation, this paper details the history and transformation of NGO involvement in the HIV epidemic from 1986 through economic liberalisation in the 1990s up to the recently concluded National AIDS Control Program (NACP II, 1999-2006). It additionally examines findings from interviews and participant observation of NGO workers (N=24) from four Targeted Intervention NGOs in Delhi funded under NACP II. Analysis reveals that a ‘second wave’ of HIV-related NGO involvement has mushroomed in the past two decades, affording NGO workers multiple pathways to credibility in the Indian response to the epidemic. Contradictions embedded in the overlap of these pathways produce stigma, reflecting ‘adverse incorporation.’ Drawing upon noteworthy exceptions to this trend from the ‘first wave’ of Indian HIV-related NGOs, the paper calls for NGO participation as an explicitly political project of addressing the social inequalities that shape stigma as well as vulnerability to illness writ large. PMID:22150236

  13. Predictors of HIV-related Stigma among Young People Living with HIV

    PubMed Central

    Swendeman, Dallas; Rotheram-Borus, Mary Jane; Comulada, Scott; Weiss, Robert; Ramos, Maria Elena

    2008-01-01

    Enacted and perceived HIV-stigma was examined among substance using young people living with HIV (YPLH) in Los Angeles, San Francisco, and New York City (N = 147). Almost all YPLH (89%) reported perceived stigma and 31% report enacted experiences in the past three months; 64% reported experiences during their lifetime. The HIV-stigma questions were characterized by factors of avoidance, social rejections, abuse and shame. In multivariate models enacted stigma was associated with gay/bisexual identity, symptomatic HIV or AIDS, and bartering sex. Perceived stigma was associated with female gender, symptomatic HIV or AIDS, bartering sex, lower injection drug use, and fewer friends and family knowing serostatus. Gay/bisexual YPLH who were also HIV symptomatic or AIDS diagnosed experienced more HIV-stigma than their heterosexual peers. PMID:16846325

  14. Functional Analysis of HIV/AIDS Stigma: Consensus or Divergence?

    ERIC Educational Resources Information Center

    Hosseinzadeh, Hassan; Hossain, Syeda Zakia

    2011-01-01

    Functional theory proposes that attitudes may serve a variety of purposes for individuals. This study aimed to determine whether stigmatized attitudes toward HIV/AIDS serve the same function for all (consensus function) or serve different functions for different individuals (divergence function) by assessing various aspects of HIV/AIDS stigma…

  15. HIV/AIDS Adherence: Teaching about Treatment and Stigma

    ERIC Educational Resources Information Center

    Curtis, Jena Nicols

    2008-01-01

    Advances in HIV/AIDS treatment have dramatically changed the nature of HIV/AIDS education and prevention, creating new opportunities and challenges. This activity is designed to help participants reflect on the impact that HIV treatment can have on a person's life. It also enables trainers to engage participants in a dialogue about the impact of…

  16. 'The mercurial piece of the puzzle': Understanding stigma and HIV/AIDS in South Africa.

    PubMed

    Gilbert, Leah

    2016-01-01

    Although stigma and its relationship to health and disease is not a new phenomenon, it has not been a major feature in the public discourse until the emergence of HIV. The range of negative responses associated with the epidemic placed stigma on the public agenda and drew attention to its complexity as a phenomenon and concept worthy of further investigation. Despite the consensus that stigma is one of the major contributors to the rapid spread of HIV and the frequent use of the term in the media and among people in the street, the exact meaning of 'stigma' remains ambiguous. The aim of this paper is to briefly re-visit some of the scholarly deliberations and further interrogate their relevance in explaining HIV-related stigma evidenced in South Africa. In conclusion a model is presented. Its usefulness--or explanatory potential--is that it attempts to provide a comprehensive framework that offers insights into the individual as well as the social/structural components of HIV-related stigma in a particular context. As such, it has the potential to provide more nuanced understandings as well as to alert us to knowledge-gaps in the process. PMID:26781444

  17. HIV-Related Stigma, Social Norms and HIV Testing in Soweto and Vulindlela, South Africa: NIMH Project Accept (HPTN 043)

    PubMed Central

    Young, Sean D.; Hlavka, Zdenek; Modiba, Precious; Gray, Glenda; Van Rooyen, Heidi; Richter, Linda; Szekeres, Greg; Coates, Thomas

    2010-01-01

    Objective HIV testing is necessary to curb the increasing epidemic. However, HIV-related stigma and perceptions of low likelihood of societal HIV testing may reduce testing rates. This study aimed to explore this association in South Africa, where HIV rates are extraordinarily high. Methods Data were taken from the Soweto and Vulindlela, South African sites of Project Accept, a multi-national HIV prevention trial. Self-reported HIV testing, stigma, and social norms items were used to study the relationship between HIV testing, stigma, and perceptions about societal testing rates. The stigma items were broken into 3 factors: negative attitudes, negative perceptions about people living with HIV, and perceptions of fair treatment for people living with HIV (equity). Results Results from a univariate logistic regression suggest that past history of HIV testing was associated with decreased negative attitudes about people living with HIV/AIDS, increased perceptions that people living with HIV/AIDS experience discrimination, and increased perceptions that people with HIV should be treated equitably. Results from a multivariate logistic regression confirm these effects and suggests these differences vary according to gender and age. Compared to people who had never tested for HIV, those who had previously tested were more likely to believe that the majority of people have tested for HIV. Conclusion Data suggest that interventions designed to increase HIV testing in South Africa should address stigma and perceptions of societal testing. Keywords: stigma, HIV testing, South Africa, Project Accept PMID:20980913

  18. Development and Validation of a Culturally Appropriate HIV/AIDS Stigma Scale for Puerto Rican Health Professionals in Training

    PubMed Central

    Díaz, Nelson Varas; Neilands, Torsten B.

    2009-01-01

    HIV/AIDS stigma continues to be an obstacle for primary and secondary HIV prevention. Its consequences for the lives of people living with the disease have been well documented and continue to be of great concern for health care providers and researchers in the field. These consequences are worsened when such stigma emanates from health professionals, as this can limit access to services. One of the main obstacles for HIV/AIDS Stigma research in Puerto Rico is the absence of quantitative measures to assess HIV/AIDS stigma manifestations among health professionals. In light of this gap in the scientific literature, the main objective of this study was to develop and test the psychometric properties of a culturally appropriate HIV/AIDS stigma scale for Puerto Rican health care providers and to develop a reduced form of the scale suitable for use in time-limited clinical settings. The developed measure was based on previous qualitative evidence gathered from Puerto Rican health professionals (Varas-Díaz, Serrano-García & Toro-Alfonso, 2005) and administered to a sample of 421 health professionals in training. The scale addresses 12 HIV/AIDS stigma dimensions. In quantitative analyses 11 of these dimensions demonstrated satisfactory validity and reliability. These dimensions in turn were subcomponents of a higher-order general stigma factor. Implications and limitations of these findings are discussed. PMID:20024702

  19. Validation of a brief stigma-by-association scale for use with HIV/AIDS-affected youth in South Africa.

    PubMed

    Boyes, Mark E; Mason, Sally J; Cluver, Lucie D

    2013-01-01

    This study validated a brief stigma-by-association scale for use with South African youth (adapted from the HIV Stigma-by-Association Scale for Adolescents). Participants were 723 youth (364 male, 359 female) from poor urban communities around Cape Town. Youths completed the brief stigma-by-association scale and measures of bullying victimisation and peer-problems, as well as inventories measuring symptoms of depression and anxiety. Exploratory analyses revealed that the scale consists of two subscales: (1) experience of stigma-by-association and (2) consequences of stigma-by-association. This two factor structure was obtained in the full sample and both the HIV/AIDS-affected and unaffected subgroups. The full stigma-by-association scale showed excellent reliability (α = 0.89-0.90) and reliabilities for both subscales were also good (α = 0.78-0.87). As predicted, children living in HIV/AIDS-affected households obtained significantly higher stigma-by-association scores than children in non-affected households [F(1, 693) = 46.53, p<0.001, partial η(2)=0.06] and hypothesized correlations between stigma-by-association, bullying, peer problems, depression and anxiety symptoms were observed. It is concluded that the brief stigma-by-association scale is a reliable and valid instrument for use with South African youth; however, further confirmatory research regarding the structure of the scale is required. PMID:22774842

  20. Disease and Stigma: A Review of Literature

    ERIC Educational Resources Information Center

    Pettit, Michele L.

    2008-01-01

    This article presents a review of literature pertaining to disease and stigma. Specifically, a definition of stigma is provided along with an historical overview of disease and stigma and research trends related to three public health perils-AIDS, mental illness, and obesity.

  1. Persistent HIV-related stigma in rural Uganda during a period of increasing HIV incidence despite treatment expansion

    PubMed Central

    Chan, Brian T.; Weiser, Sheri D.; Boum, Yap; Siedner, Mark J.; Mocello, A. Rain; Haberer, Jessica E.; Hunt, Peter W.; Martin, Jeffrey N.; Mayer, Kenneth H.; Bangsberg, David R.; Tsai, Alexander C.

    2014-01-01

    Objective Program implementers have argued that the increasing availability of anti-retroviral therapy (ART) will reduce the stigma of HIV. We analyzed data from Uganda to assess how HIV-related stigma has changed during a period of ART expansion. Design Serial cross-sectional surveys. Methods We analyzed data from the Uganda AIDS Rural Treatment Outcomes (UARTO) study during 2007-2012 to estimate trends in internalized stigma among people living with HIV (PLHIV) at the time of treatment initiation. We analyzed data from the Uganda Demographic and Health Surveys (DHS) from 2006 and 2011 to estimate trends in stigmatizing attitudes and anticipated stigma in the general population. We fitted regression models adjusted for socio-demographic characteristics, with year of data collection as the primary explanatory variable. Results We estimated an upward trend in internalized stigma among PLHIV presenting for treatment initiation (adjusted b=0.18; 95% CI, 0.06 to 0.30). In the general population, the odds of reporting anticipated stigma were greater in 2011 compared to 2006 (adjusted OR=1.80; 95% CI, 1.51 to 2.13), despite an apparent decline in stigmatizing attitudes (adjusted OR=0.62; 95% CI, 0.52 to 0.74). Conclusions Internalized stigma has increased over time among PLHIV in the setting of worsening anticipated stigma in the general population. Further study is needed to better understand the reasons for increasing HIV-related stigma in Uganda and its impact on HIV prevention efforts. PMID:25268886

  2. HIV-Related Stigma: Implications for Symptoms of Anxiety and Depression among Malawian Women

    PubMed Central

    Kamen, Charles; Arganbright, Jill; Kienitz, Eliza; Weller, Melissa; Khaylis, Anna; Shenkman, Tammy; Smith, Sarah; Koopman, Cheryl; Gore-Felton, Cheryl

    2015-01-01

    An estimated 11% of the adult population in Malawi, Africa, is living with HIV/AIDS. The disease has taken a toll on communities, resulting in high morbidity and mortality. Malawian women carry the burden of being caretakers for individuals infected with HIV while also worrying about their own health; however, little is known about how HIV/AIDS affects psychological functioning among Malawian women in areas hit hardest by the epidemic. To that end, this paper examined the influence of HIV-related stigma on symptoms of anxiety and depression among 59 women 17-46 years old who were recruited from the Namitete area of Malawi. Women who reported greater worry about being infected with HIV and greater HIV-related stigma were significantly more likely to report greater symptoms of anxiety and depression. These findings suggest that interventions that reduce HIV-related stigma are likely to enhance psychological functioning among Malawian women, which in turn will improve the women's quality of life and well-being. PMID:25920985

  3. Understanding HIV-Related Stigma and Discrimination in a "Blameless" Population

    ERIC Educational Resources Information Center

    Cao, Xiaobin; Sullivan, Sheena G.; Xu, Jie; Wu, Zunyou

    2006-01-01

    HIV-related stigma and discrimination are major barriers to the successful control of HIV. Stigma is associated with the disease as well as the behaviors that lead to infection. A qualitative study was conducted to identify the reasons, sources, and types of HIV-related stigma prevalent in rural China. Eighty in-depth interviews were conducted…

  4. Examining cultural, social, and self-related aspects of stigma in relation to sexual assault and trauma symptoms.

    PubMed

    Deitz, Mandi F; Williams, Stacey L; Rife, Sean C; Cantrell, Peggy

    2015-05-01

    The current study investigated a model explaining sexual assault victims' severity of trauma symptoms that incorporated multiple stigma constructs. Integrating the sexual assault literature with the stigma literature, this study sought to better understand trauma-related outcomes of sexual assault by examining three levels of stigma-cultural, social, and self. Results showed self-stigma was significantly and positively related to trauma symptom severity. Thus, results revealed that the internalized aspect of stigma served as a mechanism in the relation between sexual assault severity and increased levels of trauma symptom severity, highlighting the importance of assessing self-stigma in women reporting sexual assault experiences. PMID:25732041

  5. Social relationships, stigma and adherence to antiretroviral therapy for HIV/AIDS.

    PubMed

    Ware, N C; Wyatt, M A; Tugenberg, T

    2006-11-01

    Research on adherence to combination antiretroviral therapy has up to now focused largely upon problems of definition and measurement, and on the identification of barriers and supports. This paper examines the intersection between taking HAART and building a life with HIV/AIDS. Data consist of 214 qualitative interviews with 52 HIV-positive, active illegal drug users. A interpretive analysis drawing upon stigma and fear of disclosure as analytical constructs was applied to explain working tensions between efforts to develop social relationships on the one hand, and attempts to safeguard health through adherence on the other. The analysis specifies a mechanism through which stigma as a social process results in marginalization and exclusion. The hierarchical organization of multiple stigma is also noted. Loneliness and the desire for relatedness is intensified by drug use. Results suggest that persons with HIV/AIDS will not consistently subordinate other interests to prioritize adherence. Interventions aimed at supporting long-term adherence must address experienced conflicts between 'health' and 'life'. PMID:17012079

  6. The impact of HIV treatment-related stigma on uptake of antiretroviral therapy.

    PubMed

    Cama, Elena; Brener, Loren; Slavin, Sean; de Wit, John

    2015-01-01

    HIV-related stigma has been linked to avoidance of health care services and suboptimal adherence to antiretroviral therapy (ART). However, less is known about concerns of stigma related specifically to the taking of ART in uptake of treatment. This study examines experiences of HIV treatment-related stigma and assesses if these experiences are associated with ART uptake, independent of general HIV-related stigma. People living with HIV (PLHIV; n = 697) were targeted to complete an online questionnaire measuring perceived HIV- and treatment-related stigma, social support, self-esteem, resilience, psychological distress, health satisfaction and quality of life. Findings suggest that experiences of general and treatment-related stigma were common, and that participants appear to experience greater stigma related to taking HIV treatment than general stigma associated with HIV. Neither general nor treatment-related stigma uniquely impacted HIV treatment uptake. Instead, treatment uptake was associated with being older (adjusted OR 1.05; 95% CIs: 1.03, 1.08), greater duration of HIV infection (adjusted OR 1.07; 95% CIs: 1.03-1.11) and having greater health satisfaction (adjusted OR 1.28; 95% CIs: 1.03, 1.59). Findings highlight that concerns around taking HIV treatment can be an added source of stigma for PLHIV, however other factors may be greater contributors to the likelihood of taking HIV treatment. PMID:25564893

  7. The effectiveness of interventions for reducing stigma related to substance use disorders: a systematic review

    PubMed Central

    Livingston, James D; Milne, Teresa; Fang, Mei Lan; Amari, Erica

    2012-01-01

    Aims This study provides a systematic review of existing research that has empirically evaluated interventions designed to reduce stigma related to substance use disorders. Methods A comprehensive review of electronic databases was conducted to identify evaluations of substance use disorder related stigma interventions. Studies that met inclusion criteria were synthesized and assessed using systematic review methods. Results Thirteen studies met the inclusion criteria. The methodological quality of the studies was moderately strong. Interventions of three studies (23%) focused on people with substance use disorders (self-stigma), three studies (23%) targeted the general public (social stigma) and seven studies (54%) focused on medical students and other professional groups (structural stigma). Nine interventions (69%) used approaches that included education and/or direct contact with people who have substance use disorders. All but one study indicated their interventions produced positive effects on at least one stigma outcome measure. None of the interventions have been evaluated across different settings or populations. Conclusions A range of interventions demonstrate promise for achieving meaningful improvements in stigma related to substance use disorders. The limited evidence indicates that self-stigma can be reduced through therapeutic interventions such as group-based acceptance and commitment therapy. Effective strategies for addressing social stigma include motivational interviewing and communicating positive stories of people with substance use disorders. For changing stigma at a structural level, contact-based training and education programs targeting medical students and professionals (e.g. police, counsellors) are effective. PMID:21815959

  8. A systematic review of interventions to reduce HIV-related stigma and discrimination from 2002 to 2013: how far have we come?

    PubMed Central

    Stangl, Anne L; Lloyd, Jennifer K; Brady, Laura M; Holland, Claire E; Baral, Stefan

    2013-01-01

    Introduction HIV-related stigma and discrimination continue to hamper efforts to prevent new infections and engage people in HIV treatment, care and support programmes. The identification of effective interventions to reduce stigma and discrimination that can be integrated into national responses is crucial to the success of the global AIDS response. Methods We conducted a systematic review of studies and reports that assessed the effectiveness of interventions to reduce HIV stigma and discrimination between 1 January 2002 and 1 March 2013. Databases searched for peer-reviewed articles included PubMed, Scopus, EBSCO Host –CINAHL Plus, Psycinfo, Ovid, Sociofile and Popline. Reports were obtained from the www.HIVAIDSClearinghouse.eu, USAID Development Experience Clearinghouse, UNESCO HIV and AIDS Education Clearinghouse, Google, WHO and UNAIDS. Ancestry searches for articles included in the systematic review were also conducted. Studies of any design that sought to reduce stigma as a primary or secondary objective and included pre- and post-intervention measures of stigma were included. Results Of 2368 peer-reviewed articles and reports identified, 48 were included in our review representing 14 different target populations in 28 countries. The majority of interventions utilized two or more strategies to reduce stigma and discrimination, and ten included structural or biomedical components. However, most interventions targeted a single socio-ecological level and a single domain of stigma. Outcome measures lacked uniformity and validity, making both interpretation and comparison of study results difficult. While the majority of studies were effective at reducing the aspects of stigma they measured, none assessed the influence of stigma or discrimination reduction on HIV-related health outcomes. Conclusions Our review revealed considerable progress in the stigma-reduction field. However, critical challenges and gaps remain which are impeding the identification of

  9. Stigma, secrecy, and discrimination: ethnic/racial differences in the concerns of people living with HIV/AIDS.

    PubMed

    Rao, Deepa; Pryor, John B; Gaddist, Bambi W; Mayer, Randy

    2008-03-01

    The HIV Stigma Scale is a measure that assesses stigmatization perceived and experienced by people living with HIV/AIDS (PLWHA). Using Item Response Theory (IRT) methodologies, the present study examined HIV Stigma Scale responses from 224 Black and 317 White PLWHA to determine whether cross-cultural differences exist in responses to items of the scale. IRT analysis revealed that eleven out of forty items functioned differently across groups. Black respondents had a higher probability of indicating greater stigmatization on items that described situations in which others discriminated against them, and White respondents had a higher probability of indicating greater stigmatization on items that described a resolve to keep their status a secret and fears of interpersonal rejection. These differences suggest that PLWHA have different experiences of stigma based on their ethnic/racial background, either because of cultural differences or the ways in which the participants interpreted items of the HIV Stigma Scale. PMID:17588146

  10. Re-thinking HIV-Related Stigma in Health Care Settings: A Qualitative Study.

    PubMed

    Gagnon, Marilou

    2015-01-01

    People living with HIV (PLWH) continue to endure stigma and discrimination in the context of health care. This paper presents the findings of a qualitative study designed to (a) describe stigmatizing and discriminatory practices in health care settings, and (b) explore both symbolic and structural stigma from the perspectives of PLWH. For the purpose of this qualitative study, 21 semi-structured in-depth interviews were conducted in the province of Quebec, Canada. The data were analyzed following the principles of thematic analysis. During analysis, three themes were identified, and relations between these themes were delineated to reflect the experiences of participants. The findings suggest that HIV-related stigma in health care settings is episodic in nature. The findings also suggest that HIV-related stigma is experienced through interactions with health care providers (symbolic stigma) and, finally, that it is applied systematically to manage risk in the context of health care (structural stigma). PMID:26300466

  11. HIV Treatment Scale-Up and HIV-Related Stigma in Sub-Saharan Africa: A Longitudinal Cross-Country Analysis

    PubMed Central

    Tsai, Alexander C.; Siedner, Mark J.

    2015-01-01

    Objectives. We estimated the association between antiretroviral therapy (ART) uptake and HIV-related stigma at the population level in sub-Saharan Africa. Methods. We examined trends in HIV-related stigma and ART coverage in sub-Saharan Africa during 2003 to 2013 using longitudinal, population-based data on ART coverage from the Joint United Nations Program on HIV/AIDS and on HIV-related stigma from the Demographic and Health Surveys and AIDS Indicator Surveys. We fitted 2 linear regression models with country fixed effects, with the percentage of men or women reporting HIV-related stigma as the dependent variable and the percentage of people living with HIV on ART as the explanatory variable. Results. Eighteen countries in sub-Saharan Africa were included in our analysis. For each 1% increase in ART coverage, we observed a statistically significant decrease in the percentage of women (b = −0.226; P = .007; 95% confidence interval [CI] = −0.383, −0.070) and men (b = −0.281; P = .009; 95% CI = −0.480, −0.082) in the general population reporting HIV-related stigma. Conclusions. An important benefit of ART scale-up may be the diminution of HIV-related stigma in the general population. PMID:26066939

  12. Rural children's attitudes to people with HIV/AIDS in Mali: the causes of stigma.

    PubMed

    Castle, Sarah

    2004-01-01

    Qualitative research among young people and other community members in rural Mali elicited knowledge and attitudes with regard to HIV/AIDS. Findings indicated that rumours concerning methods of infection are likely to increase the stigmatization of those with the disease. The most frequently stated mode of transmission involved urinating in a place where someone with AIDS had already urinated. Shared clothes, food and water were seen as sources of infection. Both children and teachers recommended that people with AIDS be isolated. Even talking to them would lead to a risk of infection. Discriminatory views were likely to have been reinforced by parents and community elders who possessed the same misinformation. The notion that AIDS results from sexual encounters between young women and dogs belonging to white people in Côte d'Ivoire was also widespread. These discourses may reflect perceived xenophobia and risk to migrants associated with current tensions between the two countries, together with misgivings about Western sexual liberalism. A holistic educational programme is proposed to address not simply HIV/AIDS, but the social context in which infection occurs, with view to combating stigma and discrimination associated with not just HIV but also with migration in this setting. PMID:21972829

  13. Psychological reactance and HIV-related stigma among women living with HIV.

    PubMed

    Brown, Monique J; Serovich, Julianne M; Kimberly, Judy A; Hu, Jinxiang

    2016-06-01

    Psychological reactance is defined as the drive to re-establish autonomy after it has been threatened or constrained. People living with HIV may have high levels of psychological reactance due to the restrictions that they may perceive as a result of living with HIV. People living with HIV may also exhibit levels of HIV-related stigma. The relationship between psychological reactance and HIV-related stigma is complex yet understudied. Therefore, the main aim of this study was to examine the association between psychological reactance and HIV-related stigma among women living with HIV. Data were obtained from one time-point (a cross-sectional assessment) of a longitudinal HIV disclosure study. Psychological reactance was measured using the 18-item Questionnaire for the Measurement of Psychological Reactance. HIV-related stigma was measured using the HIV Stigma Scale, which has four domains: personalized, disclosure concerns, negative self-image, and concerns with public attitudes. Principal component analysis was used to derive components of psychological reactance. Linear regression models were used to determine the association between overall psychological reactance and its components, and stigma and its four domains, and depressive and anxiety symptoms. The associations between stigma and mental health were also examined. Three components of psychological reactance were derived: Opposition, Irritability, and Independence. Overall psychological reactance and irritability were associated with all forms of stigma. Opposition was linked to overall and negative self-image stigma. Overall psychological reactance, opposition, and irritability were positively associated with anxiety symptoms while opposition was also associated with Centers for Epidemiologic Studies-Depression depressive symptoms. There were also positive associations between all forms of stigma, and depressive and anxiety symptoms. Health-care providers and counselors for women living with HIV

  14. Structural Forces and the Production of TB-related Stigma among Haitians in Two Contexts

    PubMed Central

    Coreil, Jeannine; Mayard, Gladys; Simpson, Kelly M; Lauzardo, Michael; Zhu, Yiliang; Weiss, Mitchell

    2012-01-01

    In recent years renewed interest in health-related stigma has underscored the importance of better understanding the structural underpinnings of stigma processes. This study investigated the influence of sociocultural context on perceived components of tuberculosis-related stigma in non-affected persons by comparing Haitians living in South Florida, USA, with Haitians residing in Léogane Commune, Haiti. Using the methods of cultural epidemiology, a two-phase study based on fieldwork between 2004–07 collected ethnographic data on the cultural context and components of tuberculosis (TB) stigma, and administered a stigma scale developed specifically for these populations. Thematic analysis of stigma components expressed in interviews, focus groups and observation revealed commonalities as well as distinctive emphases of TB stigma in the two comparison groups. Factor analyses of stigma scale scores confirmed the thematic differences revealed in ethnographic findings and highlight the influence of political and economic factors in shaping the meaning and experience of illness. Perceived components of TB stigma among Haitians in South Florida incorporated aspects of Haitian identity as a negatively stereotyped minority community within the larger society, while in Haiti, stigma was associated primarily with poverty, malnutrition, and HIV co-infection. Discussion of findings focuses on the social production of perceived and anticipated stigma as it is influenced by structural forces including the influences of politics, economics, institutional policies, and health service delivery structures. The findings also demonstrate the value of a transnational framework encompassing both sending and receiving countries for understanding TB related stigma in immigrant communities. PMID:20724052

  15. Beyond Silence and Rumor: Storytelling as an Educational Tool to Reduce the Stigma around HIV/AIDS in South Africa

    ERIC Educational Resources Information Center

    Zeelen, Jacques; Wijbenga, Hieke; Vintges, Marga; de Jong, Gideon

    2010-01-01

    Purpose: This paper aims to explore the role of a small-scale project around storytelling as a form of informal education in five health clinics in rural areas of the Limpopo Province in South Africa. The aim of the project is to decrease the stigma around HIV/AIDS and to start an open dialogue in local communities about the disease.…

  16. AIDS-related myopathy.

    PubMed

    Sheikh, Rafiq A.; Yasmeen, Shagufta; Munn, Robert; Ruebner, Boris H.; Ellis, William G.

    1999-09-01

    Infection with the human immunodeficiency virus (HIV) is often associated with the acquired immunodeficiency syndrome (AIDS), and wasting is one of the defining clinical features of AIDS. Muscular weakness due to myopathy may develop at any stage of HIV infection. We report two illustrative cases of HIV-associated myopathies. One was due to inflammatory myosits most likely directly related to the HIV infection, and the other was most likely the result of mitochondrial damage due to zidovudine, a nucleoside analogue commonly used in treating HIV infection. Biopsies from both patients showed alterations of myofiber structures, of varying severity, culminating in necrosis, lipid droplets, and lymphoplasmocytic inflammatory response. The zidovudine-treated patient also showed distinctive mitochondrial changes, predominantly enlargement, variation in shape and size, and disorganization of the cristae. These two types of HIV-associated inflammatory myopathies are reviewed, along with other HIV-associated myopathies, including HIV wasting syndrome, nemaline rod myopathy, pyomyositis, rhabdomyolysis, cardiomyopathy, and other miscellaneous myopathies associated with HIV infection. PMID:11810429

  17. Antiretroviral Therapy and Reproductive Life Projects: Mitigating the Stigma of AIDS in Nigeria

    PubMed Central

    Mbakwem, Benjamin C

    2010-01-01

    As millions of people infected with HIV in Africa are increasingly able to live longer and healthier lives because of access to antiretroviral therapy, concerns have emerged that people might eschew protective practices after their health improves. Extending beyond the notion of sexual “disinhibition,” researchers have begun to analyze the sexual behavior of people in treatment through the perspective of their marital and childbearing aspirations. This article explores the reproductive life projects of HIV-positive men and women in southeastern Nigeria, showing how actions that contradict medical advice are understandable in the context of patients’ socially normative desires for marriage and children. Based on in-depth interviews and observations (June–December 2004; June–July 2006; June–July 2007) of people enrolled in the region’s oldest treatment program, we argue that broadly held social expectations with regard to reproduction are experienced even more acutely by HIV-positive people. This is because in Nigeria the stigma associated with AIDS is closely tied to widespread perceptions of social and moral crisis, such that AIDS itself is seen as both a cause and a symptom of anxiety-producing forms of social change. Specifically, in an era of rapid societal transformation, Nigerians see sexual promiscuity and the alienation of young people from traditional obligations to kin and community as indicative of threatened social reproduction. For people who are HIV-positive, marrying and having children offer not only the opportunity to lead normal lives, but also a means to mitigate the stigma associated with the disease. Four ethnographic case studies are provided to exemplify how and why social and personal life projects can trump or complicate medical and public health priorities. These examples suggest that treatment programs must openly address and proactively support the life projects of people on antiretroviral therapy if the full benefits of

  18. HIV/AIDS stigma among a sample of primarily African-American and Latino men who have sex with men social media users.

    PubMed

    Garett, Renee; Smith, Justin; Chiu, Jason; Young, Sean D

    2016-01-01

    The recent increase in social media use allows these technologies to rapidly reach communities with higher HIV prevalence, such as African-American and Latino men who have sex with men (MSM). However, no studies have looked at HIV/AIDS stigma among social media users from African-American and Latino MSM communities, or the association between stigma and social media use among these groups. This study sought to assess the level of HIV/AIDS stigma among a sample of social media-using African-American and Latino MSM from Los Angeles. A total of 112 (primarily African-American and Latino, n = 98, 88%) MSM Facebook users completed a survey on demographics, online social network use, and HIV/AIDS stigma. A composite stigma score was created by taking the cumulative score from a 15-item stigma questionnaire. Cumulative logistic models were used to assess the association between HIV/AIDS stigma and online social network use. In general, participants reported a low level of HIV/AIDS stigma (mean = 22.2/75, SD = 5.74). HIV/AIDS stigma composite score was significantly associated with increased time spent on online social networks each day (Adjusted odds ratios (AOR): 1.07, 95% CI: 1.00, 1.15). Among this diverse sample of MSM online social network users, findings suggest that HIV/AIDS stigma is associated with usage of social media. We discuss the implications of this work for future HIV prevention. PMID:26873022

  19. Substance Use Related Stigma: What we Know and the Way Forward

    PubMed Central

    Kulesza, Magdalena; Larimer, Mary E.; Rao, Deepa

    2014-01-01

    Aims To conduct a systematic review of the literature investigating the relationship between stigma experienced by individuals who use drugs. Methods We conducted an online literature search and identified articles related to stigma among individuals who use drugs. Studies evaluating associations between stigma and socio-demographic variables and if applicable clinical and substance use variables are presented. In addition, recommendations for future research are provided. Results We identified 26 articles describing 28 studies evaluating stigma. The majorities of studies were published in the last 11 years and conducted in the U.S. Samples were relatively diverse: 41.7% of all participants who provided data identified as racial/ethnic minorities. The vast majority of the relationships between stigma and socio-demographic characteristics were included in only one or very few studies, which limits conclusions. The relationship between stigma and psychological well-being is the only consistent finding reported in the literature. Specifically, results suggest that stigma has a detrimental effect on psychological well-being among individuals who use drugs. Conclusions While this literature is expanding at a rapid pace, this review indicates several areas for future research and needed improvements in research methodology in this area. Specifically, lack of comprehensive description of sample characteristics, lack of construct identification and proper definition, a dearth of longitudinal studies and limited research describing relationships between stigma and substance use behavior are a few areas identified for further research. PMID:25401117

  20. [Stigmatization in HIV/AIDS: first German adaptation of the HIV-stigma scale (HSS-D)].

    PubMed

    Dinkel, Andreas; Nather, Christina; Jaeger, Hans; Jaegel-Guedes, Eva; Lahmann, Claas; Steinke, Christina; Wolf, Eva; Ronel, Joram

    2014-01-01

    Despite improvements in medical treatment and numerous public health campaigns stigmatization remains a potent stressor for people living with HIV/ AIDS. This study provides an initial German adaptation of the HIV Stigma Scale (HSS-D). Participants were 167 HIV-positive homosexual men aged 22-74 years. Exploratory factor analysis replicated the original four-factor structure (subscales: enacted stigma, disclosure concerns, negative self-image, concern with public attitudes). Further psychometric analysis led to a revised version comprising 21 items (HSS-D21). The scale showed high reliability (α=0.90). Significant associations with anxiety, depres-sion, life satisfaction and perceived social support confirmed for construct validity. The majority of the respondents expressed high acceptance of the stigma measure. In order to eslish a thorough German adaptation further research with diverse samples is needed. PMID:23677626

  1. HIV-related knowledge, stigma, and willingness to disclose: A mediation analysis

    PubMed Central

    YANG, H.; LI, X.; STANTON, B.; FANG, X.; LIN, D.; NAAR-KING, S.

    2007-01-01

    Increasing HIV knowledge is a focus of many HIV education and prevention efforts. While the bivariate relationship of HIV serostatus disclosure with HIV-related knowledge and stigma has been reported in the literature, little is known about the mediation effect of stigma on the relationship of HIV knowledge with HIV serostatus disclosure. Data from 4,208 rural-to-urban migrants in China were analyzed to explore this issue. Overall, 70% of respondents reported willingness to disclose their HIV status if they were HIV-positive. Willingness to disclose was negatively associated with misconceptions about HIV transmission and stigma. Stigma mediated the relationship between misconceptions and willingness to disclose among women but not men. The mediation effect of stigma suggests that stigmatization reduction would be an important component of HIV prevention approaches. Gender inequality needs to be addressed in stigmatization reduction efforts. PMID:16971280

  2. Factors associated with pregnant women's anticipations and experiences of HIV-related stigma in rural Kenya.

    PubMed

    Cuca, Yvette P; Onono, Maricianah; Bukusi, Elizabeth; Turan, Janet M

    2012-01-01

    Pregnant women who fear or experience HIV-related stigma may not get care for their own health or medications to reduce perinatal transmission of HIV. This study examined factors associated with anticipating and experiencing HIV-related stigma among 1777 pregnant women attending antenatal care clinics in rural Kenya. Women were interviewed at baseline, offered HIV testing and care, and a sub-set was re-interviewed at 4-8 weeks postpartum. Women who were older, had less education, whose husbands had other wives, and who perceived community discrimination against people with HIV had significantly greater adjusted odds of anticipating HIV stigma. Over half of the HIV-positive women interviewed postpartum reported having experienced stigma, much of which was self-stigma. Women experiencing minor depression, and those whose family knew of their HIV status had significantly greater adjusted odds of experiencing stigma. Lack of women's empowerment, as well as depression, may be important risk factors for HIV-related stigma and discrimination. PMID:22799618

  3. Stigma Related Avoidance in People Living with Severe Mental Illness (SMI): Findings of an Integrative Review.

    PubMed

    Abiri, Sadat; Oakley, Linda Denise; Hitchcock, Mary E; Hall, Amanda

    2016-04-01

    The purpose of this integrative review is to synthesize primary evidence of the impact of internalized stigma on avoidance in adult community treatment patients living with SMI. A keyword database search of articles published through 2015 yielded 21 papers and a total of 4256 patients. Our analyses found that stigmatizing beliefs associated with avoidance are related to significant loss of self-esteem. Factors generally thought to reduce stigma internalized as self-stigmatizing beliefs, such as improved insight, increased self-awareness, and psycho-education to improve stigma coping skills, do not appear to improve self-esteem. PMID:26668008

  4. Stigma Related to HIV among Community Health Workers in Chile

    PubMed Central

    Cianelli, Rosina; Ferrer, Lilian; Norr, Kathleen F.; McCreary, Linda; Irarrázabal, Lisette; Bernales, Margarita; Miner, Sarah

    2011-01-01

    Purpose When healthcare workers have stigmatizing attitudes toward people living with HIV it may lead to discriminatory behavior that interferes with prevention, treatment, and care. This research examined the HIV-related stigmatizing attitudes reported by health workers in Santiago, Chile. Methods The study used focus group data from the first phase of a larger study to develop and test a HIV prevention intervention for Chilean health workers. Ten focus groups were conducted with Health workers in two communities in Santiago, Chile. Content analysis was used to analyze the data. Results Two central themes emerged: Societal stigma and discrimination towards people living with HIV and healthcare system’s policies related to HIV. Both inaccurate fears of transmission among the general public and Chilean Health workers and societal prejudices against homosexuals contributed to stigmatization and discrimination. Conclusions Health workers did not recognize their own stigmatizing attitudes or discriminatory behaviors, but their discussion indicated that these behaviors and attitudes did exist. Healthcare system issues identified included problems with confidentiality due to the desire to inform other health workers about client HIV status. Health workers must be sensitized to the current stigmatization and misinformation associated with HIV and its negative impacts on persons living with HIV and the general community. Implications All clinical and non-clinical workers at community clinics need mandatory education for HIV prevention that focuses on changing attitudes as well as sharing knowledge. Also, the Chilean law protecting people living with HIV and the confidentiality of their medical care needs to be publicized, along with guidelines for its enactment in clinics and other health facilities. PMID:21687824

  5. Changing patterns in HIV/AIDS stigma and uptake of voluntary counselling and testing services: the results of two consecutive community surveys conducted in the Western Cape, South Africa.

    PubMed

    Mall, Sumaya; Middelkoop, Keren; Mark, Daniella; Wood, Robin; Bekker, Linda-Gail

    2013-01-01

    Voluntary counselling and HIV testing (VCT) has been associated with decreased human immunodeficiency virus (HIV) risk behaviour, but in South Africa, which has the largest HIV/acquired immune deficiency syndrome (AIDS) epidemic in the world, uptake of VCT remains low. HIV/AIDS-associated stigma has been identified as a barrier to HIV testing. This study explored changes in stigma, and VCT access in a peri-urban South African community with high HIV prevalence, following education and research interventions, as well as the introduction of a wide-scale antiretroviral therapy (ART) programme. Two cross-sectional community surveys assessing HIV knowledge, attitudes and uptake of VCT services were conducted. The first survey was performed in 2004 prior to the implementation of a community-based HIV awareness and education campaign, HIV prevention research studies and the introduction of an ART programme. The second survey was performed in 2008 after a three-year education programme, the implementation of HIV-related research studies and following the scale-up of the ART programme. The same study design was used in both the 2004 and 2008 surveys: 10% of households were randomly selected and all residents aged ≥ 14 years were invited to complete a self-administered questionnaire. Overall basic knowledge of HIV/AIDS increased from 2004 to 2008 (p=0.04) and stigmatisation towards HIV-positive individuals decreased over the same time period (p<0.001). Increasing knowledge score was significantly associated with a lower stigma score (p<0.001). Decreasing stigma score was associated with knowing someone who was HIV infected (p<0.001), or who had died from HIV/AIDS (p=0.04). The proportion of participants who had undergone HIV testing increased from 2004 to 2008 (40 vs. 70%, respectively) and, in particular, VCT increased from 26 to 43%. In adjusted analysis, participants who had undergone HIV testing were more likely to have a higher HIV knowledge score (p=0.02) and a lower

  6. Health-Related Stigma as a Determinant of Functioning in Young Adults with Narcolepsy

    PubMed Central

    Kapella, Mary C.; Berger, Barbara E.; Vern, Boris A.; Vispute, Sachin; Prasad, Bharati; Carley, David W.

    2015-01-01

    Symptoms of narcolepsy tend to arise during adolescence or young adulthood, a formative time in human development during which people are usually completing their education and launching a career. Little is known about the impact of narcolepsy on the social aspects of health-related quality of life in young adults. The purpose of this study was to examine relationships between health-related stigma, mood (anxiety and depression) and daytime functioning in young adults with narcolepsy compared to those without narcolepsy. Young adults (age 18–35) with narcolepsy (N = 122) and without narcolepsy (N = 93) were mailed a packet that included questionnaires and a self-addressed postage paid envelope. The questionnaire included demographic information and a composite of instruments including the SF 36, Functional Outcomes of Sleep Questionnaire (FOSQ), Fife Stigma Scale (FSS), Epworth Sleepiness Scale (ESS) and Hospital Anxiety and Depression Scale (HADS). Variable associations were assessed using descriptive statistics, ANOVA, Mann-Whitney U Test, correlations, stepwise multiple regression and path analysis. Young adults with narcolepsy perceived significantly more stigma and lower mood and health-related quality of life than young adults without narcolepsy (p<0.01). Health-related stigma was directly and indirectly associated with lower functioning through depressed mood. Fifty-two percent of the variance in functioning was explained by the final model in the young adults with narcolepsy. Health-related stigma in young adults with narcolepsy is at a level consistent with other chronic medical illnesses. Health-related stigma may be an important determinant of functioning in young adults with narcolepsy. Future work is indicated toward further characterizing stigma and developing interventions that address various domains of stigma in people with narcolepsy. PMID:25898361

  7. Predictors of HIV-related stigmas among African American and Latino religious congregants

    PubMed Central

    Derose, Kathryn Pitkin; Kanouse, David E.; Bogart, Laura M.; Griffin, Beth Ann; Haas, Ann; Stucky, Brian D.; Williams, Malcolm V.; Flórez, Karen R.

    2015-01-01

    Objectives Inform church-based stigma interventions by exploring dimensions of HIV stigma among African American and Latino religious congregants and how these are related to drug addiction and homosexuality stigmas and knowing someone HIV-positive. Methods In-person, self-administered surveys of congregants 18+ years old across two African American and three Latino churches (n=1235, response rate 73%) in a western US city with high HIV prevalence. Measures included 12 items that captured dimensions of HIV stigma, a 5-item scale that assessed attitudes towards people who are addicted to drugs, a 7-item scale assessing attitudes towards homosexuality, and questions regarding socio-demographics and previous communication about HIV. Results 63.8% of survey participants were women, mean age was 40.2 years, and 34.4% were African American, 16.8% were U.S.-born Latinos, 16.0% were foreign-born, English-speaking Latinos, and 32.9% were foreign-born, Spanish-speaking Latinos. Exploratory and confirmatory factor analyses identified four dimensions of HIV stigma – discomfort interacting with people with HIV (4 items, α=0.86), feelings of shame “if you had HIV” (3 items, α=0.78), fears of rejection “if you had HIV” (3 items, α=0.71) and feelings of blame towards people with HIV (2 items, α=0.65). Across all dimensions, after controlling for socio-demographic characteristics and previous communication about HIV, knowing someone with HIV was associated with lower HIV stigma, and greater stigma concerning drug addiction and homosexuality were associated with higher HIV stigma. Conclusions Congregation-based HIV stigma reduction interventions should consider incorporating contact with HIV-affected people. It may also be helpful to address attitudes toward drug addiction and sexual orientation. PMID:26213890

  8. Tablet-Based Education to Reduce Depression-Related Stigma

    ERIC Educational Resources Information Center

    Lu, Catherine; Winkelman, Megan; Wong, Shane Shucheng

    2016-01-01

    Objectives: This study investigated the efficacy of a tablet-based multimedia education application, the Project Not Alone Depression Module, in improving depression literacy and reducing depression stigma among a community-based mental health clinic population. Methods: A total of 93 participants completed either a tablet-based multimedia…

  9. Cancer-related trauma, stigma and growth: the 'lived' experience of head and neck cancer.

    PubMed

    Threader, J; McCormack, L

    2016-01-01

    Head and neck cancer is associated with multiple layers of distress including stigma. Stigma attraction or devalued social identity is twofold: (1) it is a cancer associated with lifestyle risk factors and (2) treatment often results in confronting facial disfigurement. Subjective interpretations from nine head and neck cancer patients were analysed using Interpretative Phenomenological Analysis. An overarching superordinate theme--Distress, Stigma and Psychological Growth--encompassed four subordinate themes. Two themes captured the expressed trauma and terror as a result of diagnosis and treatment, and two the redefining of self despite stigma through meaning making. Distress was interpreted as a catalyst for awakening new life interpretations and combined with social support to facilitate two distinct pathways of growth: (1) psychological growth without support; (2) psychological and relational growth with support. Previously unfelt empathetic understanding and altruism for others with cancer emerged from the impact of stigma on 'self'. Acceptance allowed a new sense of identity that recognised cancer-related traumatic distress as integral to growth for these participants. The present study offers a unique insight into cancer-related trauma and stigma and the potential to redefine a more accepting, empathic and altruistic 'self' for psychological growth. Implications are discussed. PMID:25899673

  10. Strategies to overcome type 1 diabetes–related social stigma in the Iranian society

    PubMed Central

    Irani, Mehri Doosti; Abdoli, Samereh; Bijan, Iraj; Parvizy, Soroor; Fatemi, Naimeh Seyed; Amini, Massoud

    2014-01-01

    Background: This study explored the strategies to overcome diabetes-related social stigma in Iran. Materials and Methods: This paper is part of an action research study which was designed in Iran in 2012 to plan and implement a program for overcoming diabetes-related stigma. Participants were people with type 1 diabetes, their family members, people without diabetes, and care providers in a diabetes center. Data collection was done through unstructured in-depth interviews, focus groups, e-mail, Short Message Service (SMS), and telephone interview. Data were analyzed using inductive content analysis approach. Results: Participants believed that it is impossible to overcome the stigma without community-based strategies. Community-based strategies include education, advocacy, contact, and protest. Conclusions: The anti-stigma strategies obtained in the study are based on the cultural context in Iran. They are extracted from statements of a wide range of people (with and without diabetes). However, during planning for stigma reduction, it is necessary to note that the effectiveness of social strategies varies in different studies and in different stigmatizing conditions and many factors are involved. These strategies should be implemented simultaneously at different levels to produce structural and social changes. It should be accepted that research on reducing health-related stigma has shown that it is very difficult to change beliefs and behavior. Evidence suggests that individuals and their families should be involved in all aspects of the program, and plans should be made according to the local conditions. PMID:25400672

  11. Women of Color Reflect on HIV-Related Stigma through PhotoVoice.

    PubMed

    Davtyan, Mariam; Farmer, Shu; Brown, Brandon; Sami, Mojgan; Frederick, Toni

    2016-01-01

    HIV-related stigma affects people living with HIV (PLWH), especially in communities of color. In our study, African American and Latina/Hispanic women living with HIV (WLWH) described experiences of stigma through PhotoVoice, a community-based participatory method of documentary photography. Ten WLWH from Los Angeles documented stigma experiences through photographs for up to 5 weeks and discussed their images during a focus group or semi-structured individual interview. Qualitative interpretive phenomenological analysis of participant narratives and photographs revealed lack of education and cultural myths as the main triggers of the stigma our participants faced. Stigma was experienced in health care settings, and participants identified depression, fear of intimate relationships, and nondisclosure of HIV status as its consequences. Social support and faith were noted as key coping mechanisms. WLWH recommended involving PLWH and public health officials in stigma reduction campaigns and youth education. PhotoVoice was perceived as a useful tool for education and self-improvement. PMID:27085253

  12. Preexposure prophylaxis-related stigma: strategies to improve uptake and adherence - a narrative review.

    PubMed

    Haire, Bridget G

    2015-01-01

    Despite high levels of efficacy, the implementation of preexposure prophylaxis (PrEP) as a strategy to prevent new HIV infection has been slow. Studies show that PrEP works so long as it is taken, making adherence one of the great challenges of effective PrEP implementation alongside issues of access and uptake. Given that effective PrEP use requires ongoing self-administration of pills by people at high risk of HIV acquisition, it is a strategy best understood not as simply biomedical, but as biobehavioral or biopsychosocial, meaning that that social, psychological, cultural, and structural factors all contribute to the success or failure of the intervention. The willingness of people at risk of HIV to take up and adhere to PrEP depends greatly upon social understandings - whether it is seen as effective, as a healthy option, and a socially acceptable strategy for preventing HIV. Stigma - unfavorable associations - can negatively influence the implementation of PrEP. Because it is associated with high-risk sexual activity, PrEP risks multiple stigmas that can differ according to specific cultural conditions. This includes the stigma of being related to HIV (which may also relate to other stigmas, such as homosexuality, sex work, and/or drug use) and the stigma of PrEP being an alternative to condoms (as condom use is associated with responsible sexual activity). PrEP-related stigma has emerged as a significant social harm that can arise from PrEP research participation, reported by trial participants from a range of different trial sites, different trial populations, and spanning different continents. Social marketing needs to redress PrEP-related stigmas through health promotion campaigns aimed at clinicians, HIV-affected communities, and people at high risk of HIV who might benefit from PrEP access. PrEP access needs to be reframed as a positive and responsible option to help people remain HIV-negative. PMID:26508889

  13. Stigma against People Living with HIV/AIDS in China: Does the Route of Infection Matter?

    PubMed Central

    Zhang, Chen; Li, Xiaoming; Liu, Yu; Qiao, Shan; Zhang, Liying; Zhou, Yuejiao; Tang, Zhenzhu; Shen, Zhiyong; Chen, Yi

    2016-01-01

    In the current study, we tested the hypothesis that people who contracted HIV from “blameless” routes (e.g., blood transfusion, sex with stable partners) are less stigmatized compared to people who contracted HIV from “blamable” routes (e.g., injection drug use, sex with sex workers). A cross-sectional study was conducted among 2,987 participants in Guangxi province, China, between 2012 and 2013. We employed both explanatory and predictive modeling strategy by using multivariate linear regression models. In the explanatory models, we assessed the association between routes of infection and three types of stigma (perceived, internalized, and enacted). From identified routes of infection that significantly contributed to higher stigma, we employed predictive modeling to explore predictors for the specific type of stigma. Multiple-imputation was employed for sensitivity analyses. Of the total sample, 63% were male and the average age was 42.9 years (ranged between 18 and 88). Multivariate regression models revealed that contraction from commercial sex increased the perceived (β = 0.46, 95%CI = 0.02, 0.90) and internalized stigma (β = 0.60, 95%CI = 0.09, 1.10), while injecting drug use increased the perceived (β = 0.65, 95%CI = 0.07, 1.22) and enacted stigma (β = 0.09, 95%CI = 0.02, 0.16) after controlling for confounders. Among PLWHA who were infected via commercial sex partners, social support was negatively associated with perceived (β = -0.47, 95%CI = -0.79, -0.14) and internalized stigma (β = -0.80, 95%CI = -1.24, -0.35). Among PLWHA who were infected via injecting drugs, no adherence to antiretroviral treatment (β = 0.41, 95%CI = 0.01, 0.82) was positively associated with perceived stigma, and disclosure of serostatus to others was negatively associated with enacted stigma (β = -0.20, 95%CI = -0.34, -0.05). Knowledge of the association between routes of infection and stigma can guide health professionals and policy makers to develop tailored

  14. Stigma against People Living with HIV/AIDS in China: Does the Route of Infection Matter?

    PubMed

    Zhang, Chen; Li, Xiaoming; Liu, Yu; Qiao, Shan; Zhang, Liying; Zhou, Yuejiao; Tang, Zhenzhu; Shen, Zhiyong; Chen, Yi

    2016-01-01

    In the current study, we tested the hypothesis that people who contracted HIV from "blameless" routes (e.g., blood transfusion, sex with stable partners) are less stigmatized compared to people who contracted HIV from "blamable" routes (e.g., injection drug use, sex with sex workers). A cross-sectional study was conducted among 2,987 participants in Guangxi province, China, between 2012 and 2013. We employed both explanatory and predictive modeling strategy by using multivariate linear regression models. In the explanatory models, we assessed the association between routes of infection and three types of stigma (perceived, internalized, and enacted). From identified routes of infection that significantly contributed to higher stigma, we employed predictive modeling to explore predictors for the specific type of stigma. Multiple-imputation was employed for sensitivity analyses. Of the total sample, 63% were male and the average age was 42.9 years (ranged between 18 and 88). Multivariate regression models revealed that contraction from commercial sex increased the perceived (β = 0.46, 95%CI = 0.02, 0.90) and internalized stigma (β = 0.60, 95%CI = 0.09, 1.10), while injecting drug use increased the perceived (β = 0.65, 95%CI = 0.07, 1.22) and enacted stigma (β = 0.09, 95%CI = 0.02, 0.16) after controlling for confounders. Among PLWHA who were infected via commercial sex partners, social support was negatively associated with perceived (β = -0.47, 95%CI = -0.79, -0.14) and internalized stigma (β = -0.80, 95%CI = -1.24, -0.35). Among PLWHA who were infected via injecting drugs, no adherence to antiretroviral treatment (β = 0.41, 95%CI = 0.01, 0.82) was positively associated with perceived stigma, and disclosure of serostatus to others was negatively associated with enacted stigma (β = -0.20, 95%CI = -0.34, -0.05). Knowledge of the association between routes of infection and stigma can guide health professionals and policy makers to develop tailored intervention

  15. Evaluating the Measurement Structure of the Abbreviated HIV Stigma Scale in a Sample of African Americans Living with HIV/AIDS

    ERIC Educational Resources Information Center

    Johnson, Eboneé T.; Yaghmaian, Rana A.; Best, Andrew; Chan, Fong; Burrell, Reginald, Jr.

    2016-01-01

    Purpose: The purpose of this study was to validate the 10-item version of the HIV Stigma Scale (HSS-10) in a sample of African Americans with HIV/AIDS. Method: One hundred and ten African Americans living with HIV/AIDS were recruited from 3 case management agencies in Baton Rouge, Louisiana. Measurement structure of the HSS-10 was evaluated using…

  16. Adapting the minority stress model: associations between gender non-conformity stigma, HIV-related stigma and depression among men who have sex with men in South India.

    PubMed

    Logie, Carmen H; Newman, Peter A; Chakrapani, Venkatesan; Shunmugam, Murali

    2012-04-01

    Marginalization and stigmatization heighten the vulnerability of sexual minorities to inequitable mental health outcomes. There is a dearth of information regarding stigma and mental health among men who have sex with men (MSM) in India. We adapted Meyer's minority stress model to explore associations between stigma and depression among MSM in South India. The study objective was to examine the influence of sexual stigma, gender non-conformity stigma (GNS) and HIV-related stigma (HIV-S) on depression among MSM in South India. A cross-sectional survey was administered to MSM in urban (Chennai) (n=100) and semi-urban (Kumbakonam) (n=100) locations in Tamil Nadu. The majority of participants reported moderate/severe depression scores. Participants in Chennai reported significantly higher levels of GNS, social support and resilient coping, and lower levels of HIV-S and depression, than participants in Kumbakonam. Hierarchical block regression analyses were conducted to measure associations between independent (GNS, HIV-S), moderator (social support, resilient coping) and dependent (depression) variables. Sexual stigma was not included in regression analyses due to multicollinearity with GNS. The first regression analyses assessed associations between depression and stigma subtypes. In Chennai, perceived GNS was associated with depression; in Kumbakonam enacted/perceived GNS and vicarious HIV-S were associated with depression. In the moderation analyses, overall GNS and HIV-S scores (subtypes combined) accounted for a significant amount of variability in depression in both locations, although HIV-S was only a significant predictor in Kumbakonam. Social support and resilient coping were associated with lower depression but did not moderate the influence of HIV-S or GNS on depression. Differences in stigma, coping, social support and depression between locations highlight the salience of considering geographical context in stigma analyses. Associations between HIV-S and

  17. Coping strategies for HIV-related stigma in Liuzhou, China.

    PubMed

    Zhang, Ying-Xia; Ying-Xia, Zhang; Golin, Carol E; Bu, Jin; Jin, Bu; Emrick, Catherine Boland; Nan, Zhang; Li, Ming-Qiang; Ming-Qiang, Li

    2014-02-01

    This study explores the feelings, experiences, and coping strategies of people living with HIV (PLHIV) in Liuzhou, China. In a southwestern Chinese city with high HIV prevalence, we conducted semi-structured in-depth interviews with 47 PLHIV selected to represent individuals who had acquired HIV via different acquisition routes. Many participants felt severely stigmatized; they commonly reported having very low self-esteem and feelings of despair. Based on style of coping and whether it occurred at the interpersonal or intrapersonal level, four types of coping that participants used to deal with HIV-associated stigma were identified: (1) Compassion (Passive/Avoidant-Interpersonal); (2) Hiding HIV status (Passive/Avoidant-Intrapersonal); (3) Social support (Active/Problem-focused-Interpersonal; and (4) Self-care (Active/Problem-focused-Intrapersonal). Educational and stigma-reduction interventions targeting potential social support networks for PLHIV (e.g., family, close friends, and peers) could strengthen active interpersonal PLHIV coping strategies. Interventions teaching self-care to PLHIV would encourage active intrapersonal coping, both of which may enhance PLHIV quality of life in Liuzhou, China. PMID:24337724

  18. Gender and ethnicity differences in HIV-related stigma experienced by people living with HIV in Ontario, Canada.

    PubMed

    Loutfy, Mona R; Logie, Carmen H; Zhang, Yimeng; Blitz, Sandra L; Margolese, Shari L; Tharao, Wangari E; Rourke, Sean B; Rueda, Sergio; Raboud, Janet M

    2012-01-01

    This study aimed to understand gender and ethnicity differences in HIV-related stigma experienced by 1026 HIV-positive individuals living in Ontario, Canada that were enrolled in the OHTN Cohort Study. Total and subscale HIV-related stigma scores were measured using the revised HIV-related Stigma Scale. Correlates of total stigma scores were assessed in univariate and multivariate linear regression. Women had significantly higher total and subscale stigma scores than men (total, median = 56.0 vs. 48.0, p<0.0001). Among men and women, Black individuals had the highest, Aboriginal and Asian/Latin-American/Unspecified people intermediate, and White individuals the lowest total stigma scores. The gender-ethnicity interaction term was significant in multivariate analysis: Black women and Asian/Latin-American/Unspecified men reported the highest HIV-related stigma scores. Gender and ethnicity differences in HIV-related stigma were identified in our cohort. Findings suggest differing approaches may be required to address HIV-related stigma based on gender and ethnicity; and such strategies should challenge racist and sexist stereotypes. PMID:23300514

  19. Gender and Ethnicity Differences in HIV-related Stigma Experienced by People Living with HIV in Ontario, Canada

    PubMed Central

    Loutfy, Mona R.; Logie, Carmen H.; Zhang, Yimeng; Blitz, Sandra L.; Margolese, Shari L.; Tharao, Wangari E.; Rourke, Sean B.; Rueda, Sergio; Raboud, Janet M.

    2012-01-01

    This study aimed to understand gender and ethnicity differences in HIV-related stigma experienced by 1026 HIV-positive individuals living in Ontario, Canada that were enrolled in the OHTN Cohort Study. Total and subscale HIV-related stigma scores were measured using the revised HIV-related Stigma Scale. Correlates of total stigma scores were assessed in univariate and multivariate linear regression. Women had significantly higher total and subscale stigma scores than men (total, median = 56.0 vs. 48.0, p<0.0001). Among men and women, Black individuals had the highest, Aboriginal and Asian/Latin-American/Unspecified people intermediate, and White individuals the lowest total stigma scores. The gender-ethnicity interaction term was significant in multivariate analysis: Black women and Asian/Latin-American/Unspecified men reported the highest HIV-related stigma scores. Gender and ethnicity differences in HIV-related stigma were identified in our cohort. Findings suggest differing approaches may be required to address HIV-related stigma based on gender and ethnicity; and such strategies should challenge racist and sexist stereotypes. PMID:23300514

  20. Evidence for effective interventions to reduce mental-health-related stigma and discrimination.

    PubMed

    Thornicroft, Graham; Mehta, Nisha; Clement, Sarah; Evans-Lacko, Sara; Doherty, Mary; Rose, Diana; Koschorke, Mirja; Shidhaye, Rahul; O'Reilly, Claire; Henderson, Claire

    2016-03-12

    Stigma and discrimination in relation to mental illnesses have been described as having worse consequences than the conditions themselves. Most medical literature in this area of research has been descriptive and has focused on attitudes towards people with mental illness rather than on interventions to reduce stigma. In this narrative Review, we summarise what is known globally from published systematic reviews and primary data on effective interventions intended to reduce mental-illness-related stigma or discrimination. The main findings emerging from this narrative overview are that: (1) at the population level there is a fairly consistent pattern of short-term benefits for positive attitude change, and some lesser evidence for knowledge improvement; (2) for people with mental illness, some group-level anti-stigma inventions show promise and merit further assessment; (3) for specific target groups, such as students, social-contact-based interventions usually achieve short-term (but less clearly long-term) attitudinal improvements, and less often produce knowledge gains; (4) this is a heterogeneous field of study with few strong study designs with large sample sizes; (5) research from low-income and middle-income countries is conspicuous by its relative absence; (6) caution needs to be exercised in not overgeneralising lessons from one target group to another; (7) there is a clear need for studies with longer-term follow-up to assess whether initial gains are sustained or attenuated, and whether booster doses of the intervention are needed to maintain progress; (8) few studies in any part of the world have focused on either the service user's perspective of stigma and discrimination or on the behaviour domain of behavioural change, either by people with or without mental illness in the complex processes of stigmatisation. We found that social contact is the most effective type of intervention to improve stigma-related knowledge and attitudes in the short term

  1. The Association of HIV-Related Stigma to HIV Medication Adherence: A Systematic Review and Synthesis of the Literature.

    PubMed

    Sweeney, Shannon M; Vanable, Peter A

    2016-01-01

    This paper provides a review of the quantitative literature on HIV-related stigma and medication adherence, including: (1) synthesis of the empirical evidence linking stigma to adherence, (2) examination of proposed causal mechanisms of the stigma and adherence relationship, and (3) methodological critique and guidance for future research. We reviewed 38 studies reporting either cross-sectional or prospective analyses of the association of HIV-related stigma to medication adherence since the introduction of antiretroviral therapies (ART). Although there is substantial empirical evidence linking stigma to adherence difficulties, few studies provided data on psychosocial mechanisms that may account for this relationship. Proposed mechanisms include: (a) enhanced vulnerability to mental health difficulties, (b) reduction in self-efficacy, and (c) concerns about inadvertent disclosure of HIV status. Future research should strive to assess the multiple domains of stigma, use standardized measures of adherence, and include prospective analyses to test mediating variables. PMID:26303196

  2. Tuberculosis-related stigma leading to an incomplete contact investigation in a low-incidence country.

    PubMed

    Faccini, M; Cantoni, S; Ciconali, G; Filipponi, M T; Mainardi, G; Marino, A F; Senatore, S; Codecasa, L R; Ferrarese, M; Gesu, G; Mazzola, E; Filia, A

    2015-10-01

    A contact investigation following a case of infectious tuberculosis (TB) reported in a call centre in Milan (Italy) led to the identification of three additional cases that had occurred in employees of the same workplace during the previous 5 years, one of whom was the probable source case. Thirty-three latent infections were also identified. At the time of diagnosis, the source case, because of fear of stigma related to TB, claimed to be unemployed and a contact investigation was not performed in the workplace. Cases were linked through genotyping of Mycobacterium tuberculosis. TB stigma has been described frequently, mainly in high-incidence settings, and is known to influence health-seeking behaviours and treatment adherence. The findings in this report highlight that TB-associated stigma may also lead to incomplete contact investigations. Little is known about the causes and impact of TB-related stigma in low-incidence countries and this warrants further exploration. Research is also needed to evaluate the effectiveness of specific interviewing techniques and training interventions for staff in reducing feelings of stigma in TB patients. Finally, the outbreak emphasizes the importance of integrating routine contact investigations with genotyping. PMID:25600903

  3. Duty and destiny: psychometric properties and correlates of HIV-related stigma among youth NGO workers in Delhi, India.

    PubMed

    Nambiar, Devaki; Rimal, Rajiv N

    2012-01-01

    Nongovernmental organizations (NGOs) are increasingly providing critical health-related services to hard-to-reach populations. In India, stigma has been cited as a barrier to NGO participation in HIV-prevention activities with high-risk populations. Our study undertook to characterize and contextualize HIV-related stigma within HIV NGOs in Delhi, India. We investigated psychometric characteristics and correlates of HIV-related stigma in a sample of youth NGO practitioners (N=122) working on peer HIV prevention. Factor analyses revealed a "cultural inflection" of stigma in this population: assignment of blame on people living with HIV (PLWH) factored along with individual behaviors and care-taking (Dharma, or Duty), distinct from the perception of HIV as God's punishment, which was connected to ostracism from society (Karma, or Destiny). Exposure to HIV-related messages in newspapers was associated with 55.7% lower levels of Dharma-related stigma (p=0.07) and 58% lower levels of Karma-related stigma scores (p=0.01), respectively, while recall of HIV-related messages on the radio was associated with 57.3% lower Dharma-related (p=0.03) and 34.1% lower Karma-related stigma scores (p=0.06), respectively. The strongest correlate of lower HIV-related stigma was social proximity to PLWH (~76% reduction on both stigma factors, p<0.03). Future research on HIV-related stigma should consider the unique cultural properties and correlates of stigma among young NGO practitioners. PMID:22292453

  4. Use of indigenous cultural idioms by Chinese immigrant relatives for psychosis: impacts on stigma and psychoeducational approaches.

    PubMed

    Yang, Lawrence H; Singla, Daisy R

    2011-11-01

    Indigenous interpretations of mental illness might negatively impact treatment adherence. However, psychiatric "labeling" potentially leads to stigma among Chinese groups, thus encouraging the use of indigenous idioms. We examined how relatives' use of indigenous labeling varied with the consumers' experience of illness and whether indigenous labeling protected relatives from internalized and experienced forms of stigma. Forty-nine relatives of Chinese-immigrant consumers with psychosis were sampled. Although consumers had progressed to the middle stages of psychosis, 39% of relatives used indigenous idioms to label psychosis. Indigenous labeling decreased when illness duration increased and when visual hallucinations were present. Indigenous labeling further predicted lower internalized stigma among relatives. Relatives who used indigenous labeling also reported fewer indirect stigma experiences, although not after controlling for illness severity. The frequency of direct discrimination among relatives did not differ by labeling. These forms of felt stigma might be embedded into relatives' psychoeducation programs to mitigate adverse consequences of psychiatric labeling. PMID:22048140

  5. Making sense of HIV stigma: representations in young Africans’ HIV-related narratives

    PubMed Central

    Winskell, Kate; Holmes, Kathleen; Neri, Elizabeth; Berkowitz, Rachel; Mbakwem, Benjamin; Obyerodhyambo, Oby

    2015-01-01

    In addition to undermining the quality of life of those infected and affected by HIV, HIV-related stigma impedes access to prevention and treatment services, thereby threatening to erode the promise of recent advances in these areas. This paper provides insights into the socio-contextual and sense-making processes that inform HIV stigma through an innovative form of empirical data: creative fictional narratives written by young Africans (aged 10–24) for an HIV-themed scriptwriting competition. From a sample of 586 narratives from six sub-Saharan countries, we selected for illustrative purposes three on account of the complexity of their representation of HIV stigma. We conducted a close reading of each, using stigma theory as a lens. Through their explicit accounts of stigmatizing attitudes and behaviours of characters and through implicit contradictions, tensions, and ambivalence in their messaging, the narratives provides insights into the symbolic and social processes that create and sustain HIV stigma. Our analysis illuminates the authors’ struggles to navigate the cultural resources available to them in their efforts to make sense of HIV, gender and sexuality. It highlights some limitations of current communication efforts and the potential for narrative-based communication approaches to engage with representations that devalue women and people living with HIV. PMID:26132087

  6. Making sense of HIV stigma: Representations in young Africans' HIV-related narratives.

    PubMed

    Winskell, Kate; Holmes, Kathleen; Neri, Elizabeth; Berkowitz, Rachel; Mbakwem, Benjamin; Obyerodhyambo, Oby

    2015-01-01

    In addition to undermining the quality of life of those infected and affected by HIV, HIV-related stigma impedes access to prevention and treatment services, thereby threatening to erode the promise of recent advances in these areas. This paper provides insights into the socio-contextual and sense-making processes that inform HIV stigma through an innovative form of empirical data: creative fictional narratives written by young Africans (aged 10-24) for an HIV-themed scriptwriting competition. From a sample of 586 narratives from six sub-Saharan countries, we selected for illustrative purposes three on account of the complexity of their representation of HIV stigma. We conducted a close reading of each, using stigma theory as a lens. Through their explicit accounts of stigmatising attitudes and behaviours of characters and through implicit contradictions, tensions and ambivalence in their messaging, the narratives provide insights into the symbolic and social processes that create and sustain HIV stigma. Our analysis illuminates the authors' struggles to navigate the cultural resources available to them in their efforts to make sense of HIV, gender and sexuality. It highlights some limitations of current communication efforts and the potential for narrative-based communication approaches to engage with representations that devalue women and people living with HIV. PMID:26132087

  7. The Public Stigma of Problem Gambling: Its Nature and Relative Intensity Compared to Other Health Conditions.

    PubMed

    Hing, Nerilee; Russell, Alex M T; Gainsbury, Sally M; Nuske, Elaine

    2016-09-01

    Problem gambling attracts considerable public stigma, with deleterious effects on mental health and use of healthcare services amongst those affected. However, no research has examined the extent of stigma towards problem gambling within the general population. This study aimed to examine the stigma-related dimensions of problem gambling as perceived by the general public compared to other health conditions, and determine whether the publicly perceived dimensions of problem gambling predict its stigmatisation. A sample of 2000 Australian adults was surveyed, weighted to be representative of the state population by gender, age and location. Based on vignettes, the online survey measured perceived origin, peril, concealability, course and disruptiveness of problem gambling and four other health conditions, and desired social distance from each. Problem gambling was perceived as caused mainly by stressful life circumstances, and highly disruptive, recoverable and noticeable, but not particularly perilous. Respondents stigmatised problem gambling more than sub-clinical distress and recreational gambling, but less than alcohol use disorder and schizophrenia. Predictors of stronger stigma towards problem gambling were perceptions it is caused by bad character, is perilous, non-recoverable, disruptive and noticeable, but not due to stressful life circumstances, genetic/inherited problem, or chemical imbalance in the brain. This new foundational knowledge can advance understanding and reduction of problem gambling stigma through countering inaccurate perceptions that problem gambling is caused by bad character, that people with gambling problems are likely to be violent to other people, and that people cannot recover from problem gambling. PMID:26487344

  8. Subjective experiences of stigma. A focus group study of schizophrenic patients, their relatives and mental health professionals.

    PubMed

    Schulze, Beate; Angermeyer, Matthias C

    2003-01-01

    Schizophrenia has been found to be one of the most stigmatising conditions. To the present, most research on stigma related to mental illness has drawn conclusions on the adverse reactions faced by people with schizophrenia from studies on public attitudes or analogue behavioural studies. The views of those exposed to the stigmatising reactions, however, has largely been absent. Aiming to explore stigma from the subjective perspective of people with schizophrenia, a focus group study was carried out at the four centres involved in the WPA Global Programme against Stigma and Discrimination because of Schizophrenia in Germany. In order to get a comprehensive picture of how stigma affects the lives of schizophrenic patients, collateral information was sought from relatives and mental health professionals. The focus groups enquired about concrete stigmatisation experiences of the patients and incidences of stigma witnessed by the other two groups. Focus group sessions were tape-recorded and transcripts were coded using an inductive method. Results reveal four dimensions of stigma: interpersonal interaction, structural discrimination, public images of mental illness and access to social roles. Examples are given for the views of patients, relatives and mental health professionals on each of the four stigma types. The consequences for conceptualisations of stigma and the development of effective strategies to reduce stigma and discrimination because of schizophrenia are discussed. PMID:12473315

  9. Impact of HIV-related stigma on treatment adherence: systematic review and meta-synthesis

    PubMed Central

    Katz, Ingrid T; Ryu, Annemarie E; Onuegbu, Afiachukwu G; Psaros, Christina; Weiser, Sheri D; Bangsberg, David R; Tsai, Alexander C

    2013-01-01

    Introduction Adherence to HIV antiretroviral therapy (ART) is a critical determinant of HIV-1 RNA viral suppression and health outcomes. It is generally accepted that HIV-related stigma is correlated with factors that may undermine ART adherence, but its relationship with ART adherence itself is not well established. We therefore undertook this review to systematically assess the relationship between HIV-related stigma and ART adherence. Methods We searched nine electronic databases for published and unpublished literature, with no language restrictions. First we screened the titles and abstracts for studies that potentially contained data on ART adherence. Then we reviewed the full text of these studies to identify articles that reported data on the relationship between ART adherence and either HIV-related stigma or serostatus disclosure. We used the method of meta-synthesis to summarize the findings from the qualitative studies. Results Our search protocol yielded 14,854 initial records. After eliminating duplicates and screening the titles and abstracts, we retrieved the full text of 960 journal articles, dissertations and unpublished conference abstracts for review. We included 75 studies conducted among 26,715 HIV-positive persons living in 32 countries worldwide, with less representation of work from Eastern Europe and Central Asia. Among the 34 qualitative studies, our meta-synthesis identified five distinct third-order labels through an inductive process that we categorized as themes and organized in a conceptual model spanning intrapersonal, interpersonal and structural levels. HIV-related stigma undermined ART adherence by compromising general psychological processes, such as adaptive coping and social support. We also identified psychological processes specific to HIV-positive persons driven by predominant stigmatizing attitudes and which undermined adherence, such as internalized stigma and concealment. Adaptive coping and social support were critical

  10. Knowledge of depression and depression related stigma in immigrants from former Yugoslavia.

    PubMed

    Copelj, Anja; Kiropoulos, Litza

    2011-12-01

    The aim of the current research was to assess and compare level of depression literacy and level of depression related stigma in first generation immigrants from former Yugoslavia (FY) with a same aged Anglo Australian (AA) sample. The community sample comprised of 54 immigrants born in the FY and 54 AA born participants living in Melbourne. Participants were recruited through various social and recreational clubs. All participants completed questionnaires assessing depression literacy, self and perceived stigma and level of acculturation for the immigrants from FY in an interview format. After controlling for level of education, immigrants from the FY demonstrated lower depression literacy and higher personal and perceived depression stigma scores compared to the AA participants. The findings provide further insight to potential barriers impeding access to mental health care in immigrant populations living in Australia. Implications for mental health professionals working with immigrant populations in Australia are discussed. PMID:21424537

  11. Details for Manuscript Number SSM-D-07-01631R1 “HIV-Related Stigma: Adapting a Theoretical Framework for Use in India”

    PubMed Central

    Herek, Gregory M; Ramakrishna, Jayashree; Bharat, Shalini; Chandy, Sara; Wrubel, Judith; Ekstrand, Maria L

    2008-01-01

    Stigma complicates the treatment of HIV worldwide. We examined whether a multi-component framework, initially consisting of enacted, felt normative, and internalized forms of individual stigma experiences, could be used to understand HIV-related stigma in Southern India. In Study 1, qualitative interviews with a convenience sample of 16 people living with HIV revealed instances of all three types of stigma. Experiences of discrimination (enacted stigma) were reported relatively infrequently. Rather, perceptions of high levels of stigma (felt normative stigma) motivated people to avoid disclosing their HIV status. These perceptions often were shaped by stories of discrimination against others HIV-infected individuals, which we adapted as an additional component of our framework (vicarious stigma). Participants also varied in their acceptance of HIV stigma as legitimate (internalized stigma). In Study 2, newly-developed measures of the stigma components were administered in a survey to 229 people living with HIV. Findings suggested that enacted and vicarious stigma influenced felt normative stigma; that enacted, felt normative, and internalized stigma were associated with higher levels of depression; and that the associations of depression with felt normative and internalized forms of stigma were mediated by the use of coping strategies designed to avoid disclosure of one's HIV serostatus. PMID:18599171

  12. Experiences of HIV-related stigma among HIV-positive older persons in Uganda – a mixed methods analysis

    PubMed Central

    Kuteesa, Monica O.; Wright, Stuart; Seeley, Janet; Mugisha, Joseph; Kinyanda, Eugene; Kakembo, Frederick; Mwesigwa, Richard; Scholten, Francis

    2014-01-01

    Abstract There is limited data on stigma among older HIV-infected adults in sub-Saharan Africa. We describe the experiences of stigma and disclosure in a cohort of HIV-positive older people in Uganda. Using data from the Wellbeing of Older Peoples' Study of Kalungu (rural site) and Wakiso district (peri-urban site) residents, we measured self-reported stigma levels for 183 respondents (94 on antiretroviral therapy (ART); 88, not on ART) using a stigma score generated using three questions on stigma perceptions where 0 meant no stigma at all and 100 was maximum stigma. Based on two questions on disclosure, an overall score was computed. High disclosure was assigned to those who often or very often disclosed to the family and were never or seldom afraid to disclose elsewhere. We examined the experiences of HIV stigma of 25 adults (52% females) using semi-structured, open-ended interviews and monthly oral diaries over one year. Mean age of the respondents was 70 years (range 60–80 years) and 80% of all respondents were enrolled in ART. Interview transcripts were analysed using thematic content analysis. Overall, 55% of respondents had a high disclosure score, meaning they disclosed easily, and 47% had a high stigma score. The stigma scores were similar among those with high and low disclosure scores. In multivariate analyses with disclosure and stigma scores as dependent variables none of the respondents' characteristics had a significant effect at the 5% level. Qualitative data revealed that stigma ranges from: (1) perceptions (relatively passive, but leading to behaviour such as gossip, especially if not intended maliciously); to (2) discriminatory behaviour (active or enacted stigma; from malicious gossip to outright discrimination). Despite the relatively high levels of disclosure, older people suffer from high levels of stigma of various forms apart from HIV-related stigma. Efforts to assess for different forms of stigma at an individual level deserve greater

  13. Experiences of HIV-related stigma among HIV-positive older persons in Uganda--a mixed methods analysis.

    PubMed

    Kuteesa, Monica O; Wright, Stuart; Seeley, Janet; Mugisha, Joseph; Kinyanda, Eugene; Kakembo, Frederick; Mwesigwa, Richard; Scholten, Francis

    2014-01-01

    There is limited data on stigma among older HIV-infected adults in sub-Saharan Africa. We describe the experiences of stigma and disclosure in a cohort of HIV-positive older people in Uganda. Using data from the Wellbeing of Older Peoples' Study of Kalungu (rural site) and Wakiso district (peri-urban site) residents, we measured self-reported stigma levels for 183 respondents (94 on antiretroviral therapy (ART); 88, not on ART) using a stigma score generated using three questions on stigma perceptions where 0 meant no stigma at all and 100 was maximum stigma. Based on two questions on disclosure, an overall score was computed. High disclosure was assigned to those who often or very often disclosed to the family and were never or seldom afraid to disclose elsewhere. We examined the experiences of HIV stigma of 25 adults (52% females) using semi-structured, open-ended interviews and monthly oral diaries over one year. Mean age of the respondents was 70 years (range 60-80 years) and 80% of all respondents were enrolled in ART. Interview transcripts were analysed using thematic content analysis. Overall, 55% of respondents had a high disclosure score, meaning they disclosed easily, and 47% had a high stigma score. The stigma scores were similar among those with high and low disclosure scores. In multivariate analyses with disclosure and stigma scores as dependent variables none of the respondents' characteristics had a significant effect at the 5% level. Qualitative data revealed that stigma ranges from: (1) perceptions (relatively passive, but leading to behaviour such as gossip, especially if not intended maliciously); to (2) discriminatory behaviour (active or enacted stigma; from malicious gossip to outright discrimination). Despite the relatively high levels of disclosure, older people suffer from high levels of stigma of various forms apart from HIV-related stigma. Efforts to assess for different forms of stigma at an individual level deserve greater attention

  14. Weight-related stigma is a significant psychosocial stressor in developing countries: Evidence from Guatemala.

    PubMed

    Hackman, Joseph; Maupin, Jonathan; Brewis, Alexandra A

    2016-07-01

    Weight-related stigma is established as a major psychosocial stressor and correlate of depression among people living with obesity in high-income countries. Anti-fat beliefs are rapidly globalizing. The goal of the study is to (1) examine how weight-related stigma, enacted as teasing, is evident among women from a lower-income country and (2) test if such weight-related stigma contributes to depressive symptoms. Modeling data for 12,074 reproductive-age women collected in the 2008-2009 Guatemala National Maternal-Infant Health Survey, we demonstrate that weight-related teasing is (1) experienced by those both underweight and overweight, and (2) a significant psychosocial stressor. Effects are comparable to other factors known to influence women's depressive risk in lower-income countries, such as living in poverty, experiencing food insecurity, or suffering sexual/domestic violence. That women's failure to meet local body norms-whether they are overweight or underweight-serves as such a strong source of psychological distress is particularly concerning in settings like Guatemala where high levels of over- and under-nutrition intersect at the household and community level. Current obesity-centric models of weight-related stigma, developed from studies in high-income countries, fail to recognize that being underweight may create similar forms of psychosocial distress in low-income countries. PMID:27254116

  15. Death Anxiety and Cancer-Related Stigma: A Terror Management Analysis

    ERIC Educational Resources Information Center

    Mosher, Catherine E.; Danoff-Burg, Sharon

    2007-01-01

    In a study designed to examine correlates of cancer-related stigma, 405 college students were assigned randomly to listen to an audiotaped interview in which the target's cancer type and smoking status were manipulated. In the lung cancer conditions, target gender also was manipulated. Social distance and emotional responses differed according to…

  16. Preexposure prophylaxis-related stigma: strategies to improve uptake and adherence – a narrative review

    PubMed Central

    Haire, Bridget G

    2015-01-01

    Despite high levels of efficacy, the implementation of preexposure prophylaxis (PrEP) as a strategy to prevent new HIV infection has been slow. Studies show that PrEP works so long as it is taken, making adherence one of the great challenges of effective PrEP implementation alongside issues of access and uptake. Given that effective PrEP use requires ongoing self-administration of pills by people at high risk of HIV acquisition, it is a strategy best understood not as simply biomedical, but as biobehavioral or biopsychosocial, meaning that that social, psychological, cultural, and structural factors all contribute to the success or failure of the intervention. The willingness of people at risk of HIV to take up and adhere to PrEP depends greatly upon social understandings – whether it is seen as effective, as a healthy option, and a socially acceptable strategy for preventing HIV. Stigma – unfavorable associations – can negatively influence the implementation of PrEP. Because it is associated with high-risk sexual activity, PrEP risks multiple stigmas that can differ according to specific cultural conditions. This includes the stigma of being related to HIV (which may also relate to other stigmas, such as homosexuality, sex work, and/or drug use) and the stigma of PrEP being an alternative to condoms (as condom use is associated with responsible sexual activity). PrEP-related stigma has emerged as a significant social harm that can arise from PrEP research participation, reported by trial participants from a range of different trial sites, different trial populations, and spanning different continents. Social marketing needs to redress PrEP-related stigmas through health promotion campaigns aimed at clinicians, HIV-affected communities, and people at high risk of HIV who might benefit from PrEP access. PrEP access needs to be reframed as a positive and responsible option to help people remain HIV-negative. PMID:26508889

  17. Comparing HIV-related symbolic stigma in six African countries: social representations in young people's narratives.

    PubMed

    Winskell, Kate; Hill, Elizabeth; Obyerodhyambo, Oby

    2011-10-01

    HIV-related symbolic stigma arises from moralistic value judgements attached to people living with HIV and has negative consequences from both public health and human rights perspectives. Relatively little is known about cross-national variation in symbolic stigma. With the purpose of informing stigma reduction efforts within and across settings, we compared social representations of HIV in six African countries with estimated adult HIV prevalence rates ranging from 1 to 33%. Our study used a unique data source, namely a stratified random sample (n = 586, ∼5%) from 11,354 creative ideas contributed from six countries to a continent-wide HIV-related scriptwriting contest held between February and April 2005. The narratives were written by equal numbers of males and females aged 10-24 in urban and rural areas of Swaziland, Namibia, Kenya, South-East Nigeria, Burkina Faso and Senegal. We combined three analytical approaches: descriptive statistics on certain quantifiable characteristics of the narratives, thematic data analysis, and a narrative-based approach. The association of HIV with outsiders ("othering") and preoccupation with the circumstances of infection are more common in lower prevalence countries but vary substantially in tone depending on the sociocultural context. The highest proportion both of moralising narratives and of narratives with pessimistic outcomes come from South-East Nigeria and, to a lesser extent, from Kenya, countries with prevalence levels of 3.9 and 6.1% respectively, in which evangelical Christian movements, including Pentecostalism, have sizeable followings. The data provide a rare cross-cultural overview of symbolic stigma, identify country-specific needs, and point to strategies for future programming. Social representations from the highest prevalence countries, Swaziland and Namibia, and from lower prevalence Burkina Faso offer potential models for the framing of HIV in ways that serve to increase social proximity and counteract

  18. Predictors of internalised HIV-related stigma: a systematic review of studies in sub-Saharan Africa.

    PubMed

    Pantelic, Marija; Shenderovich, Yulia; Cluver, Lucie; Boyes, Mark

    2015-01-01

    This systematic review aims to synthesise evidence on predictors of internalised HIV stigma amongst people living with HIV in sub-Saharan Africa. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used. Studies were identified through electronic databases, grey literature, reference harvesting and contacts with key researchers. Quality of findings was assessed through an adapted version of the Cambridge Quality Checklists. A total of 590 potentially relevant titles were identified. Seventeen peer-reviewed articles and one draft book chapter were included. Studies investigated socio-demographic, HIV-related, intra-personal and interpersonal correlates of internalised stigma. Eleven articles used cross-sectional data, six articles used prospective cohort data and one used both prospective cohort and cross-sectional data to assess correlates of internalised stigma. Poor HIV-related health weakly predicted increases in internalised HIV stigma in three longitudinal studies. Lower depression scores and improvements in overall mental health predicted reductions in internalised HIV stigma in two longitudinal studies, with moderate and weak effects, respectively. No other consistent predictors were found. Studies utilising analysis of change and accounting for confounding factors are necessary to guide policy and programming but are scarce. High-risk populations, other stigma markers that might layer upon internalised stigma, and structural drivers of internalised stigma need to be examined. PMID:25559431

  19. "You're Awfully Old to Have This Disease": Experiences of Stigma and Ageism in Adults 50 Years and Older Living with HIV/AIDS

    ERIC Educational Resources Information Center

    Emlet, Charles A.

    2006-01-01

    Purpose: Older adults living with HIV infection may be doubly stigmatized, as they are branded by both age as well as HIV status. Through semistructured interviews, this study sought to examine whether older adults with HIV/AIDS experience both ageism and HIV stigma and how those experiences manifest in their lives. Design and Methods: This was a…

  20. AN INTERVENTION TO REDUCE HIV-RELATED STIGMA IN PARTNERSHIP WITH AFRICAN AMERICAN AND LATINO CHURCHES

    PubMed Central

    Derose, Kathryn Pitkin; Bogart, Laura M.; Kanouse, David E.; Felton, Alexandria; Collins, Deborah Owens; Mata, Michael A.; Oden, Clyde W.; Domínguez, Blanca X.; Flórez, Karen R.; Hawes-Dawson, Jennifer; Williams, Malcolm V.

    2014-01-01

    HIV-related stigma negatively affects prevention and care, and community-based interventions are needed. Here we describe the development of a multi-ethnic, faith-based intervention to reduce HIV stigma that included: educational workshops on HIV, testing, and stigma; peer leader workshops using role plays and drawing on principles of motivational interviewing; a pastor-delivered sermon on HIV that incorporated theological reflection and an imagined contact scenario; and congregation-based HIV testing events. Lessons learned include: partnership development is essential and requires substantial investment; tailoring intervention components to single race-ethnic groups may not be preferable in diverse community settings; and adapting testing processes to be able to serve larger numbers of people in shorter time frames is needed for congregational settings. This development process successfully combined the rigorous application of social science theory and community engagement to yield a multifaceted HIV stigma reduction intervention appropriate for Protestant and Catholic churches in African American and Latino communities. PMID:24450276

  1. Stigma-Related Stress and Its Correlates Among Men with Pedophilic Sexual Interests.

    PubMed

    Jahnke, Sara; Schmidt, Alexander F; Geradt, Max; Hoyer, Jürgen

    2015-11-01

    Despite decades of research on the adverse consequences of stereotyping and discrimination for many stigmatized groups, little is known about how people with pedophilia perceive and react to stigma. In this article, we present a framework that outlines how stigma-related stress might negatively affect emotional and social areas of functioning, cognitive distortions, and the motivation to pursue therapy, all of which may contribute to an increased risk of sexual offending. We tested our hypotheses in an online survey among self-identified German-speaking people with pedophilia (N = 104) using a wide range of validated indicators of social and emotional functioning (Brief Symptom Inventory-53, UCLA Loneliness Scale, Emotion Subscale of the Coping Inventory for Stressful Situations, Fear of Negative Evaluation-5, Rosenberg Self-Esteem Scale). Specific risk factors such as self-efficacy, cognitive distortions, and the motivation to seek treatment were also assessed. In line with our hypotheses, fear of discovery generally predicted reduced social and emotional functioning. Contrary to our predictions, perceived social distance and fear of discovery were not linked to self-efficacy, cognitive distortions, or treatment motivation. Results were controlled for the effects of confounding variables (e.g., age, educational level, social desirability, relationship status). We critically evaluate the empirical contribution of this study to research on stigma and child sex offenses, including a discussion of the results in light of the potential indirect effects that public stigma may have on the overall risk for sexual offenses. PMID:25933669

  2. Mental health-related stigma in health care and mental health-care settings.

    PubMed

    Henderson, Claire; Noblett, Jo; Parke, Hannah; Clement, Sarah; Caffrey, Alison; Gale-Grant, Oliver; Schulze, Beate; Druss, Benjamin; Thornicroft, Graham

    2014-11-01

    This Review considers the evidence for mental-health-related stigma in health-care and mental-health-care settings. Do mental-health-care and other health-care professionals stigmatise people using their services? If so, what are the effects on quality of mental and physical health care? How can stigma and discrimination in the context of health care be reduced? We show that the contact mental-health-care professionals have with people with mental illness is associated with positive attitudes about civil rights, but does not reduce stigma as does social contact such as with friends or family members with mental illness. Some evidence suggests educational interventions are effective in decreasing stigma especially for general health-care professionals with little or no formal mental health training. Intervention studies are needed to underpin policy; for instance, to decrease disparity in mortality associated with poor access to physical health care for people with mental illness compared with people without mental illness. PMID:26361202

  3. Effect of media use on HIV-related stigma in Sub-Saharan Africa: a cross-sectional study.

    PubMed

    Bekalu, Mesfin Awoke; Eggermont, Steven; Ramanadhan, Shoba; Viswanath, Kasisomayajula

    2014-01-01

    It is known that HIV-related stigma hinders prevention efforts. Previous studies have documented that HIV-related stigma may be associated with socioeconomic and socioecological factors. Mass media use may moderate this association, but there is limited research addressing that possibility. In this study, based on cross-sectional data pooled from the 2006-2011 Demographic and Health Surveys of 11 sub-Saharan African countries (N = 204,343), we investigated the moderating effects of exposure to mass media on HIV-related stigma. Hierarchical regression analysis indicated that HIV-related stigma tends to be higher among rural residents and individuals with low levels of education and HIV knowledge, as well as those who do not know people living with HIV. Media use was generally associated with low levels of HIV-related stigma, and attenuated the gap between individuals with high and low educational levels. However, the effect of mass media was found to be stronger among urbanites rather than among rural residents, which could lead to a widening gap between the two groups in endorsement of HIV-related stigma. The implication of this study regarding the effect of media use on HIV-related stigma in sub-Saharan Africa is twofold: 1) mass media may have the potential to minimize the gap in HIV-related stigma between individuals with high and low educational levels, and hence future efforts of reducing HIV-related stigma in the region may benefit from utilizing media; 2) due perhaps to low media penetration to rural sub-Saharan Africa, mass media could have the unintended effect of widening the urban-rural gap further unless other more customized and rural-focused communication interventions are put in place. PMID:24945251

  4. Effect of Media Use on HIV-Related Stigma in Sub-Saharan Africa: A Cross-Sectional Study

    PubMed Central

    Bekalu, Mesfin Awoke; Eggermont, Steven; Ramanadhan, Shoba; Viswanath, Kasisomayajula

    2014-01-01

    It is known that HIV-related stigma hinders prevention efforts. Previous studies have documented that HIV-related stigma may be associated with socioeconomic and socioecological factors. Mass media use may moderate this association, but there is limited research addressing that possibility. In this study, based on cross-sectional data pooled from the 2006–2011 Demographic and Health Surveys of 11 sub-Saharan African countries (N = 204,343), we investigated the moderating effects of exposure to mass media on HIV-related stigma. Hierarchical regression analysis indicated that HIV-related stigma tends to be higher among rural residents and individuals with low levels of education and HIV knowledge, as well as those who do not know people living with HIV. Media use was generally associated with low levels of HIV-related stigma, and attenuated the gap between individuals with high and low educational levels. However, the effect of mass media was found to be stronger among urbanites rather than among rural residents, which could lead to a widening gap between the two groups in endorsement of HIV-related stigma. The implication of this study regarding the effect of media use on HIV-related stigma in sub-Saharan Africa is twofold: 1) mass media may have the potential to minimize the gap in HIV-related stigma between individuals with high and low educational levels, and hence future efforts of reducing HIV-related stigma in the region may benefit from utilizing media; 2) due perhaps to low media penetration to rural sub-Saharan Africa, mass media could have the unintended effect of widening the urban-rural gap further unless other more customized and rural-focused communication interventions are put in place. PMID:24945251

  5. HIV-related stigma in African and Afro-Caribbean communities in the Netherlands: manifestations, consequences and coping.

    PubMed

    Stutterheim, Sarah E; Bos, Arjan E R; Shiripinda, Iris; de Bruin, Marijn; Pryor, John B; Schaalma, Herman P

    2012-01-01

    HIV-related stigma in African and Afro-Caribbean diaspora communities in the Netherlands was investigated. Interviews with HIV-positive and HIV-negative community members demonstrated that HIV-related stigma manifests as social distance, physical distance, words and silence. The psychological consequences of HIV-related stigma among those diagnosed with HIV reported were emotional pain, sadness, loneliness, anger, frustration and internalised stigma. The social consequences included decreased social network size, limited social support and social isolation, and resulted from not only enacted stigma but also self-imposed social withdrawal. Also, poor treatment adherence was a health-related consequence. People living with HIV employed both problem-focused and emotion-focused coping strategies to mitigate the negative consequences of stigma. Problem-focused coping strategies included selective disclosure, disengagement, affiliating with similar others, seeking social support and, to a lesser extent, activism. Emotion-focused strategies included distraction, positive reappraisal, religious coping, external attributions, disidentification and acceptance. HIV-related stigma clearly permeates African and Afro-Caribbean communities in the Netherlands, and should be targeted for intervention. PMID:21678184

  6. General Information about AIDS-Related Lymphoma

    MedlinePlus

    ... AIDS-Related Lymphoma Treatment (PDQ®)–Patient Version General Information About AIDS-Related Lymphoma Go to Health Professional ... the PDQ Adult Treatment Editorial Board . Clinical Trial Information A clinical trial is a study to answer ...

  7. The Role of HIV-Related Stigma in Utilization of Skilled Childbirth Services in Rural Kenya: A Prospective Mixed-Methods Study

    PubMed Central

    Turan, Janet M.; Hatcher, Abigail H.; Medema-Wijnveen, José; Onono, Maricianah; Miller, Suellen; Bukusi, Elizabeth A.; Turan, Bulent; Cohen, Craig R.

    2012-01-01

    Background Childbirth with a skilled attendant is crucial for preventing maternal mortality and is an important opportunity for prevention of mother-to-child transmission of HIV. The Maternity in Migori and AIDS Stigma Study (MAMAS Study) is a prospective mixed-methods investigation conducted in a high HIV prevalence area in rural Kenya, in which we examined the role of women's perceptions of HIV-related stigma during pregnancy in their subsequent utilization of maternity services. Methods and Findings From 2007–2009, 1,777 pregnant women with unknown HIV status completed an interviewer-administered questionnaire assessing their perceptions of HIV-related stigma before being offered HIV testing during their first antenatal care visit. After the visit, a sub-sample of women was selected for follow-up (all women who tested HIV-positive or were not tested for HIV, and a random sample of HIV-negative women, n = 598); 411 (69%) were located and completed another questionnaire postpartum. Additional qualitative in-depth interviews with community health workers, childbearing women, and family members (n = 48) aided our interpretation of the quantitative findings and highlighted ways in which HIV-related stigma may influence birth decisions. Qualitative data revealed that health facility birth is commonly viewed as most appropriate for women with pregnancy complications, such as HIV. Thus, women delivering at health facilities face the risk of being labeled as HIV-positive in the community. Our quantitative data revealed that women with higher perceptions of HIV-related stigma (specifically those who held negative attitudes about persons living with HIV) at baseline were subsequently less likely to deliver in a health facility with a skilled attendant, even after adjusting for other known predictors of health facility delivery (adjusted odds ratio = 0.44, 95% CI 0.22–0.88). Conclusions Our findings point to the urgent need for interventions to reduce HIV-related

  8. Multi-ethnic perspective of uptake of HIV testing and HIV-related stigma: a cross-sectional population-based study.

    PubMed

    Wong, Li Ping

    2013-01-01

    The objective of this study was to identify demographic characteristics and correlates of the uptake of HIV testing, willingness to be tested and perceived HIV-related stigma of Malaysian lay public. A cross-sectional computer-assisted telephone interview survey of a representative sample of multiracial Malaysians aged 18 years and above was conducted between December and July 2011. The survey collected information on demographics, knowledge about HIV transmission and religious beliefs on attitudes to HIV/AIDS. A total of 2271 households were successfully interviewed. The response rate was 48.65%. The HIV transmission knowledge score ranged from 0 to 15 (mean =10.56; SD±2.42). Three of the most common misconceptions about HIV transmission were mosquito bite (42.8%), eating in a restaurant where the cook is HIV positive (20.4%) and using a public toilet (20.1%). Only 20.6% reported ever having been tested for HIV, 49.1% reported a willingness to be tested for HIV and 30.3% had no intention of getting an HIV test. Low-risk perception (63.7%) constitutes a major barrier to HIV testing. Being Malay and Chinese (relative to Indian) were the strongest predictors of low-risk perception. Other significant predictors of low-risk perception were being male, being married and living in an urban locality. Perceived self-stigma if tested positive for HIV was prevalent (78.8%). Multivariate findings showed that being female, Malay, low income, living in rural localities and public stigma were significant correlates of self-stigma. These findings warrant interventions to reduce the disproportionate HIV transmission misconception, barriers to HIV testing and stigma and discriminative attitudes to involve considerations of sociocultural economic and demographic characteristics. PMID:23406514

  9. Tobacco Control, Stigma, and Public Health: Rethinking the Relations

    PubMed Central

    Bayer, Ronald; Stuber, Jennifer

    2006-01-01

    The AIDS epidemic has borne witness to the terrible burdens imposed by stigmatization and to the way in which marginalization could subvert the goals of HIV prevention. Out of that experience, and propelled by the linkage of public health and human rights, came the commonplace assertion that stigmatization was a retrograde force. Yet, strikingly, the antitobacco movement has fostered a social transformation that involves the stigmatization of smokers. Does this transformation represent a troubling outcome of efforts to limit tobacco use and its associated morbidity and mortality; an ineffective, counterproductive, and moralizing approach that leads to a dead end; or a signal of public health achievement? If the latter is the case, are there unacknowledged costs? PMID:16317199

  10. Reducing stigma related to mental disorders: initiatives, interventions, and recommendations for nursing.

    PubMed

    Pinto-Foltz, Melissa D; Logsdon, M Cynthia

    2009-02-01

    Twenty percent of Americans suffer from mental disorders, but most do not receive treatment. Stigma is an important barrier to mental health treatment and recovery. This article aims to summarize current national initiatives to reduce stigma, clarify the current knowledge of stigma-reducing interventions, and provide recommendations to nurses on implementing and investigating stigma-reducing interventions. PMID:19216986

  11. Factors Associated with Pregnant Women’s Anticipations and Experiences of HIV-related Stigma in Rural Kenya

    PubMed Central

    Cuca, Yvette P.; Onono, Maricianah; Bukusi, Elizabeth; Turan, Janet M.

    2012-01-01

    Pregnant women who fear or experience HIV-related stigma may not get care for their own health or medications to reduce perinatal transmission of HIV. This study examined factors associated with anticipating and experiencing HIV-related stigma among 1,777 pregnant women attending antenatal care clinics in rural Kenya. Women were interviewed at baseline, offered HIV testing and care, and a sub-set was re-interviewed at 4–8 weeks postpartum. Women who were older, had less education, whose husbands had other wives, and who perceived community discrimination against people with HIV had significantly greater adjusted odds of anticipating HIV stigma. Over half of the HIV-positive women interviewed postpartum reported having experienced stigma, much of which was self-stigma. Women experiencing minor depression, and those whose family knew of their HIV status had significantly greater adjusted odds of experiencing stigma. Lack of women’s empowerment, as well as depression, may be important risk factors for HIV-related stigma and discrimination. PMID:22799618

  12. The "hidden patient": older relatives raising children orphaned by AIDS.

    PubMed

    Joslin, D; Harrison, R

    1998-01-01

    In the United States today, thousands of grandmothers and other third- and fourth-generation relatives are raising children and adolescents whose primary parent, usually the mothers, has died from acquired immune deficiency syndrome (AIDS) or is too ill to serve as the primary parent. More than 100,000 children below the age of 18 are expected to lose their mothers to AIDS by the year 2000, most in poor communities. Isolated by the demands of caregiving, child care, and the stigma of AIDS on even uninfected family members, this group of older surrogate parents is at risk not only for chronic conditions and stress-related somatic complaints, but for neglected health. Using the gerontological concept of the "hidden patient," this article presents four cases drawn from an exploratory study of the physical and emotional health risks and health behaviors of older adults raising children orphaned by AIDS. External and internal barriers to self-care are described, including lack of child and respite care and health insurance, caregiver depression, and denial of health problems. PMID:9595898

  13. HIV-Related Stigma, Shame, and Avoidant Coping: Risk Factors for Internalizing Symptoms Among Youth Living with HIV?

    PubMed

    Bennett, David S; Hersh, Jill; Herres, Joanna; Foster, Jill

    2016-08-01

    Youth living with HIV (YLH) are at elevated risk of internalizing symptoms, although there is substantial individual variability in adjustment. We examined perceived HIV-related stigma, shame-proneness, and avoidant coping as risk factors of internalizing symptoms among YLH. Participants (N = 88; ages 12-24) completed self-report measures of these potential risk factors and three domains of internalizing symptoms (depressive, anxiety, and PTSD) during a regularly scheduled HIV clinic visit. Hierarchical regressions were conducted for each internalizing symptoms domain, examining the effects of age, gender, and maternal education (step 1), HIV-related stigma (step 2), shame- and guilt-proneness (step 3), and avoidant coping (step 4). HIV-related stigma, shame-proneness, and avoidant coping were each correlated with greater depressive, anxiety, and PTSD symptoms. Specificity was observed in that shame-proneness, but not guilt-proneness, was associated with greater internalizing symptoms. In multivariable analyses, HIV-related stigma and shame-proneness were each related to greater depressive and PTSD symptoms. Controlling for the effects of HIV-related stigma and shame-proneness, avoidant coping was associated with PTSD symptoms. The current findings highlight the potential importance of HIV-related stigma, shame, and avoidant coping on the adjustment of YLH, as interventions addressing these risk factors could lead to decreased internalizing symptoms among YLH. PMID:26458909

  14. HIV-Related Stigma Among Healthcare Providers in the Deep South.

    PubMed

    Stringer, Kristi L; Turan, Bulent; McCormick, Lisa; Durojaiye, Modupeoluwa; Nyblade, Laura; Kempf, Mirjam-Colette; Lichtenstein, Bronwen; Turan, Janet M

    2016-01-01

    Stigma towards people living with HIV (PLWH) in healthcare settings is a barrier to optimal treatment. However, our understanding of attitudes towards PLWH from healthcare providers' perspective in the United States is limited and out-of-date. We assessed HIV-related stigma among healthcare staff in Alabama and Mississippi, using online questionnaires. Participants included 651 health workers (60 % White race; 83 % female). Multivariate regression suggests that several factors independently predict stigmatizing attitudes: Protestant compared to other religions (β = 0.129, p ≤ 0.05), White race compared to other races (β = 0.162, p ≤ 0.001), type of clinic (HIV/STI clinic: β = 0.112, p ≤ 0.01), availability of post-exposure prophylaxis (yes: β = -0.107, p ≤ 0.05), and perceptions of policy enforcement (policies not enforced: β = 0.058, p = p ≤ 0.05). These findings may assist providers wishing to improve the quality care for PLWH. Enforcement of policies prohibiting discrimination may be a useful strategy for reducing HIV-related stigma among healthcare workers. PMID:26650383

  15. Development and validation of the Self-Stigma Questionnaire (SSQ) for people with schizophrenia and its relation to social functioning.

    PubMed

    Ochoa, Susana; Martínez-Zambrano, Francisco; Garcia-Franco, Mar; Vilamala, Sonia; Ribas, Maria; Arenas, Oti; Garcia-Morales, Esther; Álvarez, Irene; Escartin, Gemma; Villellas, Raul; Escandell, Maria Jose; Martínez-Raves, Mónica; López-Arias, Elisabeth; Cunyat, Christian; Haro, Josep Maria

    2015-10-01

    Self-stigma specifically in people with schizophrenia has been little studied. The aims of the present study were to validate a new instrument for the assessment of self-stigma (SSQ) and to assess the relationship between self-stigma and social functioning in people with schizophrenia. A sample of 76 people with schizophrenia was assessed at two moments in time with the SSQ, the PDD (stigma), two scales of social functioning (LSP, SFS), and a scale of general functioning (GAF). The results indicated that SSQ presented good psychometric properties, with Cronbach's alpha ranging between 0.75 and 0.901. The stability of the instrument was between 0.836 and 0.402. Three factors were found in the factor analysis (social discrimination, perceived capabilities, concealment of the disease), explaining 62.66% of the total variance. A relationship was found between self-stigma and social functioning in people with schizophrenia, especially in relation to social contact. In conclusion, the SSQ seems to be a valid and reliable questionnaire for the assessment of self-stigma in people with schizophrenia, and interventions should be designed to cope with self-stigma in order to improve the social functioning of people who suffer schizophrenia. PMID:26343472

  16. A Loss of Moral Experience: Understanding HIV-Related Stigma in the New York City House and Ball Community

    PubMed Central

    2013-01-01

    Objectives. I incorporated qualitative methods to explore how HIV-related stigma functions in New York City’s House and Ball Community (HBC). Methods. From January through March 2009, I conducted 20 in-depth 1-on-1 interviews with a diverse sample of New York City HBC members. Interviews addressed perceptions of HIV-related stigma, the treatment of HIV-positive members in the community, and the potential impact of HIV-related stigma on risk behaviors. Results. HIV-related stigma contributes to a loss of moral experience for HBC members. Moral experience (i.e., threats to what really matters in a community) disrupts established social connections and hinders the attainment of “ball status” (i.e., amassing social recognition) in the local world of these individuals. Conclusions. My recommendations address HIV-related stigma in the New York City HBC from the vantage of moral experience and highlight the need for longitudinal studies of individual house members and for the implementation of stigma-focused interventions in the community that utilize the unique ball status hierarchy and HBC network to influence social norms surrounding the treatment of HIV-positive community members. PMID:23237182

  17. The Relative Stigma Associated with Smoking, Obesity, and Criminality.

    ERIC Educational Resources Information Center

    Venuti, John Paul; Conroy, Matthew; Bucy, Paige; Landis, Pamela L.; Chambliss, Catherine

    Despite the increased use of cigarettes among college students, there is evidence to suggest that anti-smoking norms still predominate among both students and faculty. In order to assess the prejudice against college students who smoke, relative to that associated with membership in other disparaged groups, a sample of 99 college students were…

  18. Experiences of mental illness stigma, prejudice and discrimination: a review of measures

    PubMed Central

    2010-01-01

    Background There has been a substantial increase in research on mental illness related stigma over the past 10 years, with many measures in use. This study aims to review current practice in the survey measurement of mental illness stigma, prejudice and discrimination experienced by people who have personal experience of mental illness. We will identify measures used, their characteristics and psychometric properties. Method A narrative literature review of survey measures of mental illness stigma was conducted. The databases Medline, PsychInfo and the British Nursing Index were searched for the period 1990-2009. Results 57 studies were included in the review. 14 survey measures of mental illness stigma were identified. Seven of the located measures addressed aspects of perceived stigma, 10 aspects of experienced stigma and 5 aspects of self-stigma. Of the identified studies, 79% used one of the measures of perceived stigma, 46% one of the measures of experienced stigma and 33% one of the measures of self-stigma. All measures presented some information on psychometric properties. Conclusions The review was structured by considering perceived, experienced and self stigma as separate but related constructs. It provides a resource to aid researchers in selecting the measure of mental illness stigma which is most appropriate to their purpose. PMID:20338040

  19. The Contribution of Applied Social Sciences to Obesity Stigma-Related Public Health Approaches

    PubMed Central

    Bombak, Andrea E.

    2014-01-01

    Obesity is viewed as a major public health concern, and obesity stigma is pervasive. Such marginalization renders obese persons a “special population.” Weight bias arises in part due to popular sources' attribution of obesity causation to individual lifestyle factors. This may not accurately reflect the experiences of obese individuals or their perspectives on health and quality of life. A powerful role may exist for applied social scientists, such as anthropologists or sociologists, in exploring the lived and embodied experiences of this largely discredited population. This novel research may aid in public health intervention planning. Through these studies, applied social scientists could help develop a nonstigmatizing, salutogenic approach to public health that accurately reflects the health priorities of all individuals. Such an approach would call upon applied social science's strengths in investigating the mundane, problematizing the “taken for granted” and developing emic (insiders') understandings of marginalized populations. PMID:24782921

  20. HIV/AIDS Stigma Attitudes among Educators in KwaZulu-Natal, South Africa

    ERIC Educational Resources Information Center

    Chao, Li-Wei; Gow, Jeff; Akintola, Goke; Pauly, Mark

    2010-01-01

    Background: One hundred and twenty educators from KwaZulu-Natal, South Africa, underwent HIV/AIDS training. The educators were surveyed about their attitudes toward people with HIV. Methods: The educators completed self-administered survey questionnaires both before and after 2 interventions. Measures included demographic characteristics,…

  1. AIDS and the stigma of sexual promiscuity: Thai nurses' risk perceptions of occupational exposure to HIV.

    PubMed

    Chan, Kit Yee; Rungpueng, Arattha; Reidpath, Daniel D

    2009-05-01

    This paper examines the culturally shaped meanings of AIDS and perceptions of accidental occupational exposure to HIV among a group of twenty nurses in Bangkok, Thailand. The findings are based on data collected as a part of a larger mixed-methods study that examined how perceptions of risk behaviours (including sexual promiscuity) shape health workers' perceptions of patients living with HIV/AIDS. Nurses' narratives revealed that despite acknowledgement of the low probability of occupational exposure to HIV, the fear of HIV infection remained and was largely driven by the enormity of the anticipated social (rather than the health) consequences of being HIV-positive. The perceived certainty of social ostracism was reinforced by participants' observations of the social rejection experienced by people living with HIV/AIDS both within and outside clinical settings. For female nurses, the dominant social perception that women living with HIV/AIDS were violators of gender norms, and thus 'guilty' victims, was an issue central to their self-identities. Ways of improving care for people living with HIV in the light of the nurses' concerns and future research are discussed. PMID:19263260

  2. Stigmatization of AIDS patients: disentangling Thai nursing students' attitudes towards HIV/AIDS, drug use, and commercial sex.

    PubMed

    Chan, Kit Yee; Stoové, Mark A; Sringernyuang, Luechai; Reidpath, Daniel D

    2008-01-01

    This paper analyzes the interrelationships between the stigma of HIV/AIDS stigma and the co-stigmas of commercial sex (CS) and injecting drug use (IDU). Students of a Bangkok nursing college (N=144) were presented with vignettes describing a person varying in the disease diagnoses (AIDS, leukemia, no disease) and co-characteristics (IDU, CS, blood transfusion, no co-characteristic). For each vignette, participants completed a social distance measure assessing their attitudes towards the hypothetical person portrayed. Multivariate analyses showed strong interactions between the stigmas of AIDS and IDU but not between AIDS and CS. Although AIDS was shown to be stigmatizing in and of itself, it was significantly less stigmatizing than IDU. The findings highlight the need to consider the non-disease-related stigmas associated with HIV as well as the actual stigma of HIV/AIDS in treatment and care settings. Methodological strengths and limitations were evaluated and implications for future research discussed. PMID:17364148

  3. Improving hospital-based quality of care by reducing HIV-related stigma: evaluation results from Vietnam.

    PubMed

    Pulerwitz, Julie; Oanh, Khuat Thi Hai; Akinwolemiwa, Dayo; Ashburn, Kim; Nyblade, Laura

    2015-02-01

    Operations Research conducted at four hospitals in Vietnam sought to reduce HIV-related stigma and discrimination among hospital workers. The quasi-experimental study compared effects of focusing on 'fear-based' stigma (stemming from lack of knowledge) versus both fear-based and social stigma (stemming from moral judgments). Interventions included staff training (ranging from physicians to ward cleaners), hospital policy development, and supplies provision. At baseline (n = 795), reported stigma was substantial (e.g., about half of hospital workers indicated fear of casually touching PLHIV, and felt HIV was a punishment for bad behavior). By endline, stigma measures had improved significantly for both intervention groups (e.g., proportion reporting signs on beds indicating HIV status decreased from 51 to 24 % in Arm 1, and 31 to 7 % in Arm 2), with the combined intervention group showing greater effects. This study highlights successful strategies to reduce stigma, and thus, improve quality of care for PLHIV. PMID:25382350

  4. The fight against stigma: an overview of stigma-reduction strategies and interventions.

    PubMed

    Heijnders, Miriam; Van Der Meij, Suzanne

    2006-08-01

    In many health conditions, people are severely affected by health-related stigma and discrimination. A literature review was conducted to identify stigma-reduction strategies and interventions in the field of HIV/AIDS, mental illness, leprosy, TB and epilepsy. The review identified several levels at which interventions and strategies are being implemented. These are the intrapersonal, interpersonal, organizational/institutional, community and governmental/structural level. Although a lot of work has been carried out on stigma and stigma reduction, far less work has been done on assessing the effectiveness of stigma-reduction strategies. The effective strategies identified mainly concentrated on the individual and the community level. In order to reduce health-related stigma and discrimination significantly, single-level and single-target group approaches are not enough. What is required is a patient-centred approach, which starts with interventions targeting the intrapersonal level, to empower affected persons to assist in the development and implementation of stigma-reduction programmes at other levels. PMID:17130071

  5. The impact of exposure to mass media campaigns and social support on levels and trends of HIV-related stigma and discrimination in Nigeria: tools for enhancing effective HIV prevention programmes.

    PubMed

    Fakolade, R; Adebayo, S B; Anyanti, J; Ankomah, A

    2010-05-01

    People living with HIV and AIDS (PLWHAs) often face stigma and discrimination, especially in developing countries. HIV-related stigma is expressed through social ostracism, personal rejection, direct and indirect discrimination, and denial from families and friends. Consequently, it is associated with reduced adoption of preventive and care behaviours, including condom use, seeking for HIV test and care-seeking behaviour subsequent to diagnosis. Ignorance about the epidemiology of the disease on modes of transmission and prevention aggravates HIV-related stigma in Nigeria. Behaviour change communication activities through mass media have been shown to be an effective approach in improving people's knowledge about the disease. This paper monitors trends in the level of accepting attitudes towards PLWHAs in Nigeria between 2003 and 2007. It also evaluates the impact of exposure to mass media and social support on the levels of accepting attitudes towards PLWHAs. A significant and positive trend was evident between 2003 and 2007 (p<0.0001). Furthermore, exposure to mass media communications on HIV and AIDS issues and social support were significantly related to the reduced stigma and discrimination against PLWHAs (p<0.0001). PMID:20018118

  6. The Stigma Complex

    PubMed Central

    Pescosolido, Bernice A.; Martin, Jack K.

    2016-01-01

    Since the beginning of the twenty-first century, research on stigma has continued. Building on conceptual and empirical work, the recent period clarifies new types of stigmas, expansion of measures, identification of new directions, and increasingly complex levels. Standard beliefs have been challenged, the relationship between stigma research and public debates reconsidered, and new scientific foundations for policy and programs suggested. We begin with a summary of the most recent Annual Review articles on stigma, which reminded sociologists of conceptual tools, informed them of developments from academic neighbors, and claimed findings from the early period of “resurgence.” Continued (even accelerated) progress has also revealed a central problem. Terms and measures are often used interchangeably, leading to confusion and decreasing accumulated knowledge. Drawing from this work but focusing on the past 14 years of stigma research (including mental illness, sexual orientation, HIV/AIDS, and race/ethnicity), we provide a theoretical architecture of concepts (e.g., prejudice, experienced/received discrimination), drawn together through a stigma process (i.e., stigmatization), based on four theoretical premises. Many characteristics of the mark (e.g., discredited, concealable) and variants (i.e., stigma types and targets) become the focus of increasingly specific and multidimensional definitions. Drawing from complex and systems science, we propose a stigma complex, a system of interrelated, heterogeneous parts bringing together insights across disciplines to provide a more realistic and complicated sense of the challenge facing research and change efforts. The Framework Integrating Normative Influences on Stigma (FINIS) offers a multilevel approach that can be tailored to stigmatized statuses. Finally, we outline challenges for the next phase of stigma research, with the goal of continuing scientific activity that enhances our understanding of stigma and builds

  7. Persistent HIV-related stigma among an outpatient US clinic population.

    PubMed

    Shacham, Enbal; Rosenburg, Neal; Önen, Nur F; Donovan, Michael F; Overton, E Turner

    2015-03-01

    Despite advancements in the public's understanding of HIV infection, felt stigma towards individuals living with HIV persists. Stigma has been associated with adverse health outcomes, including poor adherence to care, and increased participation in HIV transmission risk behaviours. We evaluated the level of felt stigma and its relationship to other psychosocial and medical factors among a sample of 201 individuals with HIV engaged in care. The overall mean stigma score, as measured by the Reece Stigma Scale, was 21.7 (SD 8.7). In univariate analysis, felt stigma scores were higher among women, African Americans, younger participants, and individuals with less education. Higher felt stigma scores were also found among individuals who reported having fair to poor overall health, moderate to severe symptoms of depression and anxiety, and those with a current diagnosis of alcohol dependence, generalised anxiety disorder, agoraphobia, pain disorder, and current smokers. Higher felt stigma scores were independently associated with individuals with anxiety symptoms. These analyses highlight that stigma persists among individuals with HIV and may play an important role in HIV care. The relationship between psychiatric disorders and psychosocial factors highlights an opportunity to develop interventions that will address these common comorbidities and reduce stigma. PMID:24828557

  8. Relation of Perceived Stigma to Adverse Events of Medications in Patients with Epilepsy

    PubMed Central

    Viteva, Ekaterina

    2016-01-01

    Purpose. We aimed to assess the influence of adverse events (AEs) of antiepileptic drugs (AEDs) on perceived stigma of Bulgarian patients with epilepsy. Methods. Our study was based on questionnaires (Liverpool Adverse Events Profile (LAEP) and stigma scale), information from medical documentation, and an interview on clinical factors of 153 consecutive patients with epilepsy. Results. Perceived stigma was observed in 64.71% of the study participants. There was a significant association between perceived stigma and the total LAEP score (p < 0.05, F = 13.71). Patients who reported AEs had an increased risk of perceiving stigma compared to those who did not experience AEs. A significant correlation between perceived stigma and the presence of neurological and psychiatric AEs (p < 0.001, r = +0.60) and a mild correlation between perceived stigma and the presence of nonneurological AEs (p < 0.01, r = +0.20) were verified. In a multivariate regression analysis the only predictors of perceived stigma were AED polytherapy and the presence of neurological and psychiatric AEs. Conclusions. AEs of AEDs in patients with epilepsy significantly correlate with perceived stigma. Our study results will be useful in the campaign to overcome stigma predictors. PMID:27069681

  9. Disclosing food allergy status in schools: health-related stigma among school children in Ontario.

    PubMed

    Dean, Jennifer; Fenton, Nancy E; Shannon, Sara; Elliott, Susan J; Clarke, Ann

    2016-09-01

    In 2006, 3 years after the tragic death of 13-year-old Sabrina Shannon, the Province of Ontario (Canada) passed Sabrina's Law ushering in a new era of focus and concern for severe food allergic children at risk of anaphylaxis. Questions were raised at the time regarding the potential of doing more harm than good with the new legislation. This paper reports the experiences of health-related stigma among food allergic children at risk of anaphylaxis who were required to disclose their health status under this new legislation. In 2008, in-depth interviews were conducted with 20 children and youth and their parents in order to explore the experiences living with a severe food allergy. This particular study explores their experiences of felt and enacted stigma in the school setting as a result of the disclosure process. Interviews were tape recorded with permission and transcribed for subsequent thematic analysis using NVIVO, a qualitative analysis software package. Results indicate that participants were stigmatised as a result of protective school policies under the law, and that created tension between their physical safety and social well-being. Sabrina's Law also led to a cultural shift in awareness of food allergies that resulted in some participants normalising their health status, offering promising directions for the future. PMID:25939442

  10. A theoretical and empirical framework for constructing culture-specific stigma instruments for Chile

    PubMed Central

    Yang, Lawrence H.; Valencia, Elie; Alvarado, Ruben; Link, Bruce; Huynh, Nina; Nguyen, Kristy; Morita, Kara; Saavedra, Mariella; Wong, Chak; Galea, Sandro; Susser, Ezra

    2013-01-01

    Different cultural contexts contribute to substantial variation in the stigma faced by people with psychosis globally. We propose a new formulation of how culture affects stigma to create psychometrically-validated tools to assess stigma’s culture-specific effects. We propose to construct culture-specific stigma measures for the Chilean context via: 1) open-ended administration of ‘universal’ stigma scales to a sample of individuals with psychosis, relatives, and community respondents; 2) qualitative analyses to identify how culture shapes stigma and to derive initial ‘culture-specific’ stigma items; 3) construction and pilot-testing of final ‘culture-specific’ stigma measures; 4) initial psychometric validation among a sample of individuals with psychosis. We identify initial hypotheses for how stigma might threaten the capacities to participate in fundamental activities that ‘matter most’ in the Chilean context. These include mental illness stigma threatening the man’s ability to protect the honor of the family, and the woman’s ability to be a ‘holy and pure’ mother. Mental illness stigma may further endanger the ability of the family to uphold reciprocal obligations within their social network. Developing such measures promises to aid efforts to address culture-specific forms of stigma, and to facilitate implementation of community mental health services, in Chile and other Latin American contexts. PMID:23990755

  11. Size matters: community size, HIV stigma, & gender differences.

    PubMed

    Gonzalez, Adam; Miller, Carol T; Solomon, Sondra E; Bunn, Janice Yanushka; Cassidy, Daniel G

    2009-12-01

    Conclusions regarding HIV stigma in rural areas are hampered by lack of agreement about rural classification. This investigation examined perceptions of HIV stigma among males and females with HIV/AIDS in metropolitan, micropolitan, and rural areas. Two-hundred people with HIV/AIDS completed a measure of perceived HIV stigma. Their county or town of residence was used to classify community size. Results indicated that community size was related to one aspect of perceived stigma, disclosure concerns, differently for men and women. Rural women reported more disclosure concerns than did metropolitan and micropolitan women. They also reported more disclosure concerns than rural men. Men in micropolitan communities reported more disclosure concerns than men in rural areas and tended to report more disclosure concerns than men in metropolitan areas. Understanding the relationship of community size to HIV stigmatization requires acknowledging that many communities are neither urban nor rural, and it requires considering gender differences. PMID:18815878

  12. Navigating Diagnoses: Understanding Mind–Body Relations, Mental Health, and Stigma in Nepal

    PubMed Central

    Harper, Ian

    2013-01-01

    Anthropologists and psychiatrists traditionally have used the salience of a mind–body dichotomy to distinguish Western from non-Western ethnopsychologies. However, despite claims of mind–body holism in non-Western cultures, mind–body divisions are prominent in non-Western groups. In this article, we discuss three issues: the ethnopsychology of mind–body dichotomies in Nepal, the relationship between mind–body dichotomies and the hierarchy of resort in a medical pluralistic context, and, lastly, the role of mind–body dichotomies in public health interventions (biomedical and psychosocial) aimed toward decreasing the stigmatization of mental illness. We assert that, by understanding mind–body relations in non-Western settings, their implications, and ways in which to reconstitute these relations in a less stigmatizing manner, medical anthropologists and mental health workers can contribute to the reduction of stigma in global mental healthcare. PMID:18784989

  13. Why Culture Matters in Health Interventions: Lessons from HIV/AIDS Stigma and NCDs

    ERIC Educational Resources Information Center

    Airhihenbuwa, Collins O.; Ford, Chandra L.; Iwelunmor, Juliet I.

    2014-01-01

    Theories about health behavior are commonly used in public health and often frame problems as ascribed or related to individuals' actions or inaction. This framing suggests that poor health occurs because individuals are unable or unwilling to heed preventive messages or recommended treatment actions. The recent United Nations call for…

  14. Social Stigma and Childbearing for Women Living With HIV/AIDS.

    PubMed

    Cuca, Yvette P; Rose, Carol Dawson

    2016-09-01

    As more women become infected with HIV, the issue of childbearing becomes increasingly salient. A more nuanced understanding of women's situations is needed to provide high-quality and relevant services and support. We examined reproductive decision making among 20 women living with HIV through in-depth interviews. These women made decisions within situations of chaos, instability, and trauma, which often limited their ability to make truly informed choices about their lives and childbearing. Despite their HIV, many of the women wanted children, but experienced stigmatization related both to their HIV and to their decisions to have children. This stigmatization came from multiple sources, including health care providers, some of whom encouraged their patients to abort pregnancies because of their HIV. Participants, however, demonstrated resistance to stigmatization, through building supportive communities and developing trusting relationships with HIV providers. These results support the need for specialized HIV care for women of childbearing age. PMID:26224219

  15. Understanding HIV-related stigma in older age in rural Malawi.

    PubMed

    Freeman, Emily

    2016-09-01

    The combination of HIV- and age-related stigma exacerbates prevalence of HIV infection and late diagnosis and initiation of anti-retroviral therapy among older populations (Moore, 2012; Richards et al. 2013). Interventions to address these stigmas must be grounded in understanding of situated systems of beliefs about illness and older age. This study analyses constructions of HIV and older age that underpinned the stigmatisation of older adults with HIV in rural Balaka, Malawi. It draws on data from a series of in-depth interviews (N = 135) with adults aged 50-∼90 (N = 43) in 2008-2010. Around 40% (n = 18) of the sample had HIV. Dominant understandings of HIV in Balaka pertained to the sexual transmission of the virus and poor prognosis of those infected. They intersected with understandings of ageing. Narratives about older age and HIV in older age both centred on the importance of having bodily, moral and social power to perform broadly-defined "work". Those who could not work were physically and socially excluded from the social world. This status, labelled as "child-like", was feared by all participants. In participants' narratives, growing old involves a gradual decline in the power required to produce one's membership of the social world through work. HIV infection in old age is understood to accelerate this decline. Understandings of the sexual transmission of HIV, in older age, imply the absence of moral power and in turn, loss of social power. The prognosis of those with HIV, in older age, reflects and causes amplified loss of bodily power. In generating dependency, this loss of bodily power infantilises older care recipients and jeopardises their family's survival, resulting in further loss of social power. This age-and HIV-related loss of power to produce social membership through work is the discrediting attribute at the heart of the stigmatisation of older people with HIV. PMID:27459023

  16. Assistive Technology Use and Stigma

    ERIC Educational Resources Information Center

    Parette, Phil; Scherer, Marcia

    2004-01-01

    Issues related to stigma and its impact on assistive technology (AT) use with persons having developmental disabilities are addressed. While stigma has been known to be associated with presence of disability for many years, relationship between stigma and AT usage, particularly when working with families across cultures, has only just begun to be…

  17. The effects of a mass media HIV-risk reduction strategy on HIV-related stigma and knowledge among African American adolescents.

    PubMed

    Kerr, Jelani C; Valois, Robert F; DiClemente, Ralph J; Carey, Michael P; Stanton, Bonita; Romer, Daniel; Fletcher, Faith; Farber, Naomi; Brown, Larry K; Vanable, Peter A; Salazar, Laura F; Juzang, Ivan; Fortune, Thierry

    2015-03-01

    HIV-related stigma undermines HIV prevention, testing, and treatment. Multipronged risk-reduction strategies may reduce stigma among African American adolescents. To test the effectiveness of a risk-reduction strategy in addressing stigma, 1613 African American adolescents from four mid-sized cities participated in a randomized control trial. Participants received a sexual-risk reduction [Focus on Youth (FOY)] or general health curriculum [Promoting Health Among Teens (PHAT)]. Two cities received a culturally-tailored media intervention. Participants completed baseline, 3-, 6-, and 12-month surveys to measure HIV-related stigma and knowledge. Analysis of covariance tested for stigma and knowledge differences by media city status and curriculum/media city status (PHAT media vs. PHAT non-media, FOY media vs. FOY non-media; FOY media vs. PHAT media; FOY non-media vs. PHAT non-media) at each measurement. Hierarchical linear modeling (HLM) determined stigma and knowledge differences over time. Media participants demonstrated greater HIV-related knowledge (p<0.10) at 6 months and lower stigma at 3 months (p<0.10). FOY media participants had lower 3-month (p<0.05) and 12-month (p<0.10) stigma scores than non-media FOY participants. FOY media and non-media participants had greater knowledge than PHAT for all intervals after baseline. FOY media had lower stigma than PHAT media after baseline for all intervals after baseline. HLM indicated greater knowledge slopes for the media group (p<0.05). FOY media participants had greater knowledge slopes (p<0.05) relative to non-media FOY participants and media PHAT participants (p<0.01). A combination of a HIV risk-reduction curriculum and culturally-tailored media demonstrated some effectiveness in reducing stigma. Future use of media in HIV-prevention should include and evaluate effects on stigma. PMID:25738952

  18. The Effects of a Mass Media HIV-Risk Reduction Strategy on HIV-Related Stigma and Knowledge Among African American Adolescents

    PubMed Central

    Valois, Robert F.; DiClemente, Ralph J.; Carey, Michael P.; Stanton, Bonita; Romer, Daniel; Fletcher, Faith; Farber, Naomi; Brown, Larry K.; Vanable, Peter A.; Salazar, Laura F.; Juzang, Ivan; Fortune, Thierry

    2015-01-01

    Abstract HIV-related stigma undermines HIV prevention, testing, and treatment. Multipronged risk-reduction strategies may reduce stigma among African American adolescents. To test the effectiveness of a risk-reduction strategy in addressing stigma, 1613 African American adolescents from four mid-sized cities participated in a randomized control trial. Participants received a sexual-risk reduction [Focus on Youth (FOY)] or general health curriculum [Promoting Health Among Teens (PHAT)]. Two cities received a culturally-tailored media intervention. Participants completed baseline, 3-, 6-, and 12-month surveys to measure HIV-related stigma and knowledge. Analysis of covariance tested for stigma and knowledge differences by media city status and curriculum/media city status (PHAT media vs. PHAT non-media, FOY media vs. FOY non-media; FOY media vs. PHAT media; FOY non-media vs. PHAT non-media) at each measurement. Hierarchical linear modeling (HLM) determined stigma and knowledge differences over time. Media participants demonstrated greater HIV-related knowledge (p<0.10) at 6 months and lower stigma at 3 months (p<0.10). FOY media participants had lower 3-month (p<0.05) and 12-month (p<0.10) stigma scores than non-media FOY participants. FOY media and non-media participants had greater knowledge than PHAT for all intervals after baseline. FOY media had lower stigma than PHAT media after baseline for all intervals after baseline. HLM indicated greater knowledge slopes for the media group (p<0.05). FOY media participants had greater knowledge slopes (p<0.05) relative to non-media FOY participants and media PHAT participants (p<0.01). A combination of a HIV risk-reduction curriculum and culturally-tailored media demonstrated some effectiveness in reducing stigma. Future use of media in HIV-prevention should include and evaluate effects on stigma. PMID:25738952

  19. Development and Psychometric Assessment of a Multidimensional Measure of Internalized HIV Stigma in a sample of HIV-positive Adults

    PubMed Central

    Sayles, Jennifer N.; Hays, Ron D.; Sarkisian, Catherine A.; Mahajan, Anish P.; Spritzer, Karen L.; Cunningham, William E.

    2010-01-01

    There is a need for a psychometrically sound measure of the stigma experienced by diverse persons living with HIV/AIDS (PLHA). The goal of this study was to develop and evaluate a multidimentional measure of internalized HIV stigma that captures stigma related to treatment and other aspects of the disease among sociodemographically diverse PLHA. We developed a 28-item measure of internalized HIV stigma composed of four scales based on previous qualitative work. Internal consistency reliability estimates in a sample of 202 PLHA was 0.93 for the overall measure, and exceeded 0.85 for three of the four stigma scales. Items discriminated well across scales, and correlations of the scales with shame, social support, and mental health supported construct validity. This measure should prove useful to investigators examining in the role of stigma in HIV treatment and health outcomes, and evaluating interventions designed to mitigate the impacts of stigma on PLHA. PMID:18389363

  20. Women and AIDS-Related Concerns

    PubMed Central

    Cochran, Susan D.; Mays, Vickie M.

    2014-01-01

    Acquired Immunodeficiency Syndrome (AIDS) has important implications for the practice of psychology. As the epidemic continues, the role of behavior change and psychosocial factors in the spread and transmission of Human Immunodeficiency Virus (HIV) infections assumes increasing significance. Psychologists, as behavior change experts, have a special and challenging role to play in educating the public, particularly women, about AIDS. This article examines AIDS- and HIV-related concerns in women with a focus on the personal dilemmas for the practicing psychologist, problems in health behavior advocacy, and methods and pitfalls in modifying sexual behaviors. PMID:2930055

  1. Confronting the stigma of epilepsy.

    PubMed

    Thomas, Sanjeev V; Nair, Aparna

    2011-07-01

    Stigma and resultant psychosocial issues are major hurdles that people with epilepsy confront in their daily life. People with epilepsy, particularly women, living in economically weak countries are often ill equipped to handle the stigma that they experience at multiple levels. This paper offers a systematic review of the research on stigma from sociology and social psychology and details how stigma linked to epilepsy or similar conditions can result in stereotyping, prejudice and discrimination. We also briefly discuss the strategies that are most commonly utilized to mitigate stigma. Neurologists and other health care providers, social workers, support groups and policy makers working with epilepsy need to have a deep understanding of the social and cultural perceptions of epilepsy and the related stigma. It is necessary that societies establish unique determinants of stigma and set up appropriate strategies to mitigate stigma and facilitate the complete inclusion of people with epilepsy as well as mitigating any existing discrimination. PMID:22028525

  2. Confronting the stigma of epilepsy

    PubMed Central

    Thomas, Sanjeev V.; Nair, Aparna

    2011-01-01

    Stigma and resultant psychosocial issues are major hurdles that people with epilepsy confront in their daily life. People with epilepsy, particularly women, living in economically weak countries are often ill equipped to handle the stigma that they experience at multiple levels. This paper offers a systematic review of the research on stigma from sociology and social psychology and details how stigma linked to epilepsy or similar conditions can result in stereotyping, prejudice and discrimination. We also briefly discuss the strategies that are most commonly utilized to mitigate stigma. Neurologists and other health care providers, social workers, support groups and policy makers working with epilepsy need to have a deep understanding of the social and cultural perceptions of epilepsy and the related stigma. It is necessary that societies establish unique determinants of stigma and set up appropriate strategies to mitigate stigma and facilitate the complete inclusion of people with epilepsy as well as mitigating any existing discrimination. PMID:22028525

  3. [Aged woman's vulnerability related to AIDS].

    PubMed

    Silva, Carla Marins; Lopes, Fernanda Maria do Valle Martins; Vargens, Octavio Muniz da Costa

    2010-09-01

    This article is a systhematic literature review including the period from 1994 to 2009, whose objective was to discuss the aged woman's vulnerability in relation to Acquired Imunodeficiency Syndrome (Aids). The search for scientific texts was accomplished in the following databases: Biblioteca Virtual em Saúde, Scientific Eletronic Library Online (SciELO), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) and Medical Literature Analysis and Retrieval System Online (MEDLINE). The descriptors used were vulnerability, woman and Aids. Eighteen texts were analyzed, including articles in scientific journals, thesis and dissertations. As a conclusion, it was noted that aged women and vulnerability to Aids are directly related, through gender characteristics including submission and that were built historical and socially. We consider as fundamental the development of studies which may generate publications accessible to women, in order to help them see themselves as persons vulnerable to Aids contagion just for being women. PMID:21574329

  4. Stigma as 'othering' among Christian theology students in South Africa.

    PubMed

    Van Breda, Adrian D

    2012-11-01

    HIV is a health and developmental crisis that has profoundly challenged the Christian church in sub-Saharan Africa. Responding to stigma and prejudice against HIV and people living with HIV and AIDS has been a major concern of theologians and Christian leaders. However, Christians themselves and the church as a community are equally prone to stigma and prejudice. The author contends that this stigma is grounded in the dynamic of 'othering', which, among Christians, takes on religious or theological overtones. Drawing on qualitative data from theology students in South Africa, the paper assembles a model of AIDS stigma as othering. The central story or axis of the model is the dynamic of othering, comprising three themes, viz. lack of empathic contact, disconnection, and distancing. There are three main dynamics that appear to contribute to or feed into othering, viz. emotions related to sexuality and HIV, theology of health and judgement, and contextualised knowledge of HIV. Finally, the model presents two primary results of othering, viz. disengagement from HIV through passivity and hopelessness, and prejudice against those living with HIV. The paper endeavours to reveal the possible biblical roots of AIDS stigma. Through this, the deep violence embedded in such stigma is exposed and contrasted with a theology of inclusiveness and engagement. PMID:23234346

  5. Geographic distribution of HIV stigma among women of childbearing age in rural Kenya

    PubMed Central

    Akullian, Adam; Kohler, Pamela; Kinuthia, John; Laserson, Kayla; Mills, Lisa A.; Okanda, John; Olilo, George; Ombok, Maurice; Odhiambo, Frank; Rao, Deepa; Wakefield, Jonathan; John-Stewart, Grace

    2015-01-01

    Objective(s) HIV stigma is considered to be a major driver of the HIV/AIDS pandemic, yet there is a limited understanding of its occurrence. We describe the geographic patterns of two forms of HIV stigma in a cross-sectional sample of women of childbearing age from western Kenya: internalized stigma (associated with shame) and externalized stigma (associated with blame). Design Geographic studies of HIV stigma provide a first step in generating hypotheses regarding potential community-level causes of stigma and may lead to more effective community-level interventions. Methods Spatial regression using generalized additive models and point pattern analyses using K-functions were used to assess the spatial scale(s) at which each form of HIV stigma clusters, and to assess whether the spatial clustering of each stigma indicator was present after adjustment for individual-level characteristics. Results There was evidence that externalized stigma (blame) was geographically heterogeneous across the study area, even after controlling for individual-level factors (P=0.01). In contrast, there was less evidence (P=0.70) of spatial trend or clustering of internalized stigma (shame). Conclusion Our results may point to differences in the underlying social processes motivating each form of HIV stigma. Externalized stigma may be driven more by cultural beliefs disseminated within communities, whereas internalized stigma may be the result of individual-level characteristics outside the domain of community influence. These data may inform community-level interventions to decrease HIV-related stigma, and thus impact the HIV epidemic. PMID:24835356

  6. Stigma in HIV-infected health care workers in Kenya: a mixed-method approach.

    PubMed

    Opollo, Jackline G; Gray, Jennifer

    2015-01-01

    HIV-related stigma decreases access to HIV testing, prevention, and treatment services. Our mixed methods study explored stigma as perceived, experienced, and managed in a sample of 76 HIV-infected health care workers in Kisumu, Kenya. Stigma was quantitatively measured using the HIV/AIDS Stigma Instrument for People Living with AIDS (HASI-P). Overall, subjects experienced low stigma levels (mean = 7.88, SD = 12.90; range = 0-61), and none of the sociodemographic variables were predictive of stigma. Transcript analysis of 20 qualitative interviews revealed two negative themes (blame, lack of knowledge) and five positive themes (living positively, optimism, empathy, support, changes over time). Three themes emerged on reducing stigma (normalizing, empowerment, leading by example). Disclosure, access to treatment, stigma reduction training, workplace support groups, and awareness of an HIV workplace policy may have contributed to low stigma scores. Qualitative findings corroborated quantitative findings and corresponded to the six domains of the HASI-P. PMID:25769752

  7. Implications of Carotenoid Biosynthetic Genes in Apocarotenoid Formation during the Stigma Development of Crocus sativus and Its Closer Relatives1

    PubMed Central

    Castillo, Raquel; Fernández, José-Antonio; Gómez-Gómez, Lourdes

    2005-01-01

    Crocus sativus is a triploid sterile plant characterized by its long red stigmas, which produce and store significant quantities of the apocarotenoids crocetin and crocin, formed from the oxidative cleavage of zeaxanthin. Here, we investigate the accumulation and the molecular mechanisms that regulate the synthesis of these apocarotenoids during stigma development in C. sativus. We cloned the cDNAs for phytoene synthase, lycopene-β-cyclase, and β-ring hydroxylase from C. sativus. With the transition of yellow undeveloped to red fully developed stigmas, an accumulation of zeaxanthin was observed, accompanying the expression of CsPSY, phytoene desaturase, and CsLYCb, and the massive accumulation of CsBCH and CsZCD transcripts. We analyzed the expression of these two transcripts in relation to zeaxanthin and apocarotenoid accumulation in other Crocus species. We observed that only the relative levels of zeaxanthin in the stigma of each cultivar were correlated with the level of CsBCH transcripts. By contrast, the expression levels of CsZCD were not mirrored by changes in the apocarotenoid content, suggesting that the reaction catalyzed by the CsBCH enzyme could be the limiting step in the formation of saffron apocarotenoids in the stigma tissue. Phylogenetic analysis of the CsBCH intron sequences allowed us to determine the relationships among 19 Crocus species and to identify the closely related diploids of C. sativus. In addition, we examined the levels of the carotenoid and apocarotenoid biosynthetic genes in the triploid C. sativus and its closer relatives to determine whether the quantities of these specific mRNAs were additive or not in C. sativus. Transcript levels in saffron were clearly higher and nonadditive, suggesting that, in the triploid gene, regulatory interactions that produce novel effects on carotenoid biosynthesis genes are involved. PMID:16183835

  8. Perceived social support, hopefulness, and emotional regulations as mediators of the relationship between enacted stigma and post-traumatic growth among children affected by parental HIV/AIDS in rural China

    PubMed Central

    Wei, Wei; Li, Xiaoming; Tu, Xiaoming; Zhao, Junfeng; Zhao, Guoxiang

    2016-01-01

    ABSTRACT Some previous studies have revealed a negative impact of enacted stigma on post-traumatic growth (PTG) of children affected by HIV/AIDS, but little is known about protective psychological factors that can mitigate the effect of enacted stigma on children's PTG. This study aims to examine the mediating effects of perceived social support, hopefulness, and emotional regulation on the relationship between enacted stigma and PTG among HIV-affected children. Cross-sectional data were collected from 790 children affected by parental HIV (382 girls, 408 boys) aged 6–17 years in 2012 in rural central China. Multiple regression was conducted to test the mediation model. The study found that the experience of enacted stigma had a negative effect on PTG among children affected by HIV/AIDS. Emotional regulation together with hopefulness and perceived social support mediated the impact of enacted stigma on PTG. Perceived social support, hopefulness, and emotional regulation offer multiple levels of protection that can mitigate the impact of enacted stigma on PTG. Results suggest that future psychological intervention programs should seek strategies to reduce the stigmatizing experience of these children and promote children's level of PTG, and health professionals should also emphasize the development of these protective psychological factors. PMID:26899475

  9. Tal Como Somos/just as we are: an educational film to reduce stigma toward gay and bisexual men, transgender individuals, and persons living with HIV/AIDS.

    PubMed

    Ramirez-Valles, Jesus; Kuhns, Lisa M; Manjarrez, Dianna

    2014-04-01

    In this article, the authors describe the development and dissemination of a film-based educational intervention to reduce negative attitudes toward gay and bisexual men, transgender women, and people living with HIV/AIDS in Latino communities, with a focus on youth. The intervention, Tal Como Somos/Just as We Are, is based on stigma and attribution theories, extensive formative research, and community input. Evaluation findings among educators and school youth suggest the film has the potential to effectively influence attitudes toward gay and bisexual men, transgender women, and people living with HIV/AIDS. The film and intervention are being disseminated using diffusion of innovations theory through community-based organizations, schools, television broadcasting, and film festivals. PMID:24377496

  10. Comparing HIV-related symbolic stigma in six African countries: social representations in young people’s narratives

    PubMed Central

    Winskell, Kate; Hill, Elizabeth; Obyerodhyambo, Oby

    2011-01-01

    HIV-related symbolic stigma arises from moralistic value judgements attached to people living with HIV and has negative consequences from both public health and human rights perspectives. Relatively little is known about cross-national variation in symbolic stigma. With the purpose of informing stigma reduction efforts within and across settings, we compared social representations of HIV in six African countries with estimated adult HIV prevalence rates ranging from 1 to 33%. Our study used a unique data source, namely a stratified random sample (n=586, ~5%) from 11,354 creative ideas contributed from six countries to a continent-wide HIV-related scriptwriting contest held between February and April2005. The narratives were written by equal numbers of males and females aged 10–24 in urban and rural areas of Swaziland, Namibia, Kenya, South-East Nigeria, Burkina Faso and Senegal. We combined three analytical approaches: descriptive statistics on certain quantifiable characteristics of the narratives, thematic data analysis, and a narrative-based approach. The association of HIV with outsiders (“othering”)and preoccupation with the circumstances of infection are more common in lower prevalence countries but vary substantially in tone depending on the sociocultural context. The highest proportion both of moralising narratives and of narratives with pessimistic outcomes come from South-East Nigeria and, to a lesser extent, from Kenya, countries with prevalence levels of 3.9 and 6.1% respectively, in which evangelical Christian movements, including Pentecostalism, have sizeable followings. The data provide a rare cross-cultural overview of symbolic stigma, identify country-specific needs, and point to strategies for future programming. Social representations from the highest prevalence countries, Swaziland and Namibia, and from lower prevalence Burkina Faso offer potential models for the framing of HIV in ways that serve to increase social proximity and counteract

  11. Voices of Women Facing HIV-Related Stigma in the Deep South.

    PubMed

    Relf, Michael V; Williams, Megan; Barroso, Julie

    2015-12-01

    One in 139 women will be diagnosed with HIV in their lifetime. Thirty-four years into the epidemic, stigma remains part of the trajectory of the disease process for all individuals with HIV. Stigma associated with HIV makes it difficult for women to access HIV testing and counseling, disclose HIV status to sexual partners and health care providers, seek and remain actively engaged in medical care, effectively self-manage the disease after diagnosis, and adhere to antiretroviral therapy. The current article reports the qualitative results from a study designed to test the feasibility and acceptability of a technologically delivered stigma intervention for women with HIV in the Southeastern United States. Qualitative analysis revealed women with HIV uniformly experience, anticipate, and/or internalize stigma associated with HIV. Consequently, women with HIV experience isolation and a threat to self-concept as they make decisions about disclosure, work to maintain the secrecy of their HIV status, and contemplate a future. PMID:26505522

  12. Predictors of HIV enacted stigma among Chilean women

    PubMed Central

    Cianelli, Rosina; Villlegas, Natalia; De Oliveira, Giovanna; Hires, Kimberly; Gattamorta, Karina; Ferrer, Lilian; Peragallo, Nilda

    2015-01-01

    Aims and objectives To investigate if socio-demographic factors, religiosity, HIV-related knowledge, Marianismo, history of having been tested for HIV, knowing someone who died of AIDS and HIV risk perception were predictive factors to HIV enacted stigma predictors among Chilean women. Background HIV infection is the number one cause of death among women during their reproductive years. In Chile, studies with people living with HIV demonstrate the existence of HIV-related stigma. However, limited evidence is available about the underlying causes of HIV enacted stigma that results in stigmatisation and discrimination. Design The current cross-sectional study is a secondary analysis of data collected to assess the impact of an HIV prevention intervention (Mano a Mano-Mujer) designed for Chilean women. A quasi-experimental design was used in the original study. Methods This study was conducted in two communities in Santiago, Chile. The sample for this study consisted of 496 Chileans between ages 18–49. Descriptive statistics and multiple regression were used for the analysis. Results Participants in the study reported high levels (77·8%) of HIV enacted stigma. Higher levels of HIV-related knowledge were associated with lower levels of HIV enacted stigma. Women with higher education had lower levels of HIV enacted stigma than women with elementary education. In addition, greater levels of marianismo (cultural belief that women should be passive, faithful, and devoted to family) were associated with higher HIV enacted stigma scores. Conclusions The findings reflected the presence of HIV enacted stigma among Chilean women. Identifying the significant predictors of HIV enacted stigma can help the nursing community to design HIV prevention interventions that include the reduction in HIV enacted stigma. HIV evidence-based prevention interventions should incorporate contents related to stigma to contribute to prevent HIV enacted stigma at individual and community levels

  13. Job-related burnout among juvenile probation officers: Implications for mental health stigma and competency.

    PubMed

    White, Laura M; Aalsma, Matthew C; Holloway, Evan D; Adams, Erin L; Salyers, Michelle P

    2015-08-01

    The high demands and responsibilities of probation work, particularly with juvenile clients, may lead to burnout, which can negatively impact how probation officers work with clients, particularly individuals with behavioral health concerns. Yet, research examining burnout and related outcomes among juvenile probation officers (JPOs) is limited. We surveyed 246 JPOs in a Midwestern state to identify the prevalence, predictors, and potential outcomes of burnout. JPOs reported moderate levels of burnout; about 30% of the sample scored in the high range for emotional exhaustion and cynicism. Contrary to study hypotheses, there were no group-level differences in burnout scores across gender, race/ethnicity, age, or education. In regression models, burnout was predicted by being White (vs. minority), serving in an urban (vs. rural) county, dissatisfaction with department guidelines, job dissatisfaction, viewing job role as more treatment-oriented along the enforcement-treatment continuum, and turnover intention. JPOs with burnout were more likely to endorse mental health stigma and lack of mental health competency to address juvenile clients with behavioral health concerns. Findings suggest burnout prevention and intervention programs should be considered for JPOs to increase job satisfaction, limit job turnover, reduce burnout, and possibly increase effective practices for managing juvenile clients with behavioral health needs. PMID:26009896

  14. Effects of home-based voluntary counselling and testing on HIV-related stigma: findings from a cluster-randomized trial in Zambia.

    PubMed

    Jürgensen, Marte; Sandøy, Ingvild Fossgard; Michelo, Charles; Fylkesnes, Knut

    2013-03-01

    HIV-related stigma continues to be a prominent barrier to testing, treatment and care. However, few studies have investigated changes in stigma over time and the factors contributing to these changes, and there is no evidence of the impact of HIV testing and counselling on stigma. This study was nested within a pair-matched cluster-randomized trial on the acceptance of home-based voluntary HIV counselling and testing conducted in a rural district in Zambia between 2009 and 2011, and investigated changes in stigma over time and the impact of HIV testing and counselling on stigma. Data from a baseline survey (n = 1500) and a follow-up survey (n = 1107) were used to evaluate changes in stigma. There was an overall reduction of seven per cent in stigma from baseline to follow-up. This was mainly due to a reduction in individual stigmatizing attitudes but not in perceived stigma. The reduction did not differ between the trial arms (β = -0.22, p = 0.423). Being tested for HIV was associated with a reduction in stigma (β = -0.57, p = 0.030), and there was a trend towards home-based Voluntary Counselling and Testing having a larger impact on stigma than other testing approaches (β = -0.78, p = 0.080 vs. β = -0.37, p = 0.551), possibly explained by a strong focus on counselling and the safe environment of the home. The reduction observed in both arms may give reason to be optimistic as it may have consequences for disclosure, treatment access and adherence. Yet, the change in stigma may have been affected by social desirability bias, as extensive community mobilization was carried out in both arms. The study underscores the challenges in measuring and monitoring HIV-related stigma. Adjustment for social desirability bias and inclusion of qualitative methods are recommended for further studies on the impact of HIV testing on stigma. PMID:23422056

  15. Measuring HIV Stigma at the Family Level: Psychometric Assessment of the Chinese Courtesy Stigma Scales (CCSSs)

    PubMed Central

    Liu, Hongjie; Xu, Yongfang; Sun, Yehuan; Dumenci, Levent

    2014-01-01

    Courtesy stigma is the stigmatization a person perceives or experiences due to their association with a stigmatized individual or group. Most HIV-related stigma scales have been developed for people living with HIV/AIDS (PLWHAs), but not for their HIV-uninfected family members. To date, few measurement scales have been designed to measure the degree of stigma among both PLWHAs and their HIV-uninfected family members at the family level. We developed a set of courtesy stigma scales and estimated their reliability and validity from 256 PLWHAs and 256 of their HIV-uninfected family members. Exploratory and confirmatory factor analyses were performed in two independent samples: a development sample (N = 216) and a validation sample (N = 296), respectively. Two factors (“public stigma” and “self-perceived stigma”) had high internal consistency reliability (Cronbach's alpha coefficient between 0.83–0.90) and good construct validity (standardized factor loading range: 0.37–0.95) in both samples. These findings document that the newly developed brief instrument is a psychometrically sound measure of HIV-related stigma among both PLWHAs and their HIV-uninfected family members. PMID:24658364

  16. Tal Como Somos/Just As We Are: An Educational Film to Reduce Stigma towards Gay and Bisexual Men, Transgender Individuals & Persons Living with HIV/AIDS

    PubMed Central

    Ramirez-Valles, Jesus; Kuhns, Lisa M.; Manjarrez, Dianna

    2013-01-01

    In this paper we describe the development and dissemination of a film-based educational intervention to reduce negative attitudes towards gay and bisexual men and transgender women (GBT) and people living with HIV/AIDS (PLWHA) in Latino communities, with a focus on youth. The intervention, Tal Como Somos/Just as We Are, is based on stigma and attribution theories, extensive formative research, and community input. Evaluation findings among educators and school youth suggest the film has the potential to effectively impact attitudes towards GBT and PLWHA. The film and intervention are being disseminated using diffusion of innovations theory through community-based organizations, schools, television broadcasting and film festivals. PMID:24377496

  17. Finding benefit in stressful uncertain circumstances: relations to social support and stigma among women with unexplained illnesses.

    PubMed

    McInnis, Opal A; McQuaid, Robyn J; Bombay, Amy; Matheson, Kimberly; Anisman, Hymie

    2015-01-01

    Living with a chronic illness can be challenging, but the ability to derive benefits and grow from this experience may enhance well-being. However, the possibility of obtaining such benefits may be dependent on the levels of stigmatization and lack of social support experienced by an individual as a result of the illness. Chronic fatigue syndrome (CFS) and fibromyalgia are chronic conditions that remain largely unexplained and those with these conditions must often contend with stigma and skepticism from others. Individuals with CFS/fibromyalgia often display stress-related biological alterations and the experience of stressful life events has been associated with illness development. The present study demonstrated that women with CFS/fibromyalgia (n = 40) as well as community participants who were depressed/anxious (n = 37), reported higher stigma levels than healthy women (n = 33). Moreover, women with CFS/fibromyalgia and those with depression/anxiety also reported greater levels of stigma than women with a chronic yet more widely accepted condition (n = 35; rheumatoid arthritis, osteoarthritis and multiple sclerosis). Secrecy related to stigma among those with CFS/fibromyalgia declined with increased social support, but this was not apparent among those with other chronic conditions. In addition, posttraumatic growth was lower among women with CFS/fibromyalgia compared to those with other chronic conditions. Qualitative analysis examining both negative impacts and positive changes stemming from illness experience revealed many similarities between women with CFS/fibromyalgia and those with other chronic conditions, including elevated appreciation for life, personal growth and compassion for others. However, women with CFS/fibromyalgia tended to report less positive change regarding interpersonal relationships compared to women with other chronic conditions. In general, unexplained illnesses were also accompanied by stigmatization which might

  18. Weight-related teasing and internalized weight stigma predict abnormal eating attitudes and behaviours in Emirati female university students.

    PubMed

    O'Hara, Lily; Tahboub-Schulte, Sabrina; Thomas, Justin

    2016-07-01

    This cross-sectional study examined the relationship between abnormal eating attitudes, weight teasing, internalized weight stigma and self-esteem in the United Arab Emirates in a sample of 420 female Emirati undergraduate students (mean age = 23.12 years). Participants completed an online survey including validated and reliable measures. Regression and mediation analyses were used to test for relationships between the factors. Thirty percent of respondents had eating disorder symptomatology, and 44% of respondents reported being frequently teased about their weight. Eating disorder symptomatology was positively correlated with being bothered by teasing from family, friends and others, and internalized weight stigma. Weight- and body-related shame and guilt was the strongest predictor of eating disorder symptomatology. Public health authorities should consider these issues as priorities for action in order to improve the health and wellbeing of young women in the UAE. In addition, it is vital that public health and medical services do not inadvertently condone weight-based teasing or enhance weight stigma and shame. PMID:26774444

  19. Infectious Disease Stigmas: Maladaptive in Modern Society.

    PubMed

    Smith, Rachel A; Hughes, David

    2014-04-01

    At multiple times in human history people have asked if there are good stigmas. Is there some useful function stigmas serve in the context of our evolutionary history; is stigma adaptive? This essay discusses stigmas as a group-selection strategy and the human context in which stigmas likely appeared. The next section explores how human patterns have changed in modern society and the consequences for infectious disease (ID) stigmas in the modern age. The concluding section suggests that while social-living species may be particularly apt to create and communicate ID stigmas and enact ID-related stigmatization, such stigma-related processes no longer function to protect human communities. Stigmas do not increase the ability of modern societies to survive infectious diseases, but in fact may be important drivers of problematic disease dynamics and act as catalysts for failures in protecting public health. PMID:25477728

  20. [Fight against schizophrenia stigma].

    PubMed

    López-Ibor Aliño, J J

    2001-01-01

    Stigma, discrimination and prejudice against mental diseases, those who suffer from them and their families are common everywhere. To reduce stigma in schizophrenia is essential for a better outcome of the disease in each patient. Stigma interferes with the detection of the illness, with adherence to treatment, with rehabilitation and with social reinsertion. Stigma is everywhere in schizophrenia, from within the family itself to the health care system and into society at large. The WPA has developed a Program to fight the stigma of schizophrenia consisting on several modules: 1) Instructions on how to implement a campaign. 2) A monograph in schizophrenia. 3) A summary of the experiences in the sites where the program has been tested. 4) Further modules which include information on similar campaigns and material such as leaflets, books and videos and concrete examples of discrimination. A pilot study of the WPA Program was carried out in Madrid in 1999. A survey was undertaken to identify target population and specific messages, showing little knowledge about the disease and a small stigma amount. It was decided not to carry out an awareness campaign in the population, which has the risk of increasing stigma in parallel to being increased in awareness but to explore the amount of stigma in the environment closer to the patient such as patients themselves, relatives, neighbours and health services staff. The stigma degree was much more significant. Activities related to this group of people were undertaken specially by training psychiatrists to identify stigma and discrimination and to fight it. The outcome showed a great satisfaction among patients, relatives and physicians. A pilot media campaign was also undertaken. In previous years there was no information about schizophrenia in mass media only news on incidental problems of patients with schizophrenia. After the campaign news on the disease itself appeared in mass media. The Madrid experience shows that the

  1. Thymostimulin treatment in AIDS-related complex.

    PubMed

    Palmisano, L; Chisesi, T; Galli, M; Gritti, F M; Ielasi, G; Lazzarin, A; Mezzaroma, I; Moroni, M; Raise, E; Vaglia, A

    1988-06-01

    Thirty-four patients with AIDS-related complex (ARC) were treated for 6 months with thymostimulin, a thymic hormone. Clinical and immunological findings after a 1-year follow-up were compared with those in 24 age- and sex-matched controls receiving no immunotherapy. Statistical evaluation after 6 and 12 months showed significant differences in the two groups. The thymostimulin-treated group had higher leukocyte and lymphocyte counts, more positivity in intradermal tests with multiple recall antigens, and less lymphadenopathy and weight loss. The number of OKT3+ and OKT4+ lymphocytes decreased significantly in the control group, but did not change in the thymostimulin-treated patients. Finally, after 18 months of follow-up, no progression to AIDS was seen among the treated subjects, whereas 3 of the controls developed the disease. We conclude that thymostimulin, alone or in combination with antiviral drugs, may be helpful in the management of ARC patients. PMID:3259480

  2. Reacting to AIDS-Related Suicide: Does Time since Diagnosis Matter?

    ERIC Educational Resources Information Center

    Range, Lillian M.; Alliston, Jerry R.

    1995-01-01

    Undergraduates (n=296) read a fictional vignette concerning a person diagnosed with either terminal cancer or AIDS, and for varying lengths of time. Student reactions indicated that a person with AIDS is associated with greater stigma than a person with another fatal disease, regardless of how long ago the diagnosis was made. (JPS)

  3. Stigma and work.

    PubMed

    Stuart, Heather

    2004-01-01

    This paper addresses what is known about workplace stigma and employment inequity for people with mental and emotional problems. For people with serious mental disorders, studies show profound consequences of stigma, including diminished employability, lack of career advancement and poor quality of working life. People with serious mental illnesses are more likely to be unemployed or to be under-employed in inferior positions that are incommensurate with their skills or training. If they return to work following an illness, they often face hostility and reduced responsibilities. The result may be self-stigma and increased disability. Little is yet known about how workplace stigma affects those with less disabling psychological or emotional problems, even though these are likely to be more prevalent in workplace settings. Despite the heavy burden posed by poor mental health in the workplace, there is no regular source of population data relating to workplace stigma, and no evidence base to support the development of best-practice solutions for workplace anti-stigma programs. Suggestions for research are made in light of these gaps. PMID:15829771

  4. HIV-Related Stigma and HIV Prevention Uptake Among Young Men Who Have Sex with Men and Transgender Women in Thailand.

    PubMed

    Logie, Carmen H; Newman, Peter A; Weaver, James; Roungkraphon, Surachet; Tepjan, Suchon

    2016-02-01

    HIV-related stigma is a pervasive structural driver of HIV. With an HIV epidemic among young men who have sex with men (MSM) and transgender women (TG) in Thailand characterized as explosive, we conducted a cross-sectional survey among MSM and TG aged 18-30 years. From April-August 2013, participants recruited using venue-based sampling from gay entertainment sites and community-based organizations completed a tablet-assisted survey interview in Thai language. We conducted multiple logistic regression to assess correlations between HIV-related stigma (felt-normative, vicarious domains) and socio-demographic variables, HIV vulnerabilities (gay entertainment employment, sex work, forced sex history), and HIV prevention uptake (condom use, HIV testing, rectal microbicide acceptability). Among participants (n = 408), 54% identified as gay, 25% transgender, and 21% heterosexual. Two-thirds (65.7%) were employed at gay entertainment venues, 67.0% had more than three male partners (past month), 55.6% had been paid for sex, and 4.5% were HIV-positive. One-fifth (21.3%) reported forced sex. Most participants reported experiencing felt-normative and vicarious HIV-related stigma. Adjusting for socio-demographics, participants with higher total HIV-related stigma scores had significantly lower odds of HIV testing and rectal microbicide acceptability, and higher odds of having experienced forced sex. Both vicarious and felt-normative dimensions of HIV-related stigma were inversely associated with HIV testing and rectal microbicide acceptability. Our findings suggest that HIV-related stigma harms the health of HIV-negative MSM and TG at high risk for HIV infection. HIV-related interventions and research among young MSM and TG in Thailand should address multiple dimensions of HIV-related stigma as a correlate of risk and a barrier to accessing prevention. PMID:26788978

  5. Aids-Related Cancers in Africa

    NASA Astrophysics Data System (ADS)

    Mbulaiteye, Sam M.

    2014-07-01

    Thank you Professor Zichichi for inviting me to give a talk about AIDS-related cancers in Africa. Let me begin by congratulating the team that organized the 46th Session of the Erice International Seminar Series, whose theme is THE ROLE OF SCIENCE IN THE THIRD MILLENIUM. I also congratulate the scientists from 38 countries who are attending these seminars. They are perpetuating the principle of SCIENCE WITHOUT SECRETS in the true spirit espoused by Archimedes, Galileo, and Fermi. It is a wonderful honor for me to be here to shed some light on the health impacts of the HIV epidemic in the area of cancer...

  6. Public opinion about abortion-related stigma among Mexican Catholics and implications for unsafe abortion.

    PubMed

    McMurtrie, Stephanie M; García, Sandra G; Wilson, Kate S; Diaz-Olavarrieta, Claudia; Fawcett, Gillian M

    2012-09-01

    A nationally representative survey was conducted among 3000 Catholics in Mexico during 2009 and 2010. Respondents were presented with a hypothetical situation about a young woman who decided to have an abortion and were asked their personal opinion of her. On the basis of a stigma index, it was found that the majority (61%) had stigmatizing attitudes about abortion; however, 81% believed that abortion should be legal in at least some circumstances. Respondents were significantly more likely to stigmatize abortion if they disagreed with the Mexico City law legalizing the procedure (odds ratio 1.66; 95% CI, 1.30-2.11) and believed that abortion should be prohibited in all cases (odds ratio 3.13; 95% CI, 2.28-4.30). Such stigma can lead women to seek unsafe abortions to avoid judgment by society. PMID:22920621

  7. Stigma Power

    PubMed Central

    Link, Bruce G.; Phelan, Jo

    2015-01-01

    When people have an interest in keeping other people down, in or away, stigma is a resource that allows them to obtain ends they desire. We call this resource “stigma power” and use the term to refer to instances in which stigma processes achieve the aims of stigmatizers with respect to the exploitation, control or exclusion of others. We draw on Bourdieu (1987; 1990) who notes that power is often most effectively deployed when it is hidden or “misrecognized.” To explore the utility of the stigma power concept we examine ways in which the goals of stigmatizers are achieved but hidden in the stigma coping efforts of people with mental illnesses. We developed new self-report measures and administered them to a sample of individuals who have experienced mental illness to test whether results are consistent with the possibility that, in response to negative societal conceptions, the attitudes, beliefs and behaviors of people with psychosis lead them to be concerned with staying in, propelled to stay away and induced to feel downwardly placed –precisely the outcomes stigmatizers might desire. Our introduction of the stigma power concept carries the possibility of seeing stigmatizing circumstances in a new light. PMID:24507908

  8. From Conceptualizing to Measuring HIV Stigma: A Review of HIV Stigma Mechanism Measures

    PubMed Central

    Chaudoir, Stephenie R.

    2015-01-01

    Recent analyses suggest that lack of clarity in the conceptualization and measurement of HIV stigma at an individual level is a significant barrier to HIV prevention and treatment efforts. In order to address this concern, we articulate a new framework designed to aid in clarifying the conceptualization and measurement of HIV stigma among individuals. The HIV Stigma Framework explores how the stigma of HIV elicits a series of stigma mechanisms, which in turn lead to deleterious outcomes for HIV uninfected and infected people. We then apply this framework to review measures developed to gauge the effect of HIV stigma since the beginning of the epidemic. Finally, we emphasize the utility of using three questions to guide future HIV stigma research: who is affected by, how are they affected by, and what are the outcomes of HIV stigma? PMID:19636699

  9. Pancreatic abnormalities and AIDS related sclerosing cholangitis.

    PubMed Central

    Teare, J P; Daly, C A; Rodgers, C; Padley, S P; Coker, R J; Main, J; Harris, J R; Scullion, D; Bray, G P; Summerfield, J A

    1997-01-01

    OBJECTIVES: Biliary tract abnormalities are well recognised in AIDS, most frequently related to opportunistic infection with Cryptosporidium, Microsporidium, and cytomegalovirus. We noted a high frequency of pancreatic abnormalities associated with biliary tract disease. To define these further we reviewed the clinical and radiological features in these patients. METHODS: Notes and radiographs were available from two centres for 83 HIV positive patients who had undergone endoscopic retrograde cholangiopancreatography for the investigation of cholestatic liver function tests or abdominal pain. RESULTS: 56 patients had AIDS related sclerosing cholangitis (ARSC); 86% of these patients had epigastric or right upper quadrant pain and 52% had hepatomegaly. Of the patients with ARSC, 10 had papillary stenosis alone, 11 had intra- and extrahepatic sclerosing cholangitis alone, and 35 had a combination of the two. Ampullary biopsies performed in 24 patients confirmed an opportunistic infection in 16. In 15 patients, intraluminal polyps were noted on the cholangiogram. Pancreatograms were available in 34 of the 45 patients with papillary stenosis, in which 29 (81%) had associated pancreatic duct dilatation, often with associated features of chronic pancreatitis. In the remaining 27 patients, final diagnoses included drug induced liver disease, acalculous cholecystitis, gall bladder empyema, chronic B virus hepatitis, and alcoholic liver disease. CONCLUSION: Pancreatic abnormalities are commonly seen with ARSC and may be responsible for some of the pain not relieved by biliary sphincterotomy. The most frequent radiographic biliary abnormality is papillary stenosis combined with ductal sclerosis. Images PMID:9389948

  10. The Stigma of Families with Mental Illness

    ERIC Educational Resources Information Center

    Larson, Jon E.; Corrigan, Patrick

    2008-01-01

    Objective: This article describes family stigma, which is defined as the prejudice and discrimination experienced by individuals through associations with their relatives. Methods: The authors describe family stigma and present current research related to mental illness stigma experienced by family members. Research indicates this type of stigma…

  11. The Influence of Social Norms upon Behavioral Expressions of Implicit and Explicit Weight-Related Stigma in an Interactive Game

    PubMed Central

    Pryor, John B.; Reeder, Glenn D.; Wesselmann, Eric D.; Williams, Kipling D.; Wirth, James H.

    2013-01-01

    This research explored the roles of social influence and stigma-related attitudes in how people behaved toward an overweight female in an interactive computer game. Photographs were used to manipulate whether one of the players in the game was overweight or average weight. We found that both explicit and implicit anti-fat attitudes influenced interactions with an overweight player, but only when other players ostracized the overweight player, not when they included her. Under conditions of ostracism, explicit attitudes were better predictors of more controllable behaviors, while implicit attitudes were better predictors of more automatic behaviors. PMID:23766740

  12. The influence of social norms upon behavioral expressions of implicit and explicit weight-related stigma in an interactive game.

    PubMed

    Pryor, John B; Reeder, Glenn D; Wesselmann, Eric D; Williams, Kipling D; Wirth, James H

    2013-06-01

    This research explored the roles of social influence and stigma-related attitudes in how people behaved toward an overweight female in an interactive computer game. Photographs were used to manipulate whether one of the players in the game was overweight or average weight. We found that both explicit and implicit anti-fat attitudes influenced interactions with an overweight player, but only when other players ostracized the overweight player, not when they included her. Under conditions of ostracism, explicit attitudes were better predictors of more controllable behaviors, while implicit attitudes were better predictors of more automatic behaviors. PMID:23766740

  13. Homophobia, stigma and HIV in Jamaican prisons

    PubMed Central

    Andrinopoulos, Katherine; Figueroa, J Peter; Kerrigan, Deanna; Ellen, Jonathan M.

    2010-01-01

    Success in addressing HIV and AIDS among men who have sex with men, a key population in the global epidemic, is impeded by homophobia. Homophobia as a barrier to HIV prevention and AIDS treatment is a particularly acute problem in the prison setting. In this qualitative study, we explore HIV and AIDS, stigma, and homosexuality in the largest all male prison in Jamaica by conducting iterative in-depth interviews with 25 inmates. Participant narratives unveil a purposeful manipulation of beliefs related to homosexuality that impedes an effective response to HIV and AIDS both in prison and wider society. Findings indicate that homophobia is both a social construction and a tangible tool used to leverage power and a sense of solidarity in a larger political and economic landscape. This use of homophobia may not be unique to Jamaica, and is an important issue to address in other low and middle income post-colonialist societies. PMID:20972916

  14. "Why are you pregnant? What were you thinking?": How women navigate experiences of HIV-related stigma in medical settings during pregnancy and birth.

    PubMed

    Greene, Saara; Ion, Allyson; Kwaramba, Gladys; Smith, Stephanie; Loutfy, Mona R

    2016-02-01

    Having children is a growing reality for women living with HIV in Canada. It is imperative to understand and respond to women's unique experiences and psychosocial challenges during pregnancy and as mothers including HIV-related stigma. This qualitative study used a narrative methodological approach to understand women's experiences of HIV-related stigma as they navigate health services in pregnancy (n = 66) and early postpartum (n = 64). Narratives of women living with HIV expose the spaces where stigmatizing practices emerge as women seek perinatal care and support, as well as highlight the relationship between HIV-related stigma and disclosure, and the impact this has on women's pregnancy and birthing experiences. PMID:26684355

  15. Mechanisms for the Negative Effects of Internalized HIV-Related Stigma on Antiretroviral Therapy Adherence in Women: The Mediating Roles of Social Isolation and Depression

    PubMed Central

    Smith, Whitney; Cohen, Mardge H.; Wilson, Tracey E.; Adimora, Adaora A.; Merenstein, Daniel; Adedimeji, Adebola; Wentz, Eryka L.; Foster, Antonina G.; Metsch, Lisa; Tien, Phyllis C.; Weiser, Sheri D.; Turan, Janet M.

    2016-01-01

    Background: Internalization of HIV-related stigma may inhibit a person's ability to manage HIV disease through adherence to treatment regimens. Studies, mainly with white men, have suggested an association between internalized stigma and suboptimal adherence to antiretroviral therapy (ART). However, there is a scarcity of research with women of different racial/ethnic backgrounds and on mediating mechanisms in the association between internalized stigma and ART adherence. Methods: The Women's Interagency HIV Study (WIHS) is a multicenter cohort study. Women living with HIV complete interviewer-administered questionnaires semiannually. Cross-sectional analyses for the current article included 1168 women on ART for whom data on medication adherence were available from their last study visit between April 2013 and March 2014, when the internalized stigma measure was initially introduced. Results: The association between internalized stigma and self-reported suboptimal ART adherence was significant for those in racial/ethnic minority groups (AOR = 0.69, P = 0.009, 95% CI: 0.52 to 0.91), but not for non-Hispanic whites (AOR = 2.15, P = 0.19, 95% CI: 0.69 to 6.73). Depressive symptoms, loneliness, and low perceived social support mediated the association between internalized stigma and suboptimal adherence in the whole sample, as well as in the subsample of minority participants. In serial mediation models, internalized stigma predicted less-perceived social support (or higher loneliness), which in turn predicted more depressive symptoms, which in turn predicted suboptimal medication adherence. Conclusions: Findings suggest that interconnected psychosocial mechanisms affect ART adherence, and that improvements in adherence may require multifaceted interventions addressing both mental health and interpersonal factors, especially for minority women. PMID:26885803

  16. The state of the art in European research on reducing social exclusion and stigma related to mental health: a systematic mapping of the literature.

    PubMed

    Evans-Lacko, S; Courtin, E; Fiorillo, A; Knapp, M; Luciano, M; Park, A-L; Brunn, M; Byford, S; Chevreul, K; Forsman, A K; Gulacsi, L; Haro, J M; Kennelly, B; Knappe, S; Lai, T; Lasalvia, A; Miret, M; O'Sullivan, C; Obradors-Tarragó, C; Rüsch, N; Sartorius, N; Svab, V; van Weeghel, J; Van Audenhove, C; Wahlbeck, K; Zlati, A; McDaid, D; Thornicroft, G

    2014-08-01

    Stigma and social exclusion related to mental health are of substantial public health importance for Europe. As part of ROAMER (ROAdmap for MEntal health Research in Europe), we used systematic mapping techniques to describe the current state of research on stigma and social exclusion across Europe. Findings demonstrate growing interest in this field between 2007 and 2012. Most studies were descriptive (60%), focused on adults of working age (60%) and were performed in Northwest Europe-primarily in the UK (32%), Finland (8%), Sweden (8%) and Germany (7%). In terms of mental health characteristics, the largest proportion of studies investigated general mental health (20%), common mental disorders (16%), schizophrenia (16%) or depression (14%). There is a paucity of research looking at mechanisms to reduce stigma and promote social inclusion, or at factors that might promote resilience or protect against stigma/social exclusion across the life course. Evidence is also limited in relation to evaluations of interventions. Increasing incentives for cross-country research collaborations, especially with new EU Member States and collaboration across European professional organizations and disciplines, could improve understanding of the range of underpinning social and cultural factors which promote inclusion or contribute toward lower levels of stigma, especially during times of hardship. PMID:24726533

  17. Certified Nurses' Aide Job-Related Curriculum.

    ERIC Educational Resources Information Center

    Massachusetts Career Development Inst., Springfield.

    This document, which is designed for students preparing to become a certified nurses' aide, contains instructional text and learning activities organized in nine sections. The following topics are covered: the role of the certified nurse's aide (job duties, personal health, professionalism, code of ethics); infection control (the infection…

  18. HIV-related stigma and physical symptoms have a persistent influence on health-related quality of life in Australians with HIV infection

    PubMed Central

    2013-01-01

    Background The health-related quality of life (HRQL) of people living with HIV infection is an important consideration in HIV management. The PROQOL-HIV psychometric instrument was recently developed internationally as a contemporary, discriminating HIV-HRQL measure incorporating influential emotional dimensions such as stigma. Here we present the first within-country results of PROQOL-HIV using qualitative and quantitative data collected from a West Australian cohort who participated in the development and validation of PROQOL-HIV, and provide a comprehensive picture of HRQL in our setting. Methods We carried out a secondary analysis of data from Australian patients who participated in the international study: 15 in-depth interviews were conducted and 102 HRQL surveys using the PROQOL-HIV instrument and a symptom questionnaire were administered. We employed qualitative methods to extract description from the interview data and linear regression for exploration of the composite and sub-scale scores derived from the survey. Results Interviews revealed the long-standing difficulties of living with HIV, particularly in the domains of intimate relationships, perceived stigma, and chronic ill health. The novel PROQOL-HIV instrument discriminated impact of treatment via symptomatology, pill burden and treatment duration. Patients demonstrated lower HRQL if they were: newly diagnosed (p=0.001); naive to anti-retroviral treatment (p=0.009); reporting depression, unemployment or a high frequency of adverse symptoms, (all p<0.001). Total HRQL was notably reduced by perceived stigma with a third of surveyed patients reporting persistent fears of both disclosing their HIV status and infecting others. Conclusions The analysis showed that psychological distress was a major influence on HRQL in our cohort. This was compounded in people with poor physical health which in turn was associated with unemployment and depression. People with HIV infection are living longer and residual

  19. Evolution of MSM community and experienced stigma among MSM in Chengdu, China

    PubMed Central

    Feng, Yuji; Wu, Zunyou; Detels, Roger

    2010-01-01

    Objectives To understand the stigma and discrimination experienced by MSM in Chengdu, and to evaluate their impact on effective HIV prevention. Methods Focus group discussions and individual in-depth interviews were conducted from June to September, 2006. Results Stigma and social pressure for MSM were reported to mainly arise from their families to get married and have children to protect family reputation and lineage. Few participants reported experiencing stigma and discrimination from friends, colleagues, or general society. Nevertheless, fear of being ostracized because of their sexual orientation was frequently expressed, and was a major barrier for participating in HIV/AIDS prevention programs. Fear of stigma and discrimination related to HIV infection from inside the MSM community was also identified as a major reason for MSM reluctance to seek HIV testing and treatment. Conclusions Stigma and discrimination related to homosexual activities and HIV/STD infection have been major barriers against MSM seeking health services. HIV/AIDS programs must be sensitive to issues of stigma both from outside and inside the MSM community. PMID:20104118

  20. Link to slower access to care: what is the stigma?: an Indian perspective.

    PubMed

    Kandwal, Rashmi; Bahl, Taru

    2011-12-01

    Stigma and discrimination have been "bed fellows" of HIV and AIDS in India. Perpetuated by lack of awareness, deep-rooted traditional beliefs, adherence to harmful practices, and a moralistic tag associated with a condition connected with sex (in India the method of HIV transmission being largely heterosexual in nature) and high-risk individuals such as sex workers, it made it difficult for the country to fight an epidemic that was hard to track, estimate, diagnose, and treat. Various interventions under India's National AIDS Control Program (NACP) have targeted stigma and discrimination among different groups. The program has been fairly successful in its outreach programs, bringing about a reduction in adult HIV prevalence and new infections. As the country transitions from NACP Phase III (2007-2012) to IV (2012-2017), making treatment and longevity its top priority, stigma is no longer such a terrifying word. This review discusses the social and cultural context of HIV/AIDS-related stigma in general and highlights various policies and intervention programs that have led India's campaign against HIV/AIDS-driven stigma into the testing, care, support, and treatment ambit. PMID:21898073

  1. Psychological Consequences of AIDS-Related Bereavement among Gay Men.

    ERIC Educational Resources Information Center

    Martin, John L.

    1988-01-01

    Interviewed 745 homosexual men to examine relation between Acquired Immune Deficiency Syndrome (AIDS)-related bereavement and psychological distress. Loss of lover or close friend to AIDS was reported by 27 percent of sample. Found direct relation between number of bereavements and symptoms of traumatic stress response, demoralization, sleep…

  2. Stigma reduction in adolescents and young adults newly diagnosed with HIV: findings from the Project ACCEPT intervention.

    PubMed

    Harper, Gary W; Lemos, Diana; Hosek, Sybil G

    2014-10-01

    This article describes the influence of a group-based behavioral intervention for adolescents and young adults newly diagnosed with HIV (Project ACCEPT) on four dimensions of HIV-related stigma-personalized stigma, disclosure concerns, negative self-image, and concern with public attitudes about people with HIV-as measured by the Berger HIV Stigma Scale. Stigma was addressed in a holistic manner during the intervention by providing HIV/AIDS-related information, facilitating the acquisition of coping skills, and providing contact with other youth living with HIV in order to improve social support. Fifty youth (28 male, 22 female; mean age=19.24 years) newly diagnosed with HIV from four geographically diverse clinics participated in a one-group pretest-posttest design study whereby they received the intervention over a 12-week period, and completed assessments at baseline, post-intervention, and 3-month follow-up. Results from the combined sample (males and females) revealed overall reductions in stigma in three dimensions: personalized stigma, disclosure concerns, and negative self-image, although only the combined-sample effects for negative self-image were maintained at 3-month follow-up. Gender-specific analyses revealed that the intervention reduced stigma for males across all four dimensions of stigma, with all effects being maintained to some degree at the 3-month follow-up. Only personalized stigma demonstrated a decrease for females, although this effect was not maintained at the 3-month follow-up; while the other three types of stigma increased at post-intervention and 3-month follow-up. Findings are discussed in terms of gender specific outcomes and the need for a different type of intervention to reduce stigma for young women. PMID:25216106

  3. Reducing HIV-Related Stigma in Health Care Settings: A Randomized Controlled Trial in China

    PubMed Central

    Wu, Zunyou; Liang, Li-Jung; Guan, Jihui; Jia, Manhong; Rou, Keming; Yan, Zhihua

    2013-01-01

    Objectives. The objective of the intervention was to reduce service providers’ stigmatizing attitudes and behaviors toward people living with HIV. Methods. The randomized controlled trial was conducted in 40 county-level hospitals in 2 provinces of China between October 2008 and February 2010. Forty-four service providers were randomly selected from each hospital, yielding a total of 1760 study participants. We randomized the hospitals to either an intervention condition or a control condition. In the intervention hospitals, about 15% of the popular opinion leaders were identified and trained to disseminate stigma reduction messages. Results. We observed significant improvements for the intervention group in reducing prejudicial attitudes (P < .001), reducing avoidance intent towards people living with HIV (P < .001), and increasing institutional support in the hospitals (P = .003) at 6 months after controlling for service providers’ background factors and clinic-level characteristics. The intervention effects were sustained and strengthened at 12 months. Conclusions. The intervention reduced stigmatizing attitudes and behaviors among service providers. It has the potential to be integrated into the health care systems in China and other countries. PMID:23237175

  4. Patient and Provider Perspectives on HIV and HIV-Related Stigma in Dutch Health Care Settings

    PubMed Central

    Sicking, Lenneke; Brands, Ronald; Baas, Ineke; Roberts, Hilde; van Brakel, Wim H.; Lechner, Lilian; Kok, Gerjo; Bos, Arjan E. R.

    2014-01-01

    Abstract Ensuring that people living with HIV (PLWH) feel accepted in health care settings is imperative. This mixed methods study explored the perspectives of PLWH and health professionals on their interactions. A total of 262 predominantly gay men of Dutch origin participated in a survey study of possible negative interactions with health professionals, and semi-structured interviews were subsequently conducted with 22 PLWH and 14 health professionals. Again, most PLWH were gay men of Dutch origin. All health professionals were Dutch. PLWH reported negative experiences with health professionals including awkward interactions, irrelevant questions, rude treatment, blame, pity, excessive or differential precautions, care refusal, unnecessary referrals, delayed treatment, poor support, and confidentiality breaches. They also reported positive experiences including equal treatment, being valued as a partner in one's health, social support provision, and confidentiality assurances. Health professionals reported having little experience with PLWH and only basic knowledge of HIV. They contended that PLWH are treated equally and that HIV is no longer stigmatized, but also reported fear of occupational infection, resulting in differential precautions. Additionally, they conveyed labeling PLWH's files to warn others, and curiosity regarding how patients acquired HIV. The findings suggest that there is a gap in perception between PLWH and health professionals regarding the extent to which negative interactions occur, and that these interactions should be improved. Implications for stigma reduction and care optimization are discussed. PMID:25459231

  5. The effects of a documentary film on public stigma related to mental illness among genetic counselors

    PubMed Central

    Anderson, Kelly; Austin, Jehannine C.

    2013-01-01

    Many people, including genetic counselors (GCs), have been found to hold stigmatizing attitudes towards people with mental illnesses. We aimed to determine whether these attitudes could be changed by exposing GCs/GC students to a documentary film about people with mental illness. We screened the documentary at the 2010 North American conferences for GCs. Immediately before (T1), immediately after (T2), and one month after (T3) watching the documentary, participants self-rated their comfort with asking patients about mental illness, and completed scales measuring two aspects of stigma: stereotype endorsement (SE) and desire for social distance (SD). A total of 87 T1 and T2 questionnaires, and 39 T3 questionnaires were returned. At T2 and T3, 34.5% and 48.7% respectively reported feeling more comfortable to ask patients about mental illness. Scores on SD and SE scales decreased significantly from T1 to T2, but returned to initial levels at T3. The documentary increased GC/GC students’ comfort with asking about mental illness and temporarily decreased stigmatizing attitudes. PMID:22037897

  6. Stigma creating stigma: a vicious circle

    PubMed Central

    Dinos, Sokratis

    2014-01-01

    Despite anti-stigma campaigns in the UK in recent years, the experiences of people with mental health problems indicate that stigma is still a major problem. The stigma of being a member of a socially excluded group, based on socioeconomic, personal or cultural/ethnic characteristics, should be considered alongside the stigma of mental illness. Membership of a stigmatised group (not based on mental illness) is often itself a risk factor for developing mental health problems. This article discusses the experiences of people from Black and minority ethnic and lesbian, gay and bisexual groups to explore how stigma can create more stigma. PMID:25237533

  7. Stigma creating stigma: a vicious circle.

    PubMed

    Dinos, Sokratis

    2014-08-01

    Despite anti-stigma campaigns in the UK in recent years, the experiences of people with mental health problems indicate that stigma is still a major problem. The stigma of being a member of a socially excluded group, based on socioeconomic, personal or cultural/ethnic characteristics, should be considered alongside the stigma of mental illness. Membership of a stigmatised group (not based on mental illness) is often itself a risk factor for developing mental health problems. This article discusses the experiences of people from Black and minority ethnic and lesbian, gay and bisexual groups to explore how stigma can create more stigma. PMID:25237533

  8. Gene Therapy After Frontline Chemotherapy in Treating Patients With AIDS-Related Non-Hodgkin Lymphoma

    ClinicalTrials.gov

    2016-03-14

    AIDS-related Diffuse Large Cell Lymphoma; AIDS-related Diffuse Mixed Cell Lymphoma; AIDS-related Diffuse Small Cleaved Cell Lymphoma; AIDS-related Immunoblastic Large Cell Lymphoma; AIDS-related Lymphoblastic Lymphoma; AIDS-related Small Noncleaved Cell Lymphoma; HIV Infection

  9. Associations between Perceived HIV Stigma and Quality of Life at the Dyadic Lvel: The Actor-Partner Interdependence Model

    PubMed Central

    Liu, Hongjie; Xu, Yongfang; Lin, Xinjin; Shi, Jian; Chen, Shiyi

    2013-01-01

    Background Few studies have investigated the relationship between HIV-related stigma and quality life at the dyadic level. The objective of this study was to examine the actor and partner effects of stigma that was perceived by people living with HIV/AIDS (PLWHAs) and caregivers on quality of life at the dyadic level. Method A survey was conducted among 148 dyads consisting of one PLWHA and one caregiver (296 participants) in Nanning, China. The interdependent relationship between a pair of dyadic members that influences the associations between stigma and quality of life was analyzed, using an innovative dyadic analysis technique: the Actor-Partner Interdependence Model (APIM). Results We found in this dyadic analysis that (1) PLWHAs compared to their caregivers exhibited a higher level of perceived HIV stigma and lower level of quality of life measured in four domains; (2) both PLWHAs' and caregivers' perceived HIV stigma influenced their own quality of life; (3) The quality of life was not substantially influenced by their partners' perceived stigma; and (4) Both actor and partner effects of stigma on quality of life were similar among PLWHAs and their caregivers. Conclusion As HIV stigma and quality of life are complex phenomena rooted in cultures, intervention programs should be carefully planned based on social or cognitive theories and should be culturally adopted. PMID:23383343

  10. Physicians Mutual Aid Group: A Response to AIDS-Related Burnout.

    ERIC Educational Resources Information Center

    Garside, Bruce

    1993-01-01

    Describes origins and functioning of physician's mutual aid group for physicians providing primary care to people with Acquired Immune Deficiency Syndrome (AIDS). Offers suggestions related to overcoming resistance physicians might have to participating in such a group and reviews modalities that were helpful in facilitating participants' ability…

  11. Family relations in the context of HIV/AIDS in Southwest China.

    PubMed

    Yu, Yeon Jung; Li, Xiaoming; Qiao, Shan; Zhou, Yuejiao

    2016-10-01

    In China, an estimated 780,000 people have been infected with HIV (China AIDS, 2012 ). Even as this stigmatized population rapidly grows, with the majority of reproductive age (20-40 years old), information about their daily experiences in the domestic sphere has been scarce. Because the family remains a central unit of social and ethical organization in China, the current qualitative study examines family relations among people living with HIV (PLWH) with the goal of identifying the effect of HIV on family relations and, conversely, the effect of family relations on those with HIV. We analyzed data from 90 in-depth interviews with PLWH and people around them (i.e., their children, health care providers, other community members) in southwest China (Guangxi province). Through analyzing the families' experiences with illness, three themes emerged: how individuals with HIV interact with their community; how they cope with stigma alongside and against their family; and how families can support those with HIV. Our data ultimately showed the critical role of family in the quality of PLWH's well-being. Because concealment of their serostatus was the primary coping strategy, stigma manifestation was most obvious in the domestic spheres. Yet, when help was received, PLWH regarded family support as the most helpful, as those who received empathy from their families remained more optimistic. Thus, there is an urgent need for developing efficacious intervention programs that could lead to maximize family support, involving the families of PLWH, with a particular attention to family dynamics in daily interactions. Despite our awareness of the significance of family in China, this study reveals a particular kind of role of family that has rarely been considered, namely the role of family in healing and sustaining social bonds within the context of stigmatization, when those bonds might otherwise be broken. PMID:27160680

  12. Stigmatization of patients with AIDS: understanding the interrelationships between Thai nurses' attitudes toward HIV/AIDS, drug use, and commercial sex.

    PubMed

    Chan, Kit Yee; Reidpath, Daniel D

    2007-10-01

    There is currently a scarcity of research on the nature of HIV/AIDS stigma within the Thai health context. This is problematic given the negative role of stigma in hindering the provision of patient care and treatment. This study used a mixed-method approach to investigate the interrelationships between the stigma of HIV/AIDS and the stigmas relating to its various modes of disease transmission including injection drug use (IDU). Twenty interviews were conducted with trainees and qualified nurses from a Bangkok college. Participants were presented with vignettes describing a hypothetical person varying in disease diagnoses (AIDS, leukemia, no disease) and co-characteristics (IDU, commercial sex (CS), blood transfusion, no co-characteristic). Using a Q-sort task, participants arranged the vignettes along a bipolar scale according to their willingness to interact with the persons, and were asked to explain their decisions. Univariate and multivariate regression analyses showed that IDU, AIDS, and CS were all individually stigmatizing. Strong interactions were found between the stigmas of HIV/AIDS, IDU, and CS. Interview data also showed clear biases toward patients according to their IDU and CS habits. The findings suggest that addressing these co-stigmas could be vital to the success of efforts aimed at reducing the disease stigma of HIV/AIDS. PMID:17949275

  13. Stigma, status, and population health

    PubMed Central

    Phelan, Jo C.; Lucas, Jeffrey W.; Ridgeway, Cecilia L.; Taylor, Catherine J.

    2014-01-01

    Stigma and status are the major concepts in two important sociological traditions that describe related processes but that have developed in isolation. Although both approaches have great promise for understanding and improving population health, this promise has not been realized. In this paper, we consider the applicability of status characteristics theory (SCT) to the problem of stigma with the goal of better understanding social systemic aspects of stigma and their health consequences. To this end, we identify common and divergent features of status and stigma processes. In both, labels that are differentially valued produce unequal outcomes in resources via culturally shared expectations associated with the labels; macro-level inequalities are enacted in micro-level interactions, which in turn reinforce macro-level inequalities; and status is a key variable. Status and stigma processes also differ: Higher- and lower-status states (e.g., male and female) are both considered normal, whereas stigmatized characteristics (e.g., mental illness) are not; interactions between status groups are guided by “social ordering schemas” that provide mutually agreed-upon hierarchies and interaction patterns (e.g., men assert themselves while women defer), whereas interactions between “normals” and stigmatized individuals are not so guided and consequently involve uncertainty and strain; and social rejection is key to stigma but not status processes. Our juxtaposition of status and stigma processes reveals close parallels between stigmatization and status processes that contribute to systematic stratification by major social groupings, such as race, gender, and SES. These parallels make salient that stigma is not only an interpersonal or intrapersonal process but also a macro-level process and raise the possibility of considering stigma as a dimension of social stratification. As such, stigma’s impact on health should be scrutinized with the same intensity as that of

  14. Felt and Enacted Stigma Among HIV/HCV-Coinfected Adults: The Impact of Stigma Layering

    PubMed Central

    Lekas, Helen-Maria; Siegel, Karolynn; Leider, Jason

    2015-01-01

    The realization that many persons with HIV/AIDS are subjected to multiple layers of stigmatization because they belong to socially deviant and disenfranchised groups (e.g., injection drug users, racial/ethnic and sexual minorities) accounts for an increasing interest in the phenomenon of stigma layering. The stigma associated with HCV has also been conceptualized as layered. However, researchers have overlooked the fact that HCV adds a layer to the HIV stigma and vice versa. Qualitative interviews with 132 HIV/HCV coinfected patients were analyzed to explore how they experience the two layers of stigma. Most participants hierarchically ordered the stigmas associated with each disease and regarded HIV as the more stigmatizing of the two. A small number perceived HIV and HCV as equally stigmatizing. The impact of the hierarchical and non-hierarchical ordering of the two stigmas on coinfected patients’ felt and enacted stigmatization is explored and implications for interventions are discussed. PMID:21498828

  15. Treatment and related AIDS email lists.

    PubMed

    John, J S

    1999-12-01

    There are a number of email lists or ¿listserves' which allow people with similar interests to share information online. The article provides an introduction to this forum and topics include types of lists, email filters, and writing etiquette. Major AIDS treatment lists are also described and details include the type of site information, a web site address by which to subscribe, and projected number of messages one will receive per day. Contact information is provided for further information and other listserves. PMID:11367129

  16. “Triply cursed”: Racism, homophobia, and HIV-related stigma are barriers to regular HIV testing, treatment adherence, and disclosure among young Black gay men

    PubMed Central

    Arnold, Emily A.; Rebchook, Gregory M.; Kegeles, Susan M.

    2014-01-01

    In the USA, young Black gay men are disproportionately impacted by HIV. In this qualitative study consisting of in-depth interviews with 31 young Black gay men and 9 service providers, where we used thematic analysis to guide our interpretations, we found that HIV-related stigma and homophobia, within the larger societal context of racism, were related to sexual risk behaviour, reluctance to obtain HIV testing or care, lower adherence to treatment medication, and disclosure of a positive HIV status to sexual partners. Participants experienced homophobia and HIV-related stigma from churches and families within the Black community, and from friends within the Black gay community, that otherwise provide support in the face of racism. Vulnerability to HIV was related to strategies that young Black gay men enacted to avoid being stigmatised or as a way of coping with their alienation and rejection. PMID:24784224

  17. 'Triply cursed': racism, homophobia and HIV-related stigma are barriers to regular HIV testing, treatment adherence and disclosure among young Black gay men.

    PubMed

    Arnold, Emily A; Rebchook, Gregory M; Kegeles, Susan M

    2014-06-01

    In the USA, young Black gay men are disproportionately impacted upon by HIV. In this qualitative study consisting of in-depth interviews with 31 young Black gay men and nine service providers, where we used thematic analysis to guide our interpretations, we found that HIV-related stigma and homophobia, within the larger societal context of racism, were related to sexual risk behaviour, reluctance to obtain HIV testing or care, lower adherence to treatment medication, and non-disclosure of a positive HIV status to sexual partners. Participants experienced homophobia and HIV-related stigma from churches and families within the Black community and from friends within the Black gay community, which otherwise provide support in the face of racism. Vulnerability to HIV was related to strategies that young Black gay men enacted to avoid being stigmatised or as a way of coping with alienation and rejection. PMID:24784224

  18. Stigma Reduction in Adolescents and Young Adults Newly Diagnosed with HIV: Findings from the Project ACCEPT Intervention

    PubMed Central

    Lemos, Diana; Hosek, Sybil G.

    2014-01-01

    Abstract This article describes the influence of a group-based behavioral intervention for adolescents and young adults newly diagnosed with HIV (Project ACCEPT) on four dimensions of HIV-related stigma—personalized stigma, disclosure concerns, negative self-image, and concern with public attitudes about people with HIV—as measured by the Berger HIV Stigma Scale. Stigma was addressed in a holistic manner during the intervention by providing HIV/AIDS-related information, facilitating the acquisition of coping skills, and providing contact with other youth living with HIV in order to improve social support. Fifty youth (28 male, 22 female; mean age=19.24 years) newly diagnosed with HIV from four geographically diverse clinics participated in a one-group pretest-posttest design study whereby they received the intervention over a 12-week period, and completed assessments at baseline, post-intervention, and 3-month follow-up. Results from the combined sample (males and females) revealed overall reductions in stigma in three dimensions: personalized stigma, disclosure concerns, and negative self-image, although only the combined-sample effects for negative self-image were maintained at 3-month follow-up. Gender-specific analyses revealed that the intervention reduced stigma for males across all four dimensions of stigma, with all effects being maintained to some degree at the 3-month follow-up. Only personalized stigma demonstrated a decrease for females, although this effect was not maintained at the 3-month follow-up; while the other three types of stigma increased at post-intervention and 3-month follow-up. Findings are discussed in terms of gender specific outcomes and the need for a different type of intervention to reduce stigma for young women. PMID:25216106

  19. HIV/AIDS - Related Knowledge, Attitudes, and Sexual Practices among Migrant Wives in Rural Anhui Province, China

    PubMed Central

    Zou, Huachun; Dai, Xin; Meng, Xiaojun; Wang, Huadong; Jiang, Chao; Wang, Yanchun; Zhang, Lin; Gao, Yongqing; Tang, Song; Xu, Tan; Sun, Wenjie; Wen, Yufeng

    2015-01-01

    Background Migrant wives have been increasing in some poor rural regions of China and they may bridge HIV transmission across regions. This study aimed to assess HIV/AIDS-related knowledge, attitudes and sexual practices among this population in rural Anhui Province, China. Methods A cross-sectional survey was conducted with questionnaire of HIV/AIDS-related knowledge, attitudes, and sexual practices between June 2011 and May 2012. A total of 730 migrant wives and 207 local women were enrolled in this study. Unpaired T-test, Chi-square was utilized to compare the difference of HIV/AIDS knowledge, attitudes and sexual practices between migrant wives and local women. Results Around 80% of the migrant wives were from Yunnan, Guizhou, or Sichuan Provinces. The main sources of HIV/AIDS information were TV/radio, posters, and newspapers/periodicals. HIV/AIDS knowledge level among migrant wives was significantly lower than that among local women (e.g. 47.1% vs 57.0% (p<0.001) answered “Yes” for the question “Can an apparently healthy person be HIV-infected?”), and stigma and prejudice towards HIV/AIDS among migrant wives were more common than those among local women (e.g. 73.2% vs 65.7% (p=0.006) answered “No” for the question “If a shopkeeper or food seller had the HIV, would you buy food from them?”). Compared to local women, migrant wives were more likely to have ever had sex during menstruation (6.8% vs 3.4%, p=0.065) and extramarital sex (17.5% vs 10.1%, p=0.01), and were less likely to consistently use condoms with their husbands (45.8% vs 57.5%, p<0.001) or extramarital sex partners (48.8% vs 58.95, p<0.001). Conclusions Migrant wives in rural China had a low HIV/AIDS knowledge level and high prevalence of stigma and prejudice and risky sexual behaviors. Local HIV/AIDS prevention programs should target this neglected population. PMID:25844269

  20. Stigma and eating and weight disorders.

    PubMed

    Puhl, Rebecca; Suh, Young

    2015-03-01

    Although research has consistently documented the prevalence and negative health implications of weight stigma, little is known about the stigma associated with eating disorders. Given that weight stigma is a risk factor associated with disordered eating, it is important to address stigma across the spectrum of eating and weight disorders. The aim of this review is to systematically review studies in the past 3 years evaluating stigma in the context of obesity and eating disorders (including binge eating disorder, bulimia nervosa, and anorexia nervosa). Physical and psychological health consequences of stigma for individuals with obesity and eating disorders are discussed. Recent studies on weight stigma substantiate the unique influence of stigma on psychological maladjustment, eating pathology, and physiological stress. Furthermore, research documents negative stereotypes and social rejection of individuals with eating disorder subtypes, while attributions to personal responsibility promote blame and further stigmatization of these individuals. Future research should examine the association of stigma related to eating disorders and physical and emotional health correlates, as well as its role in health-care utilization and treatment outcomes. Additional longitudinal studies assessing how weight stigma influences emotional health and eating disorders can help identify adaptive coping strategies and improve clinical care of individuals with obesity and eating disorders. PMID:25652251

  1. Dual Psychological Processes Underlying Public Stigma and the Implications for Reducing Stigma

    PubMed Central

    Reeder, Glenn D.; Pryor, John B.

    2008-01-01

    People with serious illness or disability are often burdened with social stigma that promotes a cycle of poverty via unemployment, inadequate housing and threats to mental health. Stigma may be conceptualized in terms of self-stigma (e.g., shame and lowered self-esteem) or public stigma (e.g., the general public's prejudice towards the stigmatized). This article examines two psychological processes that underlie public stigma: associative processes and rule-based processes. Associative processes are quick and relatively automatic whereas rule-based processes take longer to manifest themselves and involve deliberate thinking. Associative and rule-based thinking require different assessment instruments, follow a different time course and lead to different effects (e.g., stigma-by-association vs attributional processing that results in blame). Of greatest importance is the fact that each process may require a different stigma-prevention strategy. PMID:22013358

  2. Between a rock and a hard place: stigma and the desire to have children among people living with HIV in northern Uganda

    PubMed Central

    Nattabi, Barbara; Li, Jianghong; Thompson, Sandra C; Orach, Christopher G; Earnest, Jaya

    2012-01-01

    Background HIV-related stigma, among other factors, has been shown to have an impact on the desire to have children among people living with HIV (PLHIV). Our objective was to explore the experiences of HIV-related stigma among PLHIV in post-conflict northern Uganda, a region of high HIV prevalence, high infant and child mortality and low contraception use, and to describe how stigma affected the desires of PLHIV to have children in the future. Methods Semi-structured interviews were conducted with 26 PLHIV in Gulu district, northern Uganda. The interviews, conducted in Luo, the local language, were audio recorded, transcribed and then translated into English. Thematic data analysis was undertaken using NVivo8 and was underpinned by the “Conceptual Model of HIV/AIDS Stigma”. Results HIV-related stigma continues to affect the quality of life of PLHIV in Gulu district, northern Uganda, and also influences PLHIV's desire to have children. PLHIV in northern Uganda continue to experience stigma in various forms, including internal stigma and verbal abuse from community members. While many PLHIV desire to have children and are strongly influenced by several factors including societal and cultural obligations, stigma and discrimination also affect this desire. Several dimensions of stigma, such as types of stigma (received, internal and associated stigma), stigmatizing behaviours (abusing and desertion) and agents of stigmatization (families, communities and health systems), either directly, or indirectly, enhanced or reduced PLHIV's desire to have more children. Conclusion The social-cultural context within which PLHIV continue to desire to have children must be better understood by all health professionals who hope to improve the quality of PLHIV's lives. By delineating the stigma process, the paper proposes interventions for reducing stigmatization of PLHIV in northern Uganda in order to improve the quality of life and health outcomes for PLHIV and their children

  3. AIDS as social construction: text mining of AIDS-related information in the Italian press.

    PubMed

    Caputo, Andrea; Giacchetta, Agnese; Langher, Viviana

    2016-09-01

    Given the relevance of AIDS as a public health problem in the Italian context and of the role of mass media in the social construction of the phenomenon, the aim of the present study is twofold: (1) to explore the main AIDS-related themes in the Italian popular press; (2) to analyse the temporal trends of AIDS representations over the last decades. For the research, we decided to consult Italian newspaper articles produced between 1985 and 1990 and between 2005 and 2010 using the archives of the main two national newspapers (La Repubblica and Corriere della Sera), resulting in an overall sample of 446 newspaper articles. A computer-aided content analysis allowed the detection of five different thematic domains (clusters), respectively focused on: Medical care (7.47%), Family support (37.03%), Science and religion debate (27%), Social exclusion (17.6%) and Healthcare policies (10.9%). These thematic domains are conceived along two main latent dimensions (factors) which explain 72.47% of the data variance which respectively deal with: (1) Attitudes towards people with AIDS (care versus avoidance) and (2) Social mandate on AIDS (powerlessness versus control). The study results also reveal the potential evolution of representations of people with AIDS over time: from stigmatised subjects who represent a risk for the entire society within a climate of social control to people progressively symbolised as frail subjects that need to be taken care of. PMID:26923156

  4. Levels of Felt Stigma among a Group of People with HIV in Puerto Rico

    PubMed Central

    Jiménez, Julio; Morales, Marangelie; Castro, Eida; Puig, Marieva; Vélez, Carmen N.; Santiago, Lydia; Zorrilla, Carmen

    2016-01-01

    Objective HIV felt stigma is a major problem needing to be addressed because of its association with poor treatment adherence, decreases in help-seeking behaviors, high-risk sexual conduct, emotional discomfort, and the reduction of well-being in people with HIV/AIDS (PWHA). The aim of this study was to identify the frequency of felt stigma among PWHA in Puerto Rico. Methods A cross-sectional study was conducted with 249 subjects (59% men, 41% women). Participants completed the Puerto Rico Comprehensive Center for HIV Disparities (PR-CCHD) Sociodemographic Questionnaire and the HIV Felt Sigma Scale. Results 80% of the subjects showed some level of felt stigma. Women showed significantly higher levels of HIV-related felt stigma than did men. Disclosure, negative self-image, and public attitude scores were also higher in women than in men. Sociodemographic variables such as age, marital status, employment status, income, and educational level showed significant associations with felt stigma and its dimensions. Conclusion Results of this study evidence the need to develop culturally sensitive intervention models to reduce the felt-stigma burden in PWHA. PMID:22783698

  5. Stigma of Mental Illness-1: Clinical reflections

    PubMed Central

    Shrivastava, Amresh; Johnston, Megan; Bureau, Yves

    2012-01-01

    Although the quality and effectiveness of mental health treatments and services have improved greatly over the past 50 years, therapeutic revolutions in psychiatry have not yet been able to reduce stigma. Stigma is a risk factor leading to negative mental health outcomes. It is responsible for treatment seeking delays and reduces the likelihood that a mentally ill patient will receive adequate care. It is evident that delay due to stigma can have devastating consequences. This review will discuss the causes and consequences of stigma related to mental illness. PMID:22654383

  6. "Inside These Fences Is Our Own Little World": Prison-Based HIV Testing and HIV-Related Stigma Among Incarcerated Men and Women.

    PubMed

    Muessig, Kathryn E; Rosen, David L; Farel, Claire E; White, Becky L; Filene, Eliza J; Wohl, David A

    2016-04-01

    Correctional facilities offer opportunities to provide comprehensive HIV services including education, testing, treatment, and coordination of post- release care. However, these services may be undermined by unaddressed HIV stigma. As part of a prison-based HIV testing study, we interviewed 76 incarcerated men and women from the North Carolina State prison system. The sample was 72% men, median age 31.5 years (range: 19 to 60). Thematic analysis revealed high levels of HIV-related fear and stigma, homophobia, incomplete HIV transmission knowledge, beliefs that HIV is highly contagious within prisons ("HIV miasma"), and the View of HIV testing as protective. Interviewees described social distancing behaviors and coping mechanisms they perceived to be protective, including knowing their HIV status and avoiding contact with others and shared objects. Interviewees endorsed universal testing, public HIV status disclosure, and segregation of HIV-positive inmates. Intensified education and counseling efforts are needed to ameliorate entrenched HIV-transmission fears and stigmatizing beliefs. PMID:27459162

  7. The Second Closet: A Qualitative Study of HIV Stigma Among Seropositive Gay Men in a Southern U.S. City

    PubMed Central

    Ross, Michael W.

    2014-01-01

    Objectives Stigma connected with HIV/AIDS has decreased considerably since the early epidemic yet affects those living with HIV in many ways. Little research, particularly qualitative research, concerning HIV stigma from the perspective of gay men has emerged. The present qualitative study aimed to fill this evidence gap by examining how HIV stigma is perceived and experienced by gay men who have become HIV-infected and how they respond to this stigma. Methods Thematic analysis of 19 gay men's narratives identified six main themes. Results Encountering HIV stigmatization was common and was linked to the physical stigmata identifying respondents as HIV-positive. Overwhelmingly, they found stigmatization to be most intensely felt within gay communities. One profound theme was internalized HIV stigma, referring to respondents' internalized negative feelings about their HIV status. A related theme was the closeted nature of HIV. Lastly, regarding how the men dealt with the HIV diagnosis and experiences of HIV stigma, a theme of adaptation became clear. Conclusions Although exploratory, the results can serve as a beginning framework for understanding and assisting seropositive gay men who experience HIV stigma. The findings are important because it is realistic to expect that in a climate in which HIV has become increasingly invisible and closeted and in which infections are on the rise, gay and bisexual men will be increasingly affected and infected by HIV. PMID:25170366

  8. Stigma, marginalization and psychosocial well-being of orphans in Rwanda: exploring the mediation role of social support.

    PubMed

    Caserta, Tehetna Alemu; Pirttilä-Backman, Anna-Maija; Punamäki, Raija-Leena

    2016-01-01

    Stigma and marginalization are one of the major challenges orphans face in their daily lives, particularly in developing countries, but little is known about their impacts on mental health. This study examines how orphan-related characteristics, stigma and marginalization are associated with psychosocial well-being. It further analyses the role of social support in mediating between stigma and marginalization and mental health, indicated by emotional well-being and mental distress. The participants in this study were 430 Rwandan orphans who were 10-25 years of age, and of whom 179 were females and 251 were males. Results showed that high levels of stigma and marginalization were associated with a lower level of emotional well-being and higher levels of mental distress. A mediation analysis indicated that low level of social support due to stigma and marginalization contributed significantly to low level of emotional well-being. Once stigma, marginalization and social support were fully accounted for, AIDS orphans exhibited higher levels of mental distress than those who were orphaned by genocide or other causes. Future interventions designed to reduce stigma and marginalization for orphans and actions that facilitate social support can significantly improve emotional well-being and reduce mental distress among orphans. PMID:26883484

  9. Evidence for effective interventions to reduce mental health-related stigma and discrimination in the medium and long term: systematic review

    PubMed Central

    Mehta, N.; Clement, S.; Marcus, E.; Stona, A.-C.; Bezborodovs, N.; Evans-Lacko, S.; Palacios, J.; Docherty, M.; Barley, E.; Rose, D.; Koschorke, M.; Shidhaye, R.; Henderson, C.; Thornicroft, G.

    2015-01-01

    Background Most research on interventions to counter stigma and discrimination has focused on short-term outcomes and has been conducted in high-income settings. Aims To synthesise what is known globally about effective interventions to reduce mental illness-based stigma and discrimination, in relation first to effectiveness in the medium and long term (minimum 4 weeks), and second to interventions in low- and middle-income countries (LMICs). Method We searched six databases from 1980 to 2013 and conducted a multi-language Google search for quantitative studies addressing the research questions. Effect sizes were calculated from eligible studies where possible, and narrative syntheses conducted. Subgroup analysis compared interventions with and without social contact. Results Eighty studies (n = 422 653) were included in the review. For studies with medium or long-term follow-up (72, of which 21 had calculable effect sizes) median standardised mean differences were 0.54 for knowledge and −0.26 for stigmatising attitudes. Those containing social contact (direct or indirect) were not more effective than those without. The 11 LMIC studies were all from middle-income countries. Effect sizes were rarely calculable for behavioural outcomes or in LMIC studies. Conclusions There is modest evidence for the effectiveness of anti-stigma interventions beyond 4 weeks follow-up in terms of increasing knowledge and reducing stigmatising attitudes. Evidence does not support the view that social contact is the more effective type of intervention for improving attitudes in the medium to long term. Methodologically strong research is needed on which to base decisions on investment in stigma-reducing interventions. PMID:26527664

  10. ‘I'm not a druggie, I'm just a diabetic’: a qualitative study of stigma from the perspective of adults with type 1 diabetes

    PubMed Central

    Browne, Jessica L; Ventura, Adriana; Mosely, Kylie; Speight, Jane

    2014-01-01

    Objectives While health-related stigma has been the subject of considerable research in other conditions (eg, HIV/AIDS, obesity), it has not received substantial attention in diabetes. Our aim was to explore perceptions and experiences of diabetes-related stigma from the perspective of adults with type 1 diabetes mellitus (T1DM). Design A qualitative study using semistructured interviews, which were audio recorded, transcribed and subject to thematic analysis. Setting All interviews were conducted in non-clinical settings in metropolitan areas of Victoria, Australia. Participants Adults aged ≥18 years with T1DM living in Victoria were eligible to take part. Participants were recruited primarily through the state consumer organisation representing people with diabetes. A total of 27 adults with T1DM took part: 15 (56%) were women; median IQR age was 42 (23) years and diabetes duration was 15 (20) years). Results Australian adults with T1DM perceive and experience T1DM-specific stigma as well as stigma-by-association with type 2 diabetes. Such stigma is characterised by blame, negative social judgement, stereotyping, exclusion, rejection and discrimination. Participants identified the media, family and friends, healthcare professionals and school teachers as sources of stigma. The negative consequences of this stigma span numerous life domains, including impact on relationships and social identity, emotional well-being and behavioural management of T1DM. This stigma also led to reluctance to disclose the condition in various environments. Adults with T1DM can be both the target and the source of diabetes-related stigma. Conclusions Stigmatisation is part of the social experience of living with T1DM for Australian adults. Strategies and interventions to address and mitigate this diabetes-related stigma need to be developed and evaluated. PMID:25056982

  11. Intragroup Stigma Among Men Who Have Sex with Men: Data Extraction from Craigslist Ads in 11 Cities in the United States

    PubMed Central

    Vansia, Dhrutika; Stephenson, Rob

    2016-01-01

    Background Gay, bisexual, and other men who have sex with men (MSM) regularly experience homophobic discrimination and stigma. While previous research has examined homophobic and HIV-related intergroup stigma originating from non-MSM directed at MSM, less is known about intragroup stigma originating from within MSM communities. While some research has examined intragroup stigma, this research has focused mostly on HIV-related stigma. Intragroup stigma may have a unique influence on sexual risk-taking behaviors as it occurs between sexual partners. Online sexual networking venues provide a unique opportunity to examine this type of stigma. Objective The purpose of this study is to examine the presence and patterns of various types of intragroup stigma represented in Men Seeking Men Craigslist sex ads. Methods Data were collected from ads on Craigslist sites from 11 of the 12 US metropolitan statistical areas with the highest HIV/AIDS prevalence. Two categories of data were collected: self-reported characteristics of the authors and reported biases in the ads. Chi-square tests were used to examine patterns of biases across cities and author characteristics. Results Biases were rarely reported in the ads. The most commonly reported biases were against men who were not “disease and drug free (DDF),” representing stigma against men living with HIV or a sexually transmitted infection. Patterns in bias reporting occurred across cities and author characteristics. There were no variations based on race, but ageism (mostly against older men) varied based on the ad author’s age and self-reported DDF status; bias against feminine gender expression varied based on self-reported sexual orientation; bias against “fat” men varied by self-reported DDF status; bias against “ugly” men varied by a self-report of being good-looking; and bias against people who do not have a DDF status varied based on self-reported HIV status and self-reported DDF status. Conclusions

  12. Stigmatization of persons with HIV/AIDS in Saudi Arabia.

    PubMed

    Badahdah, Abdallah M

    2010-10-01

    Data about the stigmatization of persons living with HIV/AIDS in Saudi Arabia are scarce. Recent statistics from Saudi Ministry of Health showed that 77% of HIV-positive Saudis were males. The present study analyzed data from 162 Saudi male college students. The findings suggest that students who knew less about HIV/AIDS were more likely to stigmatize persons living with HIV/AIDS than those who knew more. Neither degree of religiosity nor worry about HIV infection was related to AIDS stigma. However, AIDS-related shame was the best predictor of AIDS stigma. The findings of this study point to important suggestions for AIDS prevention programs in Saudi Arabia. PMID:20592063

  13. Perspectives on perceived stigma and self-stigma in adult male patients with depression.

    PubMed

    Latalova, Klara; Kamaradova, Dana; Prasko, Jan

    2014-01-01

    There are two principal types of stigma in mental illness, ie, "public stigma" and "self-stigma". Public stigma is the perception held by others that the mentally ill individual is socially undesirable. Stigmatized persons may internalize perceived prejudices and develop negative feelings about themselves. The result of this process is "self-stigma". Stigma has emerged as an important barrier to the treatment of depression and other mental illnesses. Gender and race are related to stigma. Among depressed patients, males and African-Americans have higher levels of self-stigma than females and Caucasians. Perceived stigma and self-stigma affect willingness to seek help in both genders and races. African-Americans demonstrate a less positive attitude towards mental health treatments than Caucasians. Religious beliefs play a role in their coping with mental illness. Certain prejudicial beliefs about mental illness are shared globally. Structural modeling indicates that conformity to dominant masculine gender norms ("boys don't cry") leads to self-stigmatization in depressed men who feel that they should be able to cope with their illness without professional help. These findings suggest that targeting men's feelings about their depression and other mental health problems could be a more successful approach to change help-seeking attitudes than trying to change those attitudes directly. Further, the inhibitory effect of traditional masculine gender norms on help-seeking can be overcome if depressed men feel that a genuine connection leading to mutual understanding has been established with a health care professional. PMID:25114531

  14. Is Stigma Internalized? The Longitudinal Impact of Public Stigma on Self-Stigma

    ERIC Educational Resources Information Center

    Vogel, David L.; Bitman, Rachel L.; Hammer, Joseph H.; Wade, Nathaniel G.

    2013-01-01

    Stigma is considered an important barrier to seeking mental health services. Two types of stigma exist: public stigma and self-stigma. Theoretically, it has been argued that public stigma leads to the development of self-stigma. However, the empirical support for this assertion is limited to cross-sectional data. Therefore, the goal of this…

  15. Stigma and Racial/Ethnic HIV Disparities: Moving toward Resilience

    ERIC Educational Resources Information Center

    Earnshaw, Valerie A.; Bogart, Laura M.; Dovidio, John F.; Williams, David R.

    2013-01-01

    Prior research suggests that stigma plays a role in racial/ethnic health disparities. However, there is limited understanding about the mechanisms by which stigma contributes to HIV-related disparities in risk, incidence and screening, treatment, and survival and what can be done to reduce the impact of stigma on these disparities. We introduce…

  16. Geospatial analysis of HIV-Related social stigma: A study of tested females across mandals of Andhra Pradesh in India

    PubMed Central

    2010-01-01

    Background In Geographical Information Systems issues of scale are of an increasing interest in storing health data and using these in policy support. National and international policies on treating HIV (Human Immunodeficiency Virus) positive women in India are based on case counts at Voluntary Counseling and Testing Centers (VCTCs). In this study, carried out in the Indian state of Andhra Pradesh, these centers are located in subdistricts called mandals, serving for both registration and health facility policies. This study hypothesizes that people may move to a mandal different than their place of residence for being tested for reasons of stigma. Counts of a single mandal therefore may include cases from inside and outside a mandal. HIV counts were analyzed on the presence of outside cases and the most likely explanations for movement. Counts of women being tested on a practitioners' referral (REFs) and those directly walking-in at testing centers (DWs) were compared and with counts of pregnant women. Results At the mandal level incidence among REFs is on the average higher than among DWs. For both groups incidence is higher in the South-Eastern coastal zones, being an area with a dense highway network and active port business. A pattern on the incidence maps was statistically confirmed by a cluster analysis. A spatial regression analysis to explain the differences in incidence among pregnant women and REFs shows a negative relation with the number of facilities and a positive relation with the number of roads in a mandal. Differences in incidence among pregnant women and DWs are explained by the same variables, and by a negative relation with the number of neighboring mandals. Based on the assumption that pregnant women are tested in their home mandal, this provides a clear indication that women move for testing as well as clues for explanations why. Conclusions The spatial analysis shows that women in India move towards a different mandal for getting tested on

  17. A Cluster-Randomized Controlled Intervention Study to Assess the Effect of a Contact Intervention in Reducing Leprosy-Related Stigma in Indonesia

    PubMed Central

    Peters, Ruth M. H.; Dadun; Zweekhorst, Marjolein B. M.; Bunders, Joske F. G.; Irwanto; van Brakel, Wim H.

    2015-01-01

    Background Can deliberate interaction between the public and persons affected by leprosy reduce stigmatization? The study described in this paper hypothesises that it can and assesses the effectiveness of a ‘contact intervention’. Methods/Principal Findings This cluster-randomized controlled intervention study is part of the Stigma Assessment and Reduction of Impact (SARI) project conducted in Cirebon District, Indonesia. Testimonies, participatory videos and comics given or made by people affected by leprosy were used as methods to facilitate a dialogue during so-called ‘contact events’. A mix of seven quantitative and qualitative methods, including two scales to assess aspects of stigma named the SDS and EMIC-CSS, were used to establish a baseline regarding stigma and knowledge of leprosy, monitor the implementation and assess the impact of the contact events. The study sample were community members selected using different sampling methods. The baseline shows a lack of knowledge about leprosy, a high level of stigma and contrasting examples of support. In total, 91 contact events were organised in 62 villages, directly reaching 4,443 community members (mean 49 per event). The interview data showed that knowledge about leprosy increased and that negative attitudes reduced. The adjusted mean total score of the EMIC-CSS reduced by 4.95 points among respondents who had attended a contact event (n = 58; p <0.001, effect size = 0.75) compared to the score at baseline (n = 213); for the SDS this was 3.56 (p <0.001, effect size = 0.81). About 75% of those attending a contact event said they shared the information with others (median 10 persons). Conclusions/Significance The contact intervention was effective in increasing knowledge and improving public attitudes regarding leprosy. It is relatively easy to replicate elsewhere and does not require expensive technology. More research is needed to improve scalability. The effectiveness of a contact intervention to

  18. First Aid for Sports-Related Dental Injuries.

    ERIC Educational Resources Information Center

    Castaldi, C. R.

    1987-01-01

    Sports-related dental injuries are common but first aid is usually performed by non-dental personnel. This article describes basic procedures to be followed in order to diagnose the type and severity of the injury and to determine whether emergency treatment is required. Prevention of dental injuries is addressed. (Author/MT)

  19. Reducing stigma in reproductive health.

    PubMed

    Cook, Rebecca J; Dickens, Bernard M

    2014-04-01

    Stigmatization marks individuals for disgrace, shame, and even disgust-spoiling or tarnishing their social identities. It can be imposed accidentally by thoughtlessness or insensitivity; incidentally to another purpose; or deliberately to deter or punish conduct considered harmful to actors themselves, others, society, or moral values. Stigma has permeated attitudes toward recipients of sexual and reproductive health services, and at times to service providers. Resort to contraceptive products, to voluntary sterilization and abortion, and now to medically assisted reproductive care to overcome infertility has attracted stigma. Unmarried motherhood has a long history of shame, projected onto the "illegitimate" (bastard) child. The stigma of contracting sexually transmitted infections has been reinvigorated with HIV infection. Gynecologists and their professional associations, ethically committed to uphold human dignity and equality, especially for vulnerable women for whom they care, should be active to guard against, counteract, and relieve stigmatization of their patients and of related service providers. PMID:24513258

  20. Internalized Stigma among Sexual Minority Adults: Insights from a Social Psychological Perspective

    ERIC Educational Resources Information Center

    Herek, Gregory M.; Gillis, J. Roy; Cogan, Jeanine C.

    2009-01-01

    This article describes a social psychological framework for understanding sexual stigma, and it reports data on sexual minority individuals' stigma-related experiences. The framework distinguishes between stigma's manifestations in society's institutions ("heterosexism") and among individuals. The latter include "enacted sexual stigma" (overt…

  1. Editorial: Global action to reduce HIV stigma and discrimination.

    PubMed

    Grossman, Cynthia I; Stangl, Anne L

    2013-01-01

    There is no question that the stigma and discrimination associated with HIV and AIDS can be reduced through intervention. The inclusion of stigma and discrimination reduction as a critical component of achieving an AIDS-free generation in recent UNAIDS, UN and PEPFAR political initiatives is promising. Yet national governments need evidence on effective interventions at the individual, community and societal levels in order to strategically incorporate stigma and discrimination reduction into national AIDS plans. Currently, the heterogeneity of stigma and discrimination reduction approaches and measurement makes it challenging to compare and contrast evaluated interventions. Moving forward, it is critical for the research community to: (1) clearly link intervention activities to the domains of stigma to be shifted; (2) assess the stigma domains in a consistent manner; and (3) link stigma and discrimination reduction with HIV prevention, care and treatment outcomes (e.g., uptake, adherence and retention of ART). These steps would further advance the scientific evidence base of stigma and discrimination reduction and allow for the identification of effective interventions that could be scaled up by national governments. PMID:24242269

  2. Global action to reduce HIV stigma and discrimination

    PubMed Central

    Grossman, Cynthia I; Stangl, Anne L

    2013-01-01

    There is no question that the stigma and discrimination associated with HIV and AIDS can be reduced through intervention. The inclusion of stigma and discrimination reduction as a critical component of achieving an AIDS-free generation in recent UNAIDS, UN and PEPFAR political initiatives is promising. Yet national governments need evidence on effective interventions at the individual, community and societal levels in order to strategically incorporate stigma and discrimination reduction into national AIDS plans. Currently, the heterogeneity of stigma and discrimination reduction approaches and measurement makes it challenging to compare and contrast evaluated interventions. Moving forward, it is critical for the research community to: (1) clearly link intervention activities to the domains of stigma to be shifted; (2) assess the stigma domains in a consistent manner; and (3) link stigma and discrimination reduction with HIV prevention, care and treatment outcomes (e.g., uptake, adherence and retention of ART). These steps would further advance the scientific evidence base of stigma and discrimination reduction and allow for the identification of effective interventions that could be scaled up by national governments. PMID:24242269

  3. HIV/AIDS-related stigmatizing and discriminatory attitudes and recent HIV testing among men who have sex with men in Beijing.

    PubMed

    Li, Xuefeng; Lu, Hongyan; Ma, Xiaoyan; Sun, Yanming; He, Xiong; Li, Chunmei; Raymond, H F; McFarland, Willi; Pan, Stephen W; Shao, Yiming; Vermund, Sten H; Xiao, Yan; Ruan, Yuhua; Jia, Yujiang

    2012-04-01

    This study assessed the correlates of recent HIV testing and HIV/AIDS-related stigmatizing and discriminatory attitudes among men who have sex with men (MSM) in Beijing, China. A cross-sectional study probed demographics, sexual and drug use behaviors, HIV testing, and prevention services. Of 500 participants, 39.3% recently received a test for HIV. Recent testing was independently associated with expressing lower levels of HIV/AIDS-related stigmatizing and discriminatory attitudes, more male sex partners, no female sexual partners and knowing HIV status of their last male partner. Expressing lower levels of HIV/AIDS-related stigmatizing and discriminatory attitudes was independently associated with recent testing, younger age, and knowing HIV status of their last male partner. This study revealed that HIV/AIDS-related stigmatizing and discriminatory attitudes were common and inversely associated with recent HIV testing. Low levels of testing highlighted the urgent needs to reduce HIV/AIDS-related stigma and discrimination and expand HIV testing among MSM in Beijing. PMID:22350831

  4. Stigma towards a Neglected Tropical Disease: Felt and enacted Stigma Scores among Podoconiosis Patients in Northern Ethiopia

    PubMed Central

    2013-01-01

    Background Podoconiosis, or non-filarial elephantiasis, is a neglected tropical disease (NTD) characterised by swelling of the lower legs. When left untreated, this disfiguring condition has a significant social impact. This study aimed to describe the stigma experience among podoconiosis patients in Dembecha, Northern Ethiopia and assess potential associations between stigma and sociodemographic determinants. Methods The study was conducted in May 2012 in Northern Ethiopia. A questionnaire-based cross-sectional study design was used and stigma was assessed using a validated podoconiosis stigma scale including 'felt’ and 'enacted’ stigma domains. Enacted stigma includes the experience of discrimination such as abuse, loss of employment or prejudicial attitudes, while felt stigma is the perceived fear of enacted stigma. A multivariable linear regression model was used to explore determinants that may be associated with stigma. Results A total of 346 clinically confirmed podoconiosis patients participated in the study. The total mean score of all stigma scale items was 30.7 (Range = 0 to 96). There was a higher mean score of scale items in domains of felt stigma (21.7; Range = 0 to 45) as compared to enacted stigma (9.0; Range = 0 to 51). The total mean score of all stigma scale items appeared to increase with disease stage. A final adjusted linear regression model found an association between stigma and factors including monthly income, duration lived in the current residence, and disease stage, after controlling for confounders. Conclusion Podoconiosis is a stigmatized disease with a clear social impact. This paper documented the burden of podoconiosis-related stigma and identified associated factors. Programs aimed at preventing and treating podoconiosis should incorporate interventions to mitigate both felt and enacted stigma. Interventions targeting patients should prioritize those with advanced disease. PMID:24330684

  5. Measuring HIV felt stigma: a culturally adapted scale targeting PLWHA in Puerto Rico

    PubMed Central

    Jimenez, Julio Cesar; Puig, Marieva; Ramos, Juan Carlos; Morales, Marangelie; Asencio, Gloria; Sala, Ana Cecilia; Castro, Eida; Santori, Carmen Vélez; Santiago, Lydia; Zorrilla, Carmen

    2016-01-01

    The objective of this study was to culturally adapt and validate a scale to measure HIV-related felt stigma in a group of People living with HIV/AIDS (PLWHA) in Puerto Rico. The researchers conducted a two-phase cross-sectional study with 216 participants (60, first phase; 156, second phase). The first phase consisted of the cultural adaptation of the scale; the second evaluated its psychometric properties. After conducting a factor analysis, a 17-item scale, the HIV Felt-Stigma Scale (HFSS), resulted. Participants completed the Puerto Rico Comprehensive Center for the Study of Health Disparities Socio-demographic Questionnaire, the HFSS, the Beck Depression Inventory-II, and the Sexual Abuse dimension of the History of Abuse Questionnaire; the case managers completed the Case Manager Stigma Guide with subjects. The HFSS measures four dimensions: personalized stigma, disclosure concerns, negative self-image, and concern with public attitudes. The alpha and Pearson correlation coefficients (0.91 and 0.68, respectively) indicated satisfactory validity and reliability; the scale suggested adequate convergent validity. The HFSS is a culturally sensitive instrument that fills the existing gap in the measurement of felt stigma in Spanish-speaking PLWHA. PMID:20665283

  6. Measuring HIV felt stigma: a culturally adapted scale targeting PLWHA in Puerto Rico.

    PubMed

    Jimenez, Julio Cesar; Puig, Marieva; Ramos, Juan Carlos; Morales, Marangelie; Asencio, Gloria; Sala, Ana Cecilia; Castro, Eida; Velez Santori, Carmen; Santiago, Lydia; Zorrilla, Carmen

    2010-11-01

    The objective of this study was to culturally adapt and validate a scale to measure HIV-related felt stigma in a group of People living with HIV/AIDS (PLWHA) in Puerto Rico. The researchers conducted a two-phase cross-sectional study with 216 participants (60, first phase; 156, second phase). The first phase consisted of the cultural adaptation of the scale; the second evaluated its psychometric properties. After conducting a factor analysis, a 17-item scale, the HIV Felt-Stigma Scale (HFSS), resulted. Participants completed the Puerto Rico Comprehensive Center for the Study of Health Disparities Socio-demographic Questionnaire, the HFSS, the Beck Depression Inventory-II, and the Sexual Abuse dimension of the History of Abuse Questionnaire; the case managers completed the Case Manager Stigma Guide with subjects. The HFSS measures four dimensions: personalized stigma, disclosure concerns, negative self-image, and concern with public attitudes. The alpha and Pearson correlation coefficients (0.91 and 0.68, respectively) indicated satisfactory validity and reliability; the scale suggested adequate convergent validity. The HFSS is a culturally sensitive instrument that fills the existing gap in the measurement of felt stigma in Spanish-speaking PLWHA. PMID:20665283

  7. Mental Illness Sexual Stigma: Implications for Health and Recovery

    PubMed Central

    Wainberg, Milton L.; Cournos, Francine; Wall, Melanie M.; Pala, Andrea Norcini; Mann, Claudio Gruber; Pinto, Diana; Pinho, Veronica; McKinnon, Karen

    2015-01-01

    Objective Among people in psychiatric care worldwide, the majority is sexually active, and sharply elevated rates of HIV infection compared to the general population have been shown. Recovery-oriented treatment does not routinely address sexuality. We examined the relationship between gender, severe mental illness diagnosis, and stigma experiences related to sexuality among people in psychiatric outpatient care. Method 641 sexually active adults attending eight public outpatient psychiatric clinics in Rio de Janeiro were interviewed for psychiatric diagnosis and stigma experiences. Stigma mechanisms well established in the literature but not previously examined in relation to sexuality were measured with the Mental Illness Sex Stigma Questionnaire, a 27-item interview about stigma in sexual situations and activities. Results Experiences of stigma were reported by a majority of participants for 48% of questionnaire items. Most people reported supportive attitudes toward their sexuality from providers and family members. Those with severe mental illness diagnoses showed greater stigma on Individual Discrimination and Structural Stigma mechanisms than those with non-severe mental illness diagnoses, while there was no difference on the Social Psychological Processes (internalized stigma) mechanism. Regardless of diagnosis or gender, a majority of participants devalued themselves as sexual partners. Conclusions and Implications for Practice Adults in psychiatric outpatient care frequently reported stigma experiences related to aspects of their sexual lives. From the perspectives of both HIV prevention and recovery from mental illness, examining the consequences of stigma in the sexual lives of people in psychiatric care and improving their measurement would have wide applicability. PMID:27030909

  8. The Ideology of Welfare Reform: Deconstructing Stigma.

    ERIC Educational Resources Information Center

    Mills, Frederick B.

    1996-01-01

    Critiques recent welfare reform proposals and recommends social work practices that humanize Aid to Families with Dependent Children (AFDC). The critique deconstructs the labels "dependent,""addict," and "illegitimate" as they are applied to AFDC mothers and explores the reproduction of stigma through social work practice. (Author)

  9. Ethnobotanical Study of Plants Used in the Management of HIV/AIDS-Related Diseases in Livingstone, Southern Province, Zambia

    PubMed Central

    Chinsembu, Kazhila C.

    2016-01-01

    Faced with critical shortages of staff, long queues, and stigma at public health facilities in Livingstone, Zambia, persons who suffer from HIV/AIDS-related diseases use medicinal plants to manage skin infections, diarrhoea, sexually transmitted infections, tuberculosis, cough, malaria, and oral infections. In all, 94 medicinal plant species were used to manage HIV/AIDS-related diseases. Most remedies are prepared from plants of various families such as Combretaceae, Euphorbiaceae, Fabaceae, and Lamiaceae. More than two-thirds of the plants (mostly leaves and roots) are utilized to treat two or more diseases related to HIV infection. Eighteen plants, namely, Achyranthes aspera L., Lannea discolor (Sond.) Engl., Hyphaene petersiana Klotzsch ex Mart., Asparagus racemosus Willd., Capparis tomentosa Lam., Cleome hirta Oliv., Garcinia livingstonei T. Anderson, Euclea divinorum Hiern, Bridelia cathartica G. Bertol., Acacia nilotica Delile, Piliostigma thonningii (Schumach.) Milne-Redh., Dichrostachys cinerea (L.) Wight and Arn., Abrus precatorius L., Hoslundia opposita Vahl., Clerodendrum capitatum (Willd.) Schumach., Ficus sycomorus L., Ximenia americana L., and Ziziphus mucronata Willd., were used to treat four or more disease conditions. About 31% of the plants in this study were administered as monotherapies. Multiuse medicinal plants may contain broad-spectrum antimicrobial agents. However, since widely used plants easily succumb to the threats of overharvesting, they need special protocols and guidelines for their genetic conservation. There is still need to confirm the antimicrobial efficacies, pharmacological parameters, cytotoxicity, and active chemical ingredients of the discovered plants. PMID:27069489

  10. Ethnobotanical Study of Plants Used in the Management of HIV/AIDS-Related Diseases in Livingstone, Southern Province, Zambia.

    PubMed

    Chinsembu, Kazhila C

    2016-01-01

    Faced with critical shortages of staff, long queues, and stigma at public health facilities in Livingstone, Zambia, persons who suffer from HIV/AIDS-related diseases use medicinal plants to manage skin infections, diarrhoea, sexually transmitted infections, tuberculosis, cough, malaria, and oral infections. In all, 94 medicinal plant species were used to manage HIV/AIDS-related diseases. Most remedies are prepared from plants of various families such as Combretaceae, Euphorbiaceae, Fabaceae, and Lamiaceae. More than two-thirds of the plants (mostly leaves and roots) are utilized to treat two or more diseases related to HIV infection. Eighteen plants, namely, Achyranthes aspera L., Lannea discolor (Sond.) Engl., Hyphaene petersiana Klotzsch ex Mart., Asparagus racemosus Willd., Capparis tomentosa Lam., Cleome hirta Oliv., Garcinia livingstonei T. Anderson, Euclea divinorum Hiern, Bridelia cathartica G. Bertol., Acacia nilotica Delile, Piliostigma thonningii (Schumach.) Milne-Redh., Dichrostachys cinerea (L.) Wight and Arn., Abrus precatorius L., Hoslundia opposita Vahl., Clerodendrum capitatum (Willd.) Schumach., Ficus sycomorus L., Ximenia americana L., and Ziziphus mucronata Willd., were used to treat four or more disease conditions. About 31% of the plants in this study were administered as monotherapies. Multiuse medicinal plants may contain broad-spectrum antimicrobial agents. However, since widely used plants easily succumb to the threats of overharvesting, they need special protocols and guidelines for their genetic conservation. There is still need to confirm the antimicrobial efficacies, pharmacological parameters, cytotoxicity, and active chemical ingredients of the discovered plants. PMID:27069489

  11. Stigmatizing Attitudes towards People Living with HIV/AIDS among College Students in China: Implications for HIV/AIDS Education and Prevention

    ERIC Educational Resources Information Center

    Zhang, Liying; Li, Xiaoming; Mao, Rong; Stanton, Bonita; Zhao, Qun; Wang, Bo; Mathur, Ambika

    2008-01-01

    Purpose: The purpose of this paper is to show that HIV/AIDS-related stigma has persisted world-wide for decades. However, studies on the linkage between stigmatizing attitudes towards people living with HIV/AIDS (PLWHA) and misconceptions about HIV transmission routes in the general population, especially among youth in China, are sparse--a gap…

  12. Stigma consciousness: the psychological legacy of social stereotypes.

    PubMed

    Pinel, E C

    1999-01-01

    Whereas past researchers have treated targets of stereotypes as though they have uniform reactions to their stereotyped status (e.g., J. Crocker & B. Major, 1989; C. M. Steele & J. Aronson, 1995), it is proposed here that targets differ in the extent to which they expect to be stereotyped by others (i.e., stigma consciousness). Six studies, 5 of which validate the stigma-consciousness questionnaire (SCQ), are presented. The results suggest that the SCQ is a reliable and valid instrument for detecting differences in stigma consciousness. In addition, scores on the SCQ predict perceptions of discrimination and the ability to generate convincing examples of such discrimination. The final study highlights a behavioral consequence of stigma consciousness: the tendency for people high in stigma consciousness to forgo opportunities to invalidate stereotypes about their group. The relation of stigma consciousness to past research on targets of stereotypes is considered as is the issue of how stigma consciousness may encourage continued stereotyping. PMID:9972557

  13. AIDS-related apprehensions among nursing students of Delhi.

    PubMed

    Kumar, A; Lal, P; Ingle, G K; Gulati, N

    1999-12-01

    Students from a nursing school of Delhi were surveyed anonymously using a self-administered questionnaire to explore various AIDS-related apprehensions and their possible reasons. The observations revealed that, majority of the students and their families/friends feared that these students were at risk of contracting HIV infection while providing routine patient care. A large number of students also opined that they would feel uncomfortable while talking, hugging, shaking hands, and sharing a room with an HIV positive person. The main reasons for their apprehensions were unsatisfactory anti-AIDS campaigning by the government, non-availability of sufficient protective measures in the health care settings, inadequate professional education related to prevention of HIV infection, and increase in HIV transmission following false sense of security due to excessive condom promotion. Findings of the study imply imparting factual knowledge addressing the concerns and removing misconceptions which influence attitudes and willingness of the nursing students to provide care to the HIV positives/AIDS patients, facts regarding efficacy of various preventive measures, and provision of counselling services in the event of exposure. PMID:10937297

  14. AIDS-related reasons for gay men's adoption of celibacy.

    PubMed

    Siegel, K; Raveis, V H

    1993-01-01

    Since it was first recognized that human immunodeficiency virus (HIV) infection could be sexually transmitted, celibacy has been advocated by some as the only unequivocally effective adaptation for avoiding the risk of infection. Others, however, have countered that few will be willing to be celibate and, further, that such behavior may have adverse psychosocial consequences. As part of a qualitative study of gay men's sexual decision-making in the context of the AIDS/HIV epidemic, we identified a subsample of respondents who had adopted celibacy for varying periods of time as an adaptation to the threat of AIDS/HIV infection. A content analysis of these men's interviews revealed 5 principal themes relating their reasons for choosing celibacy. PMID:8297710

  15. Religion-related stigma and discrimination experienced by lesbian, gay, bisexual and transgender students at a South African rural-based university.

    PubMed

    Mavhandu-Mudzusi, Azwihangwisi Helen; Sandy, Peter Thomas

    2015-01-01

    This paper reports on the stigma and discrimination experienced by lesbian, gay, bisexual and transgender students at a rural university in South Africa. Twenty lesbian, gay, bisexual and transgender students recruited through snowball sampling participated in this study. Interpretative Phenomenological Analysis was used as a framework for data analysis. Findings indicate that religion-related stigma and discrimination are common at a rural-based university in South Africa. Lesbian, gay, bisexual and transgender students are typically ascribed a range of labels, including 'sinners', 'devils' and 'demon possessed'. They are also exposed to a number of discriminatory acts, such as the denial of financial and healthcare services and threats of and/or actual rape. Study participants reported attempts to convert lesbian, gay, bisexual and transgender students' sexual orientation which involved the use of intervention in the form of prayers. Derogatory labelling and associated discriminatory acts, for example the threat of rape, led many students to conceal their sexual identity, not attend specific classes, terminate their studies and even attempt suicide. Universities should develop policies to promote greater social inclusion and the acceptance of lesbian, gay, bisexual and transgender students. Policies should also specify the steps or approaches to be taken in addressing discriminatory practices. PMID:25732232

  16. Relative benefits of linear analogue and advanced digital hearing aids.

    PubMed

    Wood, Sally A; Lutman, Mark E

    2004-03-01

    Speech recognition performance and self-reported benefit from linear analogue and advanced (digital) hearing aids were compared in 100 first-time hearing aid users with mild-to-moderate sensorineural hearing loss fitted monaurally with a behind-the-ear (BTE) hearing aid in a single-blind randomized crossover trial. Subjects used each aid for 5 weeks in turn, with aid order balanced across subjects. Three alternative models of digital hearing aid were assigned to subjects according to a balanced design. Aid type was disguised to keep subjects blind within practical limitations. Aided speech recognition performance in noise was measured at speech levels of 65 and 75dB at a speech-to-noise ratio (SNR) of +2dB for closed sets of single words. Self-rated benefit was measured using the Abbreviated Profile of Hearing Aid Benefit (APHAB) and the Glasgow Hearing Aid Benefit Profile (GHABP). Quality of life, hearing aid use and user preferences were also assessed. Speech recognition scores with the digital aids were significantly better at 75dB than with the analogue aids Self-reported benefit (APHAB, GHABP) and improvement in quality of life were generally not significantly different between analogue and digital aids, although aversiveness measured with the APHAB was significantly lower with digital aids, and satisfaction measured with the GHABP was greater. The digital aids were preferred significantly more often than the analogue aids, with 61 subjects choosing their digital aid, 26 choosing the analogue aid, and nine being equivocal. Overall, this study shows advantages for advanced digital over simple linear analogue aids in terms of both objective and subjective outcomes, although average differences are not large. PMID:15198378

  17. The lion at the gate: an HIV-affected caregiver resists stigma.

    PubMed

    Poindexter, Cynthia Cannon

    2005-02-01

    This article examines two bounded stories of HIV stigma told by an older woman who took care of her adult son as he died of AIDS. Her self-definition as a protector of her dying son was challenged when she encountered ostracism and prejudice. Her words and expressions illuminate her confrontation and resistance to associative stigma. An expansion of Goffman's view of stigma management is necessary to understand this caregiver's experiences in the face of the larger cultural narrative of HIV stigma:This caregiver did not manage stigma, she actively fought it. PMID:15847239

  18. STIGMA AGAINST HIV-INFECTED PERSONS AMONG MIGRANT WOMEN LIVING IN SHANGHAI, CHINA

    PubMed Central

    Cao, Haijun; He, Na; Jiang, Qingwu; Yang, Meixia; Liu, Zhenyao; Gao, Meiyang; Ding, Pengli; Chen, Li; Detels, Roger

    2011-01-01

    We examined the characteristics of 601 female migrants in Shanghai regarding stigmatizing attitudes toward people living with HIV/AIDS (PLWHA). A community-based cross-sectional study was conducted July and August 2008, using an anonymous questionnaire. Most participants (88%) were married, 9.2% reported multiple sexual partners, 19.1% knew about voluntary counseling and testing clinics, and 3.7% had been tested for HIV. About half (56.4%) agreed that people who acquire HIV/AIDS through sex or drug use deserve it. About 80% admitted that they were afraid of PLWHA. Low knowledge of HIV/AIDS, being older, low levels of education, and longer duration in Shanghai were correlates for having stigmatizing attitudes, while having premarital sex and/or multiple sex partners correlated with less stigma. HIV-related stigma among female migrants in Shanghai is common. Future stigma reduction prevention and intervention programs among female migrants should target those who are older, less educated, and have lived in Shanghai relatively longer. PMID:20973664

  19. Stigma against HIV-infected persons among migrant women living in Shanghai, China.

    PubMed

    Cao, Haijun; He, Na; Jiang, Qingwu; Yang, Meixia; Liu, Zhenyao; Gao, Meiyang; Ding, Pengli; Chen, Li; Detels, Roger

    2010-10-01

    We examined the characteristics of 601 female migrants in Shanghai regarding stigmatizing attitudes toward people living with HIV/AIDS (PLWHA). A community-based cross-sectional study was conducted July and August 2008, using an anonymous questionnaire. Most participants (88%) were married, 9.2% reported multiple sexual partners, 19.1% knew about voluntary counseling and testing clinics, and 3.7% had been tested for HIV. About half (56.4%) agreed that people who acquire HIV/AIDS through sex or drug use deserve it. About 80% admitted that they were afraid of PLWHA. Low knowledge of HIV/AIDS, being older, low levels of education, and longer duration in Shanghai were correlates for having stigmatizing attitudes, while having premarital sex and/or multiple sex partners correlated with less stigma. HIV-related stigma among female migrants in Shanghai is common. Future stigma reduction prevention and intervention programs among female migrants should target those who are older, less educated, and have lived in Shanghai relatively longer. PMID:20973664

  20. Stigma and Racial/Ethnic HIV Disparities: Moving Toward Resilience

    PubMed Central

    Earnshaw, Valerie A.; Bogart, Laura M.; Dovidio, John F.; Williams, Davird R.

    2013-01-01

    Prior research suggests that stigma plays a role in racial/ethnic health disparities. However, there is limited understanding about the mechanisms by which stigma contributes to HIV-related disparities in risk, incidence and screening, treatment, and survival and what can be done to reduce the impact of stigma on these disparities. We introduce the Stigma and HIV Disparities Model to describe how societal stigma related to race and ethnicity is associated with racial/ethnic HIV disparities via its manifestations at the structural level (e.g., residential segregation) as well as the individual level among perceivers (e.g., discrimination) and targets (e.g., internalized stigma). We then review evidence of these associations. Because racial/ethnic minorities at risk of and living with HIV often possess multiple stigmas (e.g., HIV-positive, substance use), we adopt an intersectionality framework and conceptualize interdependence among co-occurring stigmas. We further propose a resilience agenda and suggest that intervening on modifiable strength-based moderators of the association between societal stigma and disparities can reduce disparities. Strengthening economic and community empowerment and trust at the structural level, creating common ingroup identities and promoting contact with people living with HIV among perceivers at the individual level, and enhancing social support and adaptive coping among targets at the individual level can improve resilience to societal stigma and ultimately reduce racial/ethnic HIV disparities. PMID:23688090

  1. ‘I call it the blame and shame disease’: a qualitative study about perceptions of social stigma surrounding type 2 diabetes

    PubMed Central

    Browne, Jessica L; Ventura, Adriana; Mosely, Kylie; Speight, Jane

    2013-01-01

    Objectives While health-related stigma has been the subject of considerable research in other conditions (obesity and HIV/AIDS), it has not received substantial attention in diabetes. The aim of the current study was to explore the social experiences of Australian adults living with type 2 diabetes mellitus (T2DM), with a particular focus on the perception and experience of diabetes-related stigma. Design A qualitative study using semistructured interviews, which were audio recorded, transcribed and subject to thematic analysis. Setting This study was conducted in non-clinical settings in metropolitan and regional areas in the Australian state of Victoria. Participants were recruited primarily through the state consumer organisation representing people with diabetes. Participants All adults aged ≥18 years with T2DM living in Victoria were eligible to take part. Twenty-five adults with T2DM participated (12 women; median age 61 years; median diabetes duration 5 years). Results A total of 21 (84%) participants indicated that they believed T2DM was stigmatised, or reported evidence of stigmatisation. Specific themes about the experience of stigma were feeling blamed by others for causing their own condition, being subject to negative stereotyping, being discriminated against or having restricted opportunities in life. Other themes focused on sources of stigma, which included the media, healthcare professionals, friends, family and colleagues. Themes relating to the consequences of this stigma were also evident, including participants’ unwillingness to disclose their condition to others and psychological distress. Participants believed that people with type 1 diabetes do not experience similar stigmatisation. Conclusions Our study found evidence of people with T2DM experiencing and perceiving diabetes-related social stigma. Further research is needed to explore ways to measure and minimise diabetes-related stigma at the individual and societal levels, and

  2. Stigma and Sexual Health Risk in HIV-Positive African American Young Men Who Have Sex with Men

    PubMed Central

    Doty, Nathan; Hawkins, Linda A.; Gaskins, Clare S.; Beidas, Rinad; Rudy, Bret J.

    2010-01-01

    Abstract Understanding the multiple forms of stigma experienced by young HIV-positive African American men who have sex with men and how they relate to sexual risk behaviors is essential to design effective HIV prevention programs. This study of 40 African American young MSM found that 90% of those surveyed experienced sexual minority stigma, 88% experienced HIV stigma, and 78% experienced dual stigma. Sexual minority stigma was characterized by experiences of social avoidance, and HIV stigma, by shame. Individuals with high HIV stigma were significantly more likely to engage in unprotected sex while high or intoxicated. Associations between stigma and sexual practices were examined; youth endorsing higher levels of sexual minority stigma engaged in less insertive anal intercourse. Individuals endorsing more HIV stigma reported more receptive anal intercourse. These findings support the development of stigma-informed secondary prevention interventions for African American HIV-positive young MSM. PMID:20673080

  3. Reducing stigma and discrimination to improve child health and survival in low- and middle-income countries: promising approaches and implications for future research.

    PubMed

    Nayar, Usha S; Stangl, Anne L; De Zalduondo, Barbara; Brady, Laura M

    2014-01-01

    The social processes of stigmatization and discrimination can have complex and devastating effects on the health and welfare of families and communities, and thus on the environments in which children live and grow. The authors conducted a literature review to identify interventions for reducing the stigma and discrimination that impede child health and well-being in low- and middle-income countries, with a focus on nutrition, HIV/AIDS, neonatal survival and infant health, and early child development. Despite broad consensus on the importance of stigma and discrimination as barriers to access and uptake of health information and services, the authors found a dearth of research and program evaluations directly assessing effective interventions in the area of child health except in the area of reducing HIV-related stigma and discrimination. While the literature demonstrates that poverty and social exclusion are often stigma-laden and impede adult access to health information and services, and to education relevant to family planning, child rearing, nutrition, health promotion, and disease prevention, the child health literature does not document direct connections between these known mediators of child health and the stigmatization of either children or their caregivers. The child health field would greatly benefit from more research to understand and address stigma as it relates to child health and well-being. The authors suggest applying a framework, adapted from the HIV stigma field, to direct future research and the adaptation of existing strategies to reduce HIV-related stigma and discrimination to address social and health-related stigmas affecting children and their families. PMID:25207451

  4. Reducing Stigma and Discrimination to Improve Child Health and Survival in Low- and Middle-Income Countries: Promising Approaches and Implications for Future Research

    PubMed Central

    Nayar, Usha S.; Stangl, Anne L.; De Zalduondo, Barbara; Brady, Laura M.

    2014-01-01

    The social processes of stigmatization and discrimination can have complex and devastating effects on the health and welfare of families and communities, and thus on the environments in which children live and grow. The authors conducted a literature review to identify interventions for reducing the stigma and discrimination that impede child health and well-being in low- and middle-income countries, with a focus on nutrition, HIV/AIDS, neonatal survival and infant health, and early child development. Despite broad consensus on the importance of stigma and discrimination as barriers to access and uptake of health information and services, the authors found a dearth of research and program evaluations directly assessing effective interventions in the area of child health except in the area of reducing HIV-related stigma and discrimination. While the literature demonstrates that poverty and social exclusion are often stigma-laden and impede adult access to health information and services, and to education relevant to family planning, child rearing, nutrition, health promotion, and disease prevention, the child health literature does not document direct connections between these known mediators of child health and the stigmatization of either children or their caregivers. The child health field would greatly benefit from more research to understand and address stigma as it relates to child health and well-being. The authors suggest applying a framework, adapted from the HIV stigma field, to direct future research and the adaptation of existing strategies to reduce HIV-related stigma and discrimination to address social and health-related stigmas affecting children and their families. PMID:25207451

  5. The impact of aid chains: relations of dependence or supportive partnerships for community-led responses to HIV/AIDS?

    PubMed

    Aveling, E L

    2010-01-01

    In the context of increasing global emphasis on partnerships between international, governmental and civil society organisations in the distribution of international aid, this paper examines the ways in which the resulting aid chains promote and undermine community-led responses to HIV/AIDS. The impact of the aid-granting system is examined using an ethnographic case study of an HIV/AIDS prevention programme with Cambodian military families. The case study draws on observations of stakeholder meetings and programme activities, interviews with stakeholders (the donor, NGOs and military community) and textual materials (programme guidelines, policies and reports). Campbell et al.'s interrelated concepts of relational, symbolic and material context are used to frame the analysis. The establishment of a relationship with a more powerful international NGO is shown to be beneficial to the military community and civil society groups. The international NGO uses its significant material and economic leverage to improve the community's relational context (by ensuring the support of the military high command), symbolic context (by strengthening the position of community and civil society partners in relation to government bodies) and material context (through increasing access to health services). However, material and symbolic asymmetries between partners in the aid chain persist, curtailing the community's involvement and leadership. At the material and relational levels, the hierarchical flow of aid encourages accountability to the demands of the donor while excluding grassroots groups from directly accessing funding. At the symbolic level, problem-focused representations of the military further reinforce the community's position as recipients of intervention, which undermines recognition for the community's knowledge, strengths and right to fully participate. Thus while aid chains can be supportive of community-led responses, this analysis highlights how the structures

  6. INSIGHT AND SELF-STIGMA IN PATIENTS WITH SCHIZOPHRENIA.

    PubMed

    Vidović, Domagoj; Brecić, Petrana; Vilibić, Maja; Jukić, Vlado

    2016-03-01

    Poor insight and high level of self-stigma are often present among patients with schizophrenia and are related to poorer treatment adherence, poorer social function and rehabilitation, aggressive behavior, higher level of depression, social anxiety, lower quality of life and self-esteem. Reports on a relationship between insight and stigma are controversial. We examined the relationship of the level of insight and self-stigma in a sample of 149 patients with schizophrenia. Insight was measured with the Scale to assess Unawareness of Mental Disorder and self-stigma with the Internalized Stigma of Mental Illness. Results showed 88.6% of the patients to have high or moderate insight, with a mean value of 2.73. General insight showed the highest level (2.58) and insight in positive symptoms the lowest level (2.9). The self-stigma score in general was 2.13, with stereotype endorsement being lowest (1.98). According to study results, 77.1% of patients felt minimal or low self-stigma across all subscales, except for stigma resistance subscale. Statistically significant correlation was found between insight and four subscales of self-stigma, while no correlation was found for the stigma resistance subscale only. These results imply the need of individually tailored antistigma and insight promoting programs for patients with schizophrenia. PMID:27333714

  7. Perceived stigma among patients receiving antiretroviral treatment: a prospective randomised trial comparing an m-DOT strategy with standard-of-care in Kenya.

    PubMed

    Kaai, Susan; Bullock, Sandra; Sarna, Avina; Chersich, Matthew; Luchters, Stanley; Geibel, Scott; Munyao, Paul; Mandaliya, Kishorchandra; Temmerman, Marleen; Rutenburg, Naomi

    2010-08-01

    HIV and AIDS remain highly stigmatised. Modified directly observed therapy (m-DOT) supports antiretroviral treatment (ART) adherence but little is known about its association with perceived stigma in resource-constrained settings. In 2003, 234 HIV-infected adults enrolled in a two-arm randomised trial comparing a health centre-based m-DOT strategy with standard self-administration of ART. Data on perceived stigma were collected using Berger's HIV stigma scale prior to starting ART and after 12 months. This was a secondary analysis to examine whether perceived stigma was related to treatment delivery. Perceived stigma scores declined after 12 months of treatment from a mean of 44.9 (sd=7.6) to a mean of 41.4 (sd=7.7), (t=6.14, P<0.001). No differences were found between the mean scores of participants in both study arms. Also, no difference in scores was detected using GLM, controlling for socio-demographic characteristics and baseline scores. Findings indicate that a well managed clinic-based m-DOT does not increase perceived HIV-related stigma. PMID:21409296

  8. Stigma-related stressors, coping self-efficacy, and physical health in lesbian, gay, and bisexual individuals.

    PubMed

    Denton, F Nicholas; Rostosky, Sharon Scales; Danner, Fred

    2014-07-01

    Understanding and intervening to address health disparities is part of the expanding role of psychologists (Johnson, 2013). We drew on Hatzenbuehler's (2009) psychological mediation framework and Lick, Durso, and Johnson's (2013) conceptual pathways to lesbian, gay, and bisexual (LGB) physical health disparities to test a serial mediation model in which 2 types of cognitive appraisals (proximal minority stressors and coping self-efficacy) partially account for the association between perceived discrimination and prejudice (distal minority stressor) and self-reported physical health symptoms in a nationally recruited sample of 564 LGB individuals (270 women, 294 men) who participated in a web-based survey. Results indicated that perceived experiences of discrimination and prejudice were associated with expectations of rejection and internalized homonegativity. These 2 proximal stressors were associated with lower coping self-efficacy, and the combined cognitive appraisal pathways were associated with higher levels of self-reported physical symptom severity. The pathway through emotion-focused coping self-efficacy was particularly salient in accounting for the overall mediation. Interventions to address distal and proximal minority stressors and improve emotion-focused coping self-efficacy may be particularly helpful in reducing the negative effects of stigma on physical health. PMID:25019542

  9. Stigma trajectories among people living with HIV (PLHIV) embarking on a life time journey with antiretroviral drugs in Jinja, Uganda

    PubMed Central

    2013-01-01

    Background Stigma is a barrier to HIV prevention and treatment. There is a limited understanding of the types of stigma facing people living with HIV (PLHIV) on antiretroviral therapy (ART). We describe the stigma trajectories of PLHIV over a 5-year period from the time they started ART. Methods Longitudinal qualitative in-depth interviews were conducted with 41 members of The AIDS Support Organisation (TASO) from 2005 to 2008 in Jinja, Uganda, who were part of a pragmatic cluster-randomised trial comparing two different modes of ART delivery (facility and home). Participants were stratified by gender, ART delivery arm and HIV stage (early or advanced) and interviewed at enrolment on to ART and then after 3, 6, 18 and 30 months. Interviews focused on stigma and ART experiences. In 2011, follow-up interviews were conducted with 24 of the participants who could be traced. Transcribed texts were translated, coded and analyzed thematically. Results Stigma was reported to be very high prior to starting ART, explained by visible signs of long-term illnesses and experiences of discrimination and abuse. Early coping strategies included: withdrawal from public life, leaving work due to ill health and moving in with relatives. Starting ART led to a steady decline in stigma and allowed the participants to take control of their illness and manage their social lives. Better health led to resumption of work and having sex but led to reduced disclosure to employers, colleagues and new sexual partners. Some participants mentioned sero-sorting in order to avoid questions around HIV sero-status. A rise in stigma levels during the 18 and 30 month interviews may be correlated with decreased disclosure. By 2011, ART-related stigma was even more pronounced particularly among those who had started new sexual relationships, gained employment and those who had bodily signs from ART side-effects. Conclusion This study has shown that while ART comes with health benefits which help

  10. Community-based interventions that work to reduce HIV stigma and discrimination: results of an evaluation study in Thailand

    PubMed Central

    Jain, Aparna; Nuankaew, Ratana; Mongkholwiboolphol, Nungruthai; Banpabuth, Arunee; Tuvinun, Rachada; Oranop na Ayuthaya, Pakprim; Richter, Kerry

    2013-01-01

    community-level stigma – monthly campaign, Funfair and IEC materials. This is especially important given Thailand's new national AIDS strategy to reduce HIV-related stigma and discrimination by half by 2016. Knowing which interventions to invest in for HIV stigma reduction is crucial for country-wide expansion and scale-up of intervention activities. PMID:24242262

  11. Inmates with HIV, stigma, and disclosure decision-making.

    PubMed

    Derlega, Valerian J; Winstead, Barbara A; Gamble, Kimberly A; Kelkar, Kalika; Khuanghlawn, Priscilla

    2010-03-01

    Seventeen male, former inmates with HIV were interviewed about their experiences with HIV in a jail or prison in the southeastern region of the United States. Participants reported that stereotypes and prejudicial attitudes about HIV/AIDS were widely held by other inmates, and that concerns about HIV/AIDS stigma affected their decisions about HIV disclosure. The results suggest the need to better educate inmates and institutional staff about HIV/AIDS stigma and to increase privacy protection for inmates with HIV, especially in the context of providing medical care and dispensing medications. PMID:20207669

  12. Attentional Bias Associated with Habitual Self-Stigma in People with Mental Illness

    PubMed Central

    Chan, Kevin K. S.; Mak, Winnie W. S.

    2015-01-01

    As habitual self-stigma can have a tremendous negative impact on people with mental illness, it is of paramount importance to identify its risk factors. The present study aims to examine the potential contributory role of attentional bias in habitual self-stigma. People with mental illness having strong (n = 47) and weak (n = 47) habitual self-stigma completed a computerized emotional Stroop task which included stigma-related, positive, and non-affective words as stimuli. The strong habit group was found to exhibit faster color-naming of stigma-related words (compared to non-affective words), whereas the weak habit group showed no difference in the speed of response to different stimuli. These findings suggest that people with stronger habitual self-stigma may be more able to ignore the semantic meaning of stigma-related words and focus on the color-naming task. Moreover, people with stronger habitual self-stigma may have greater attentional avoidance of stigma-related material. The present study is the first to demonstrate a specific relationship between habitual self-stigma and biased processing of stigma-related information. In order to further determine the role and the nature of attentional bias in habitual self-stigma, future research should employ a broader range of experimental paradigms and measurement techniques to examine stigma-related attentional bias in people with mental illness. PMID:26177536

  13. Attentional Bias Associated with Habitual Self-Stigma in People with Mental Illness.

    PubMed

    Chan, Kevin K S; Mak, Winnie W S

    2015-01-01

    As habitual self-stigma can have a tremendous negative impact on people with mental illness, it is of paramount importance to identify its risk factors. The present study aims to examine the potential contributory role of attentional bias in habitual self-stigma. People with mental illness having strong (n = 47) and weak (n = 47) habitual self-stigma completed a computerized emotional Stroop task which included stigma-related, positive, and non-affective words as stimuli. The strong habit group was found to exhibit faster color-naming of stigma-related words (compared to non-affective words), whereas the weak habit group showed no difference in the speed of response to different stimuli. These findings suggest that people with stronger habitual self-stigma may be more able to ignore the semantic meaning of stigma-related words and focus on the color-naming task. Moreover, people with stronger habitual self-stigma may have greater attentional avoidance of stigma-related material. The present study is the first to demonstrate a specific relationship between habitual self-stigma and biased processing of stigma-related information. In order to further determine the role and the nature of attentional bias in habitual self-stigma, future research should employ a broader range of experimental paradigms and measurement techniques to examine stigma-related attentional bias in people with mental illness. PMID:26177536

  14. Immunophototherapy for the treatment of AIDS and AIDS-related infections

    NASA Astrophysics Data System (ADS)

    Schlager, Kenneth J.

    1992-06-01

    Immunophototherapy (IPT) is an experimental method of medical treatment that seeks to provide for the selective destruction of diseased cells and microbes such as human immunodeficiency virus (HIV)-T4 cells and the rapid elimination of their toxic by-products from the human body. Photosensitive monoclonal or polyclonal antibody fragments, which are specific to the diseased cell or microbe, will be used to treat acquired immunodeficiency syndrome (AIDS) and related infections. These antibody fragments are tagged with photosensitive compounds and metal colloids and then intravenously injected into the patient. The tagged antibodies quickly and selectively bind to the diseased cells or microbes in the blood stream and affected organs. These cells or microbes are then selectively destroyed by irradiation of these complexes with light of the proper wavelength. This light activates the photosensitive material which then creates singlet oxygen that destroys the microbe or cell. Toxic products of lysis are quickly discharged from the body by activation of the reticuloendothelial system. IPT has been demonstrated by Biotronics to be very effective in the in vitro selective destruction of specified cell types. In a proposed AIDS-treatment research program, IPT will be first demonstrated in vitro for a set of infected blood samples using commercially-available antibodies labeled with appropriate photosensitizers. Efficacy will be determined by a p24 antigen immunodiagnostic test that will indicate the % inhibition in comparison to controls and samples treated with the drug AZT. Subcontracted animal efficacy studies will use a SCID-hu mouse model and PCR/DNA-RNA for endpoint analysis. Toxicity studies of animal (rat) models will be based on post-treatment investigations of lymph nodes, spleen, liver and other organs.

  15. Perceived stigma in persons with early-stage dementia: Longitudinal findings: Part 1.

    PubMed

    Burgener, Sandy C; Buckwalter, Kathleen; Perkhounkova, Yelena; Liu, Megan F; Riley, Rebecca; Einhorn, Carol J; Fitzsimmons, Suzanne; Hahn-Swanson, Carolyn

    2015-09-01

    This longitudinal study examined perceived stigma in persons with dementia, with 50 persons with dementia, and 47 corresponding family caregivers. Data were collected at baseline and at 6, 12, and 18 months. Study results are reported in two parts, with findings regarding the stability of perceived stigma, measured using the modified Stigma Impact Scale, and relationship of stigma to person-centered variables being reported here. Findings included stability in perceived stigma, which did not show a downward trend until 18 months. Significant differences at baseline were found only for geographic location (rural vs. urban) with persons living in urban areas having higher levels of Stigma Impact Scale internalized shame compared to rural counterparts. Cognitive functioning was significantly, positively related to the Stigma Impact Scale social rejection and social isolation subscales. Findings support the enduring nature of perceived stigma over the early disease stages and the relationship of perceived stigma to some person-centered characteristics. PMID:24339122

  16. Stigma in Mothers of Deaf Children

    PubMed Central

    Ebrahimi, Hossein; Mohammadi, Eissa; Mohammadi, Mohammad Ali; Pirzadeh, Akbar; Mahmoudi, Hamzeh; Ansari, Ismail

    2015-01-01

    Introduction: A deaf child creates a feeling of stigma in many hearing parents. Stigma in mothers can have a negative impact on a child’s treatment and rehabilitation process. Therefore, this study was conducted to evaluate the extent of stigma in mothers with deaf children. Materials and Methods: This descriptive, cross-sectional study was conducted in 2013 among 90 mothers with deaf children. The data-collection instrument included the stigma scale in the mothers of children with disabilities. The reliability and validity of the instrument were confirmed through content validity and Cronbach’s alpha coefficient (α=86%), respectively. Data were analyzed using SPSS-15 software. Results: Results showed that most mothers suffer from stigma due to having a deaf child. The mean stigma score was 96.48 ±27.72. In total, 24.4% of mothers reported that they had received strange and mocking looks; 72.2% regarded child deafness as a sign of divine retribution; and 33.3% felt ashamed of their child’s deafness. There was an inverse relationship between the mother’s level of education and mean stigma scores (P<0.033). The stigma score was higher in mothers who were living independently of their relatives (P<0.029). The mean stigma score in mothers of children with a cochlear implant was lower than that of mothers of children with earphones (86.70 vs. 99.64), and this difference tended towards significance (P=0.057). Conclusion: This study showed that half of all mothers with deaf children were scorned and felt ashamed of having a deaf child in the family because of the stigma. The majority of mothers with deaf children felt stigmatized, and only their education and residency status affected this issue. The mothers of cochlear-implanted children perceived less stigma. Due to the various social and psychological problems caused by hearing impairment, it is necessary to consider the emotional health and psychological state of the mothers in addition to rehabilitation

  17. Schizophrenia and the cultural epidemiology of stigma in Bangalore, India.

    PubMed

    Raguram, Ramanathan; Raghu, Thubarahalli M; Vounatsou, Penelope; Weiss, Mitchell G

    2004-11-01

    Illness-related stigma is a complex and important issue, and its social impact contributes to a hidden burden of many health problems. Mitigating effects of stigma are a priority for mental health policy, especially for schizophrenia. Although numerous studies document its impact on patients and their families, health studies of stigma typically regard it in global terms without adequate attention to the conceptual and practical importance of sociocultural contexts and the particular features of illness that evoke stigma. Research at a psychiatric referral center in Bangalore, India, studied the cultural epidemiology of schizophrenia and stigma in interviews with family caretakers of 60 patients, using a locally adapted EMIC interview and the Positive and Negative Symptom Scale. An index of 13 stigma queries based on Goffman's formulation covered relevant aspects and proved to be internally consistent (Cronbach alpha = 0.81). Multivariate statistical regression and qualitative analysis of narratives were used to analyze this stigma index and identify explanatory variables based on cultural patterns of distress (PD), perceived causes (PC), and previous help seeking (HS). Significant variables included suspiciousness and inappropriate sexual behavior (PD), heredity and bad deeds (PC), and informal help seeking (HS). Previous allopathic help seeking was negatively associated with stigma. Analysis of coded text segments from respondent narratives showed how these variables were related to family-perceived stigma, with reference to marriage practices, moral meanings of schizophrenia, and ways in which effective allopathic care minimized stigma. Findings identify features of schizophrenia-related stigma in India, contribute to comparative culture studies, and inform practical approaches to mitigate stigma through community awareness and improved mental health services. PMID:15505517

  18. HIV Stigma in Prisons and Jails: Results from a Staff Survey.

    PubMed

    Belenko, Steven; Dembo, Richard; Copenhaver, Michael; Hiller, Matthew; Swan, Holly; Albizu Garcia, Carmen; O'Connell, Daniel; Oser, Carrie; Pearson, Frank; Pankow, Jennifer

    2016-01-01

    With numerous HIV service gaps in prisons and jails, there has been little research on HIV stigma attitudes among correctional staff. Such attitudes may undermine HIV services for inmates at risk of or infected with HIV. This HIV stigma attitudes survey among 218 correctional staff in 32 US facilities (1) provides an overview of staff's stigma attitudes, (2) reports psychometric analyses of domains in Earnshaw and Chaudoir's HIV Stigma Framework (HSF), and (3) explores differences in stigma attitudes among different staff types. Overall, correctional and medical staff expressed non stigmatizing attitudes toward people living with HIV/AIDS, but perceived that stigma and discrimination exist in others. Factor analyses revealed a three factor structure capturing two mechanisms of the HSF (prejudice, discrimination). Few factor score differences were found by staff type or setting. Implications for correctional HIV services and future research on HIV stigma attitudes are discussed. PMID:26036464

  19. The Stigma of Personality Disorders.

    PubMed

    Sheehan, Lindsay; Nieweglowski, Katherine; Corrigan, Patrick

    2016-01-01

    This article reviews the recent literature on the stigma of personality disorders, including an overview of general mental illness stigma and an examination of the personality-specific stigma. Overall, public knowledge of personality disorders is low, and people with personality disorders may be perceived as purposefully misbehaving rather than experiencing an illness. Health provider stigma seems particularly pernicious for those with borderline personality disorder. Most stigma research on personality disorders has been completed outside the USA, and few stigma-change interventions specific to personality disorder have been scientifically tested. Limited evidence suggests that health provider training can improve stigmatizing attitudes and that interventions combining positive messages of recovery potential with biological etiology will be most impactful to reduce stigma. Anti-stigma interventions designed specifically for health providers, family members, criminal justice personnel, and law enforcement seem particularly beneficial, given these sources of stigma. PMID:26780206

  20. “You’re an Open Target to Be Abused”: A Qualitative Study of Stigma and HIV Self-Disclosure Among Black Men Who Have Sex With Men

    PubMed Central

    Voisin, Dexter R.

    2013-01-01

    The HIV/AIDS epidemic is a health crisis among Black men who have sex with men (MSM). HIV-related stigma presents a primary barrier to sexual communication and effective HIV prevention. Using in-depth, qualitative interviews conducted with 20 HIV-positive Black MSM between 2007 and 2008 in Chicago, Illinois, we explored the themes related to HIV-related stigma and the underlying messages HIV-positive Black MSM receive regarding their status. Stigmatizing messages stem from family, churches, and the gay community and from negative, internalized, beliefs HIV-positive Black MSM held about infected individuals before their own infection. HIV stigma influences sexual silence around HIV disclosure, especially to sexual partners. PMID:24134345

  1. Respondent-driven sampling to assess mental health outcomes, stigma and acceptance among women raising children born from sexual violence-related pregnancies in eastern Democratic Republic of Congo

    PubMed Central

    Scott, Jennifer; Rouhani, Shada; Greiner, Ashley; Albutt, Katherine; Kuwert, Philipp; Hacker, Michele R; VanRooyen, Michael; Bartels, Susan

    2015-01-01

    Objectives Assess mental health outcomes among women raising children from sexual violence-related pregnancies (SVRPs) in eastern Democratic Republic of Congo and stigma toward and acceptance of women and their children. Design Participants were recruited using respondent-driven sampling. Setting Bukavu, Democratic Republic of Congo in 2012. Participants 757 adult women raising children from SVRPs were interviewed. A woman aged 18 and older was eligible for the study if she self-identified as a sexual violence survivor since the start of the conflict (∼1996), conceived an SVRP, delivered a liveborn child and was currently raising the child. A woman was ineligible for the study if the SVRP ended with a spontaneous abortion or fetal demise or the child was not currently living or in the care of the biological mother. Intervention Trained female Congolese interviewers verbally administered a quantitative survey after obtaining verbal informed consent. Outcome measures Symptom criteria for major depressive disorder, post-traumatic stress disorder, anxiety and suicidality were assessed, as well as stigma toward the woman and her child. Acceptance of the woman and child from the spouse, family and community were analysed. Results 48.6% met symptom criteria for major depressive disorder, 57.9% for post-traumatic stress disorder, 43.3% for anxiety and 34.2% reported suicidality. Women who reported stigma from the community (38.4%) or who reported stigma toward the child from the spouse (42.9%), family (31.8%) or community (38.1%) were significantly more likely to meet symptom criteria for most mental health disorders. Although not statistically significant, participants who reported acceptance and acceptance of their children from the spouse, family and community were less likely to meet symptom criteria. Conclusions Women raising children from SVRPs experience symptoms of mental health disorders. Programming addressing stigma and acceptance following sexual violence may

  2. Understanding the Effects of Multiple Stigmas Among Formerly Incarcerated HIV-Positive African American Men.

    PubMed

    Brinkley-Rubinstein, Lauren

    2015-04-01

    Race, HIV, and incarceration, as individual and intersecting markers of social identity, have associated stigma. While some research has indicated multiple burdens of stigma can be additive, there remains a lack of investigation relative to the effects of stigma among minorities who experience both HIV and incarceration. Therefore, the current study examines the impact of multiple forms of stigma via a series of ethnographic interviews (n = 46) conducted with 12 African American men over a one-year period. Results suggest that intersecting forms of stigma can have a severe impact on the general health, mental health, and the reintegration process of formerly incarcerated HIV-positive men. Additionally, participants often conceptualized all forms of stigma separately, which resulted in compounded burden of navigation. The experience of multiple forms of stigma was also often internalized as self-stigma whereby HIV-positive individuals with a history of incarceration assumed dominant norms related to both HIV and incarceration. PMID:25915701

  3. The tumor virus landscape of AIDS-related lymphomas.

    PubMed

    Arvey, Aaron; Ojesina, Akinyemi I; Pedamallu, Chandra Sekhar; Ballon, Gianna; Jung, Joonil; Duke, Fujiko; Leoncini, Lorenzo; De Falco, Giulia; Bressman, Eric; Tam, Wayne; Chadburn, Amy; Meyerson, Matthew; Cesarman, Ethel

    2015-05-14

    Immunodeficiency dramatically increases susceptibility to cancer as a result of reduced immune surveillance and enhanced opportunities for virus-mediated oncogenesis. Although AIDS-related lymphomas (ARLs) are frequently associated with known oncogenic viruses, many cases contain no known transforming virus. To discover novel transforming viruses, we profiled a set of ARL samples using whole transcriptome sequencing. We determined that Epstein-Barr virus (EBV) was the only virus detected in the tumor samples of this cohort, suggesting that if unidentified pathogens exist in this disease, they are present in <10% of cases or undetectable by our methods. To evaluate the role of EBV in ARL pathogenesis, we analyzed viral gene expression and found highly heterogeneous patterns of viral transcription across samples. We also found significant heterogeneity of viral antigen expression across a large cohort, with many patient samples presenting with restricted type I viral latency, indicating that EBV latency proteins are under increased immunosurveillance in the post-combined antiretroviral therapies era. Furthermore, EBV infection of lymphoma cells in HIV-positive individuals was associated with a distinct host gene expression program. These findings provide insight into the joint host-virus regulatory network of primary ARL tumor samples and expand our understanding of virus-associated oncogenesis. Our findings may also have therapeutic implications, as treatment may be personalized to target specific viral and virus-associated host processes that are only present in a subset of patients. PMID:25827832

  4. Perceived Mental Illness Stigma, Intimate Relationships, and Sexual Risk Behavior in Youth with Mental Illness

    ERIC Educational Resources Information Center

    Elkington, Katherine S.; Hackler, Dusty; Walsh, Tracy A.; Latack, Jessica A.; McKinnon, Karen; Borges, Cristiane; Wright, Eric R.; Wainberg, Milton L.

    2013-01-01

    The current study examines the role of mental illness-related stigma on romantic or sexual relationships and sexual behavior among youth with mental illness (MI), including youths' experiences of stigma, the internalization of these experiences, and the behavior associated with managing stigma within romantic and sexual relationships. We conducted…

  5. The Stigma of Mental Illness

    ERIC Educational Resources Information Center

    Overton, Stacy L.; Medina, Sondra L.

    2008-01-01

    Stigma surrounding major mental illness creates many barriers. People who experience mental illness face discrimination and prejudice when renting homes, applying for jobs, and accessing mental health services. The authors review the current literature regarding stigma and mental illness. They define stigma and review theories that explain its…

  6. Spatial Stigma and Health in Postindustrial Detroit.

    PubMed

    Graham, Louis F; Padilla, Mark B; Lopez, William D; Stern, Alexandra M; Peterson, Jerry; Keene, Danya E

    2016-01-01

    An emerging body of research suggests that those who reside in socially and economically marginalized places may be marked by a stigma of place, referred to as spatial stigma, which influences their sense of self, their daily experiences, and their relations with outsiders. Researchers conducted 60 semistructured interviews at partnering community-based organizations during summer 2011 with African American and Latina/o, structurally disadvantaged youth of diverse gender and sexual identities who were between 18 and 26 years of age residing in Detroit, Michigan. The disadvantaged structural conditions and dilapidated built environment were common themes in participants' narratives. Beyond these descriptions, participants' framings and expressions of their experiences in and perceptions of these spaces alluded to reputational qualities of their city and particular areas of their city that appear related to spatial stigma. Young Detroit residents articulated the ways that they experience and navigate the symbolic degradation of their city. PMID:26833796

  7. Associations between Social Capital and HIV Stigma in Chennai, India: Considerations for Prevention Intervention Design

    ERIC Educational Resources Information Center

    Sivaram, Sudha; Zelaya, Carla; Srikrishnan, A. K.; Latkin, Carl; Go, V. F.; Solomon, Suniti; Celentano, David

    2009-01-01

    Stigma against persons living with HIV/AIDS (PLHA) is a barrier to seeking prevention education, HIV testing, and care. Social capital has been reported as an important factor influencing HIV prevention and social support upon infection. In the study, we explored the associations between social capital and stigma among men and women who are…

  8. Preventing HIV among Latino and African American Gay and Bisexual Men in a Context of HIV-Related Stigma, Discrimination, and Homophobia: Perspectives of Providers

    PubMed Central

    Brooks, Ronald A.; Etzel, Mark A.; Hinojos, Ernesto; Henry, Charles L.; Perez, Mario

    2005-01-01

    HIV-related stigma, discrimination, and homophobia impede community based efforts to combat HIV disease among Latino and African American gay and bisexual men. This commentary highlights ways to address these social biases in communities of color in Los Angeles from the perspectives of staff from HIV prevention programs. Information was collected from HIV prevention program staff participating in a two-day symposium. The outcomes from the symposium offer strategies for developing and implementing HIV prevention services for Latino and African American gay and bisexual men, which include: 1) addressing social biases present in a community that can hinder, and even prohibit, utilization of effective HIV prevention programs; 2) recasting HIV prevention messages in a broader social or health context; 3) developing culturally appropriate HIV prevention messages; 4) exploring new modalities and venues for delivering HIV prevention messages that are appropriate for gay and bisexual men of color and the communities in which they live; and 5) broadening the target of HIV prevention services to include service providers, local institutions and agencies, and the community at-large. These strategies underscore the need to consider the social and contextual factors of a community when designing and implementing HIV prevention programs. PMID:16283834

  9. 'They won't change it back in their heads that we're trash': the intersection of sex work-related stigma and evolving policing strategies.

    PubMed

    Krüsi, Andrea; Kerr, Thomas; Taylor, Christina; Rhodes, Tim; Shannon, Kate

    2016-09-01

    In Vancouver, Canada, there has been a continuous shift in the policing of sex work away from arresting sex workers, which led to the implementation of a policing strategy that explicitly prioritised the safety of sex workers and continued to target sex workers' clients. We conducted semi-structured interviews with 26 cisgender and five transgender women street-based sex workers about their working conditions. Data were analysed thematically and by drawing on concepts of structural stigma and vulnerability. Our results indicated that despite police rhetoric of prioritising the safety of sex workers, participants were denied their citizenship rights for police protection by virtue of their 'risky' occupation and were thus responsiblised for sex work related violence. Our findings further suggest that sex workers' interactions with neighbourhood residents were predominantly shaped by a discourse of sex workers as a 'risky' presence in the urban landscape and police took swift action in removing sex workers in the case of complaints. This study highlights that intersecting regimes of stigmatisation and criminalisation continued to undermine sex workers citizenship rights to police protection and legal recourse and perpetuated labour conditions that render sex workers at increased risk for violence and poor health. PMID:27113456

  10. Effect of neighborhood stigma on economic transactions

    PubMed Central

    Besbris, Max; Faber, Jacob William; Rich, Peter; Sharkey, Patrick

    2015-01-01

    The hypothesis of neighborhood stigma predicts that individuals who reside in areas known for high crime, poverty, disorder, and/or racial isolation embody the negative characteristics attributed to their communities and experience suspicion and mistrust in their interactions with strangers. This article provides an experimental test of whether neighborhood stigma affects individuals in one domain of social life: economic transactions. To evaluate the neighborhood stigma hypothesis, this study adopts an audit design in a locally organized, online classified market, using advertisements for used iPhones and randomly manipulating the neighborhood of the seller. The primary outcome under study is the number of responses generated by sellers from disadvantaged relative to advantaged neighborhoods. Advertisements from disadvantaged neighborhoods received significantly fewer responses than advertisements from advantaged neighborhoods. Results provide robust evidence that individuals from disadvantaged neighborhoods bear a stigma that influences their prospects in economic exchanges. The stigma is greater for advertisements originating from disadvantaged neighborhoods where the majority of residents are black. This evidence reveals that residence in a disadvantaged neighborhood not only affects individuals through mechanisms involving economic resources, institutional quality, and social networks but also affects residents through the perceptions of others. PMID:25848041

  11. Effect of neighborhood stigma on economic transactions.

    PubMed

    Besbris, Max; Faber, Jacob William; Rich, Peter; Sharkey, Patrick

    2015-04-21

    The hypothesis of neighborhood stigma predicts that individuals who reside in areas known for high crime, poverty, disorder, and/or racial isolation embody the negative characteristics attributed to their communities and experience suspicion and mistrust in their interactions with strangers. This article provides an experimental test of whether neighborhood stigma affects individuals in one domain of social life: economic transactions. To evaluate the neighborhood stigma hypothesis, this study adopts an audit design in a locally organized, online classified market, using advertisements for used iPhones and randomly manipulating the neighborhood of the seller. The primary outcome under study is the number of responses generated by sellers from disadvantaged relative to advantaged neighborhoods. Advertisements from disadvantaged neighborhoods received significantly fewer responses than advertisements from advantaged neighborhoods. Results provide robust evidence that individuals from disadvantaged neighborhoods bear a stigma that influences their prospects in economic exchanges. The stigma is greater for advertisements originating from disadvantaged neighborhoods where the majority of residents are black. This evidence reveals that residence in a disadvantaged neighborhood not only affects individuals through mechanisms involving economic resources, institutional quality, and social networks but also affects residents through the perceptions of others. PMID:25848041

  12. Tabula diptycha: Differential HIV knowledge, stigma, and intended behavioural outcomes amongst visitors at Vietnam's Pain and Hope exhibition

    PubMed Central

    Nambiar, Devaki; Nguyen, Mai Huong; Giang, Le Minh; Hirsch, Jennifer

    2013-01-01

    Stigma reduction efforts in Vietnam have been encumbered by contradictory and dynamic views of People Living With HIV (PLWH) and the epidemic over the past two decades. World AIDS Day 2010 saw the launch of Pain and Hope, a museum exhibition showcasing the lives and experiences of Vietnamese People Living with AIDS at the Vietnam Museum of Ethnology (VME). Between December 2010 and May 2011, a random sample of visitors completed exit surveys regarding attitudes towards the exhibition and Vietnamese living with HIV/AIDS. The survey sought to determine what kind of visitors the museum and exhibition attracted, and the stigma-related impacts of this kind of exposure and parasocial contact. Of 2,500 Vietnamese visitors randomly selected, 852 completed the computer surveys (response rate of 34.1%), 92.3% of whom had seen Pain and Hope. We found two sub-strata or types of visitors attending the exhibition, with varying demographic characteristics, HIV-related knowledge, some differences in stigma ideation, and clear differences in intended behaviours specifically attributable to the exhibition. Social desirability biases notwithstanding, there has emerged a diptych typology of visitors to the VME, for whom the experience of the exhibition is likely interacting with divergent prior knowledge, experiences, interests and motivations. PMID:22974183

  13. HIV Stigma and Social Support among African Americans

    PubMed Central

    Davis, E. Maxwell; Banks, Denedria; Bing, Eric G.

    2008-01-01

    Abstract HIV-related stigma and discrimination negatively impact African Americans living with HIV. Social support theory hypothesizes that social support can serve to protect individuals against the negative effects of stressors, such as discrimination, by leading them to interpret stressful occasions less negatively. This study sought to examine the relationship between perceived social support and perceived HIV stigma among HIV-positive African Americans. A cross-sectional convenience sample of 283 HIV-positive African Americans was recruited from three social service agencies. Bivariate and multivariate regressions were used to determine the variables predicting perceived HIV stigma. The study participants were found to have a wide variety of opinions concerning perceived HIV stigma. Of the three different sources of perceived social support examined (from family, friends and a “special person”), only perceived social support from friends was found to be related to perceived HIV stigma when controlling for the presence of other relevant factors. High perceived social support from friends was associated with less perceived HIV stigma. Other factors associated with low perceived HIV stigma included a lack of current symptoms of major depression, a longer time since HIV diagnosis and higher education. Information about the beneficial effects of perceived social support from friends and other factors can help to provide guidance to those working to decrease the negative impact of HIV stigma among HIV-positive African Americans. PMID:18373417

  14. Social media as social capital of LGB individuals in Hong Kong: its relations with group membership, stigma, and mental well-being.

    PubMed

    Chong, Eddie S K; Zhang, Yin; Mak, Winnie W S; Pang, Ingrid H Y

    2015-03-01

    Social media are found to facilitate social information exchange among lesbian, gay, and bisexual (LGB) individuals who are subjected to social stigma. This study tested the protective role of LGB-tailored social media uses and gratifications in promoting LGB group membership, which we hypothesized to reduce LGB stigma and enhance mental health among LGB individuals in Hong Kong. Based on a sample of 233 Chinese LGB individuals in Hong Kong, structural equation modeling showed evidence for our hypotheses, χ(df=62)(2)= 88.20, GFI = 0.95, CFI = 0.98, NNFI = 0.98, SRMR = 0.07, RMSEA = 0.04. Community surveillance, identity expression, and emotional support on social media may promote mental health by instilling a sense of group membership and reducing stigma. Social media may build camaraderie and bolster resilience among LGB individuals that may otherwise be difficult in conservative regions. PMID:25576016

  15. Travel-Related AIDS Awareness Among Young Gulf Arab Men.

    PubMed

    Al Mulla KMA; Pugh; Hossain; Behrens

    1996-12-01

    Background: The Federal Ministry of Health of the United Arab Emirates (UAE) has a vigorous AIDS control programme that conforms to international guidelines. Available information on HIV infection in the Al Ain district (UAE) shows a low incidence among its citizens and a low frequency of spread by the sexual route. This is in keeping with cultural factors perceived to have withstood the potential for sexual spread in the Arabian Gulf area. However, there is an acknowledged concern for the risk to young male citizens while traveling abroad to popular destinations such as India, Thailand, and the Philippines. Methods: The authors attempted to determine the knowledge and attitude about AIDS among Emirati males (aged 18-25 years) by confidential, self-administered questionnaire (modification of a tested approach in the UK). A total sample of 298 subjects participated (94% response), comprising 47 medical students (16%), 194 nonmedical students (65%), and 57 school graduates (19%). Of all participants, 253 (85%) were unmarried. Results: Salient discriminatory findings were that medical students significantly differed from the other two groups in stating that AIDS could not be identified in a person by appearance (p=.003) and that the use of condoms was protective while traveling abroad (p<.001). The latter issue also reflected a significant difference between married and unmarried subjects, in that marital status influenced a positive response to the protective role of condoms. Among all subjects, 41% had visited Asian countries outside the Gulf region and 20% intended to visit. Conclusion: This study demonstrated a prevailing uncertainty about AIDS knowledge and a possible fear of AIDS, both of which tend to increase acceptance of special education programmes. PMID:9815461

  16. The social context of food insecurity among persons living with HIV/AIDS in rural Uganda

    PubMed Central

    Tsai, Alexander C.; Bangsberg, David R.; Emenyonu, Nneka; Senkungu, Jude K.; Martin, Jeffrey N.; Weiser, Sheri D.

    2011-01-01

    HIV/AIDS and food insecurity are two of the leading causes of morbidity and mortality in sub-Saharan Africa, with each heightening the vulnerability to, and worsening the severity of, the other. Less research has focused on the social determinants of food insecurity in resource-limited settings, including social support and HIV-related stigma. In this study, we analyzed data from a cohort of 456 persons from the Uganda AIDS Rural Treatment Outcomes study, an ongoing prospective cohort of persons living with HIV/AIDS (PLWHA) initiating HIV antiretroviral therapy in Mbarara, Uganda. Quarterly data were collected by structured interviews. The primary outcome, food insecurity, was measured with the Household Food Insecurity Access Scale. Key covariates of interest included social support, internalized HIV-related stigma, HIV-related enacted stigma, and disclosure of HIV serostatus. Severe food insecurity was highly prevalent overall (38%) and more prevalent among women than among men. Social support, HIV disclosure, and internalized HIV-related stigma were associated with food insecurity; these associations persisted after adjusting for household wealth, employment status, and other previously identified correlates of food insecurity. The adverse effects of internalized stigma persisted in a lagged specification, and the beneficial effect of social support further persisted after the inclusion of fixed effects. International organizations have increasingly advocated for addressing food insecurity as part of HIV/AIDS programming to improve morbidity and mortality. This study provides quantitative evidence on social determinants of food insecurity among PLWHA in resource-limited settings and suggests points of intervention. These findings also indicate that structural interventions to improve social support and/or decrease HIV-related stigma may also improve the food security of PLWHA. PMID:22019367

  17. Self-clarity and different clusters of insight and self-stigma in mental illness.

    PubMed

    Hasson-Ohayon, Ilanit; Mashiach-Eizenberg, Michal; Lysaker, Paul H; Roe, David

    2016-06-30

    The current study explored the self-experience of persons with Serious Mental Illness (SMI) by investigating the associations between different insight and self-stigma clusters, self-clarity, hope, recovery, and functioning. One hundred seven persons diagnosed with a SMI were administered six scales: self-concept clarity, self-stigma, insight into the illness, hope, recovery, and functioning. Correlations and cluster analyses were performed. Insight, as measured by a self-report scale was not related to any other variable. Self-stigma was negatively associated with self-clarity, hope, recovery and functioning. Three clusters emerged: moderate stigma/high insight (n=31), high stigma/moderate insight (n=28), and low stigma/low insight (n=42). The group with low stigma and low insight had higher mean levels of self-clarity and hope than the other two groups. There were no significant differences between cluster 1 (moderate stigma/high insight) and cluster 2 (high stigma/moderate insight) in all the variables beside self-clarity. The group with moderate stigma and high insight had significantly higher mean levels of self-clarity than the group with high stigma and moderate insight. Results reveal that when people diagnosed with SMI do not have high levels of self-stigma they often report a positive and clear sense of self accompanied with hope, regardless of having low insight. PMID:27138823

  18. Exploring children's stigmatisation of AIDS-affected children in Zimbabwe through drawings and stories.

    PubMed

    Campbell, Catherine; Skovdal, Morten; Mupambireyi, Zivai; Gregson, Simon

    2010-09-01

    AIDS-related stigma is a major contributor to the health and psychosocial well-being of children affected by AIDS. Whilst it is often suggested that AIDS-affected children may be stigmatised by other children, to date no research focuses specifically on child-on-child stigma. Using social representations theory, we explore how Zimbabwean children represent AIDS-affected peers, examining (i) whether or not they stigmatise, (ii) the forms stigma takes, and (iii) the existence of non-stigmatising representations that might serve as resources for stigma-reduction interventions. Our interest in identifying both stigmatising and non-stigmatising representations is informed by a theory of change which accords a central role to community-level debate and dialogue in challenging and reframing stigmatising representations. In late 2008, 50 children (aged 10-12) were asked to "draw a picture of a child whose family has been affected by AIDS in any way", and to write short stories about their drawings. Thematic analysis of stories and drawings revealed frequent references to stigmatisation of AIDS-affected children--with other children refusing to play with them, generally keeping their distance and bullying them. However children also frequently showed a degree of empathy and respect for AIDS-affected children's caring roles and for their love and concern for their AIDS-infected parents. We argue that a key strategy for stigma-reduction interventions is to open up social spaces in which group members (in this case children) can identify the diverse and contradictory ways they view a stigmatised out-group, providing opportunities for them to exercise agency in collectively challenging and renegotiating negative representations. Contrary to the common view that drawings enable children to achieve greater emotional expression than written stories, our children's drawings tended to be comparatively stereotypical and normative. It was in written stories that children most

  19. Stigma and Schizophrenia: Directions in Student Training

    ERIC Educational Resources Information Center

    Mason, Susan E.; Miller, Rachel

    2006-01-01

    The persistence of stigma related to schizophrenia is addressed as a continuing challenge for social work students working in mental health. Student education is best grounded in direct clinical work with clients in conjunction with field supervision and classroom education. Through direct practice in individual and group sessions, students learn…

  20. 'People like me don't make things like that': Participatory video as a method for reducing leprosy-related stigma.

    PubMed

    Peters, R M H; Zweekhorst, M B M; van Brakel, W H; Bunders, J F G; Irwanto

    2016-01-01

    The Stigma Assessment and Reduction of Impact project aims to assess the effectiveness of stigma-reduction interventions in the field of leprosy. Participatory video seemed to be a promising approach to reducing stigma among stigmatized individuals (in this study the video makers) and the stigmatisers (video audience). This study focuses on the video makers and seeks to assess the impact on them of making a participatory video and to increase understanding of how to deal with foreseeable difficulties. Participants were selected on the basis of criteria and in collaboration with the community health centre. This study draws on six qualitative methods including interviews with the video makers and participant observation. Triangulation was used to increase the validity of the findings. Two videos were produced. The impact on participants ranged from having a good time to a greater sense of togetherness, increased self-esteem, individual agency and willingness to take action in the community. Concealment of leprosy is a persistent challenge, and physical limitations and group dynamics are also areas that require attention. Provided these three areas are properly taken into account, participatory video has the potential to address stigma at least at three levels - intrapersonal, interpersonal and community - and possibly more. PMID:27219896

  1. "The way I see it": the effect of stigma and depression on self-perceived body image among HIV-positive individuals on treatment in British Columbia, Canada.

    PubMed

    Palmer, Alexis K; Duncan, Katrina C; Ayalew, Beza; Zhang, Wendy; Tzemis, Despina; Lima, V; Montaner, Julio S G; Hogg, Robert S

    2011-11-01

    With significant reductions in AIDS-related morbidity and mortality, HIV is increasingly viewed as a chronic condition. However, people on antiretroviral therapy (ART) are experiencing new challenges such as metabolic and morphological body changes, which may affect self-perceived body image. The concept of body image is complex and encompasses an individual's perception of their existential self, physical self and social interpretation of their body by others. The Longitudinal Investigations into Supportive and Ancillary Health Services (LISA) cohort is a prospective study of HIV-positive persons on ART. An interviewer-administered survey collects socio-demographic and health information including body image, stigma, depression, food insecurity, and quality of life (QoL). In bivariate analyses, Chi-squared or Wilcoxon rank sum tests were used to compare individuals reporting positive body image with those reporting negative body image. Multivariate logistic regression was used to examine associations between negative body image and covariates. Of 451 LISA participants, 47% reported negative body image. The adjusted multivariate analysis showed participants who reported high stigma in the presence of depressive symptoms were more likely to have negative body image compared to people reporting low stigma and no depressive symptoms (adjusted odds ratio [AOR]: 2.41, confidence interval [CI]: 1.24-4.68). The estimated probability of a person having positive body image without stigma or depression was 68%. When stigma alone was included, the probability dropped to 59%, and when depression was included alone the probability dropped to 34%. Depressive symptoms and high stigma combined resulted in a probability of reporting positive body image of 27%. Further efforts are needed to address body image among people living with HIV. In order to lessen the impacts of depression on body image, such issues must be addressed in health care settings. Community interventions are

  2. Stigma: a Unique Source of Distress for Family Members of Individuals with Mental Illness.

    PubMed

    Muralidharan, Anjana; Lucksted, Alicia; Medoff, Deborah; Fang, Li Juan; Dixon, Lisa

    2016-07-01

    To distinguish the impact of mental illness stigma from that of other negative caregiving experiences, this study examined the unique relationships between stigma and caregiver/family functioning. Adult relatives (n = 437) of individuals with mental illness completed questionnaires regarding caregiving experiences, distress, empowerment, and family functioning, as part of a larger study. Regression analyses examined the relationship between stigma and caregiver/family variables, while controlling for other negative caregiving experiences. Stigma was uniquely associated with caregiver distress, empowerment, and family functioning. Mental illness stigma is a potent source of distress for families and an important target of family services. PMID:25168187

  3. Culture and stigma: adding moral experience to stigma theory.

    PubMed

    Yang, Lawrence Hsin; Kleinman, Arthur; Link, Bruce G; Phelan, Jo C; Lee, Sing; Good, Byron

    2007-04-01

    Definitions and theoretical models of the stigma construct have gradually progressed from an individualistic focus towards an emphasis on stigma's social aspects. Building on other theorists' notions of stigma as a social, interpretive, or cultural process, this paper introduces the notion of stigma as an essentially moral issue in which stigmatized conditions threaten what is at stake for sufferers. The concept of moral experience, or what is most at stake for actors in a local social world, provides a new interpretive lens by which to understand the behaviors of both the stigmatized and stigmatizers, for it allows an examination of both as living with regard to what really matters and what is threatened. We hypothesize that stigma exerts its core effects by threatening the loss or diminution of what is most at stake, or by actually diminishing or destroying that lived value. We utilize two case examples of stigma--mental illness in China and first-onset schizophrenia patients in the United States--to illustrate this concept. We further utilize the Chinese example of 'face' to illustrate stigma as having dimensions that are moral-somatic (where values are linked to physical experiences) and moral-emotional (values are linked to emotional states). After reviewing literature on how existing stigma theory has led to a predominance of research assessing the individual, we conclude by outlining how the concept of moral experience may inform future stigma measurement. We propose that by identifying how stigma is a moral experience, new targets can be created for anti-stigma intervention programs and their evaluation. Further, we recommend the use of transactional methodologies and multiple perspectives and methods to more fully capture the interpersonal core of stigma as framed by theories of moral experience. PMID:17188411

  4. Parental Reports of Stigma Associated with Child's Disorder of Sex Development

    PubMed Central

    Rolston, Aimee M.; Vilain, Eric; Sandberg, David E.

    2015-01-01

    Disorders of sex development (DSD) are congenital conditions in which chromosomal, gonadal, or anatomic sex development is atypical. DSD-associated stigma is purported to threaten positive psychosocial adaptation. Parental perceptions of DSD-related stigma were assessed in 154 parents of 107 children (newborn–17 years) questionnaire comprising two scales, child-focused and parent-focused, and three subscales, perceived stigmatization, future worries, and feelings about the child's condition. Medical chart excerpts identified diagnoses and clinical management details. Stigma scale scores were generally low. Parents of children with DSD reported less stigma than parents of children with epilepsy; however, a notable proportion rated individual items in the moderate to high range. Stigma was unrelated to child's age or the number of DSD-related surgeries. Child-focused stigma scores exceeded parent-focused stigma and mothers reported more stigma than fathers, with a moderate level of agreement. Within 46,XY DSD, reported stigma was higher for children reared as girls. In conclusion, in this first quantitative study of ongoing experiences, DSD-related stigma in childhood and adolescence, while limited in the aggregate, is reported at moderate to high levels in specific areas. Because stigma threatens positive psychosocial adaptation, systematic screening for these concerns should be considered and, when reported, targeted for psychoeducational counseling. PMID:25918529

  5. A Qualitative Analysis of the Perception of Stigma Among Latinos Receiving Antidepressants

    PubMed Central

    Interian, Alejandro; Martinez, Igda E.; Guarnaccia, Peter J.; Vega, William A.; Escobar, Javier I.

    2008-01-01

    Objective This study sought to describe the role of stigma in antidepressant adherence among Latinos. Methods The study utilized data generated from six focus groups of Latino outpatients receiving antidepressants (N=30). By using a grounded theory approach, qualitative analysis focused specifically on the role of stigma in antidepressant treatment, as well as salient Latino values. Results Perceptions of stigma were related to both the diagnosis of depression and use of antidepressant medication. Qualitative analyses showed that antidepressant use was seen as implying more severe illness, weakness or failure to cope with problems, and being under the effects of a drug. Reports of stigma were also related to social consequences. Also, the perceived negative attributes of antidepressant use were at odds with self-perceived cultural values. Conclusions Stigma was a prominent concern among Latinos receiving antidepressants, and stigma often affected adherence. Furthermore, culture is likely to play an important role in the communication of stigma and its associated complications. PMID:18048562

  6. Perspectives on perceived stigma and self-stigma in adult male patients with depression

    PubMed Central

    Latalova, Klara; Kamaradova, Dana; Prasko, Jan

    2014-01-01

    There are two principal types of stigma in mental illness, ie, “public stigma” and “self-stigma”. Public stigma is the perception held by others that the mentally ill individual is socially undesirable. Stigmatized persons may internalize perceived prejudices and develop negative feelings about themselves. The result of this process is “self-stigma”. Stigma has emerged as an important barrier to the treatment of depression and other mental illnesses. Gender and race are related to stigma. Among depressed patients, males and African-Americans have higher levels of self-stigma than females and Caucasians. Perceived stigma and self-stigma affect willingness to seek help in both genders and races. African-Americans demonstrate a less positive attitude towards mental health treatments than Caucasians. Religious beliefs play a role in their coping with mental illness. Certain prejudicial beliefs about mental illness are shared globally. Structural modeling indicates that conformity to dominant masculine gender norms (“boys don’t cry”) leads to self-stigmatization in depressed men who feel that they should be able to cope with their illness without professional help. These findings suggest that targeting men’s feelings about their depression and other mental health problems could be a more successful approach to change help-seeking attitudes than trying to change those attitudes directly. Further, the inhibitory effect of traditional masculine gender norms on help-seeking can be overcome if depressed men feel that a genuine connection leading to mutual understanding has been established with a health care professional. PMID:25114531

  7. Development of laser-aided plasma diagnostics and related technology

    SciTech Connect

    Kawahata, K.; Akiyama, T.; Pavlichenko, R.; Tanaka, K.; Nakayama, K.; Okajima, S.

    2008-03-12

    Laser-aided plasma diagnostics, aiming for establishment of reliable density measurement in next step magnetically confined fusion devices, are under development at the National Institute for Fusion Science. A new type of two color laser (57.2/47.6-{mu}m CH{sub 3}OD) interferometer has been developed and its original function, vibration subtraction, was confirmed in a test stand. The line integrated density measurements by the polarimeter were demonstrated at Compact Helical System by the Cotton-Mouton polarimeter and at the LHD by the Faraday rotation polarimeter.

  8. Balancing engagement/detachment in AIDS-related multiple losses.

    PubMed

    Carmack, B J

    1992-01-01

    The process gay persons use to manage the multiple losses and cumulative grief from losing lovers, friends, colleagues and clients to AIDS was explored. Interviews with gay individuals (n = 19) in a large urban area in the West provided data for conceptual coding and comparative analysis. Balancing engagement and detachment was identified as the basic social-psychological process that described how gay individuals struggled to reach an optimal balance in their involvement in the needs of individuals and the community. Four conceptual categories were identified: dysfunctional engagement, functional engagement, functional detachment and dysfunctional detachment. These four categories occur within the contexts of previous life style and redefinition of personal values. PMID:1541482

  9. HIV/AIDS Knowledge, Attitudes, Related Behaviors, and Sources of Information among Korean Adolescents

    ERIC Educational Resources Information Center

    Yoo, Hyera; Lee, Sun Hae; Kwon, Bo Eun; Chung, Sulki; Kim, Sanghee

    2005-01-01

    To examine HIV/AIDS knowledge, attitudes, related behaviors, and sources of HIV/AIDS information among high school-aged students in South Korea. One thousand and seventy-seven students (586 females and 491 males) from 5 high schools from 5 representative school districts participated in the survey. A self-administered questionnaire measuring…

  10. Cultural Variation in Implicit Mental Illness Stigma

    PubMed Central

    Cheon, Bobby K.; Chiao, Joan Y.

    2013-01-01

    Culture shapes how individuals perceive and respond to others with mental illness. Prior studies have suggested that Asians and Asian Americans typically endorse greater stigma of mental illness compared to Westerners (White Europeans and Americans). However, whether these differences in stigma arise from cultural variations in automatic affective reactions or deliberative concerns of the appropriateness of one’s reactions to mental illness remains unknown. Here we compared implicit and explicit attitudes toward mental illness among Asian and Caucasian Americans. Asian Americans showed stronger negative implicit attitudes toward mental illness relative to Caucasian Americans, suggesting that cultural variation in stigma of mental illness can be observed even when concerns regarding the validity and appropriateness of one’s attitudes toward mental illness are minimized. Asian Americans also explicitly endorsed greater desire for social distance from mental illness relative to Caucasian Americans. These findings suggest that cultural variations in mental illness stigma may arise from cultural differences in automatic reactions to mental illness, though cultural variations in deliberative processing may further shape differences in these immediate reactions to mental illness. PMID:24311820

  11. Attitudes and beliefs related to HIV/AIDS in urban religious congregations: Barriers and opportunities for HIV-related interventions

    PubMed Central

    Bluthenthal, Ricky N.; Palar, Kartika; Mendel, Peter; Kanouse, David E.; Corbin, Dennis E.; Derose, Kathryn Pitkin

    2012-01-01

    HIV-related stigmas have been seen as a barrier to greater religious congregation involvement in HIV prevention and care in the United States and elsewhere. We explored congregational and community norms and attitudes regarding HIV, sexuality, and drug use through a qualitative case study of 14 diverse religious congregations in Los Angeles County, California between December 2006 and May 2008. Data collected included semi-structured interviews with 57 clergy and lay leaders across the congregations, structured observations of congregational activities, review of archival documents, and a questionnaire on congregational characteristics. Across and within congregations, we found a wide range of views towards HIV, people with HIV, and populations at risk for HIV, from highly judgmental and exclusionary, to “loving the sinner, not the sin,” to accepting and affirming. Attitudes and norms about HIV, homosexuality, and substance abuse appeared to be related to the type and intensity of congregational HIV-related activities. However, even among the higher activity congregations, we found a range of perceptions, including ones that were stigmatizing. Results suggest that affirming norms and attitudes are not a prerequisite for a congregation to initiate HIV activities, a finding relevant for HIV service providers and researchers seeking to engage congregations on this issue. HIV stigma-reduction is not a prerequisite for congregational HIV involvement: both may occur simultaneously, or one before the other, and they dynamically affect each other. Strategies that are congruent with congregations’ current levels of comfort and openness around HIV can themselves facilitate a process of attitudinal and normative change. PMID:22445157

  12. Evolution of college students' AIDS-related behavioral responses, attitudes, knowledge, and fear.

    PubMed

    Fisher, J D; Misovich, S J

    1990-01-01

    Data were collected (a) to document extant levels of AIDS-risk behavior, AIDS-preventive behavior, AIDS-knowledge, and attitudes toward prevention among college students, (b) to assess the evolution from 1986 to 1988 of college students' behavioral and attitudinal responses to the AIDS epidemic, and (c) to document changes over time in college students' knowledge about AIDS. Although students' current levels of AIDS-knowledge were found to be relatively high, and their attitudes toward prevention were in the neutral range, actual preventive behavior was low, and unsafe sexual practices were high. Concerning changes in these dimensions across time, data using comparable samples of undergraduates in 1986, 1987, and 1988 indicated that there were substantial increases in knowledge about AIDS, in the favorability of attitudes toward certain "safer-sex" behaviors (e.g., discussing "safer sex"), and in the utilization of relevant informational resources. Students' perceptions of others' vulnerability to AIDS (but not their own vulnerability), had also increased. However, at the same time, students reported a decrease in the safety of their sexual behaviors. Numbers of sexual partners, likelihood of being in an intimate (sexual) relationship, and unsafe sexual practices have all increased since 1986. Finally, evidence suggested that alcohol may play a significant role in students' AIDS-risk behavior. PMID:2288814

  13. Community, family, and partner-related stigma experienced by pregnant and postpartum women with HIV in Ho Chi Minh City, Vietnam.

    PubMed

    Brickley, Deborah Bain; Le Dung Hanh, Dang; Nguyet, Luu Thi; Mandel, Jeffrey S; Giang, Le Truong; Sohn, Annette H

    2009-12-01

    Pregnant and postpartum women with HIV often face stigma and discrimination at home and in the community. In Vietnam, associations between HIV and the "social evils" of drug use and sex work contribute to stigmatization of people with HIV. We conducted a qualitative study to explore discrimination experienced by HIV-positive pregnant and postpartum women in Ho Chi Minh City at home and in the community. We conducted 20 in-depth interviews and two focus group discussions. Participants described managing disclosure of their HIV infection because of fear of stigma and discrimination, particularly to the wider community. In cases where their HIV status was disclosed, women experienced both discrimination and support. The findings highlight the need for targeted interventions to support pregnant and postpartum women with HIV, particularly during this period when they are connected to the healthcare system and more readily available for counseling. PMID:19085100

  14. Personal stigma in schizophrenia spectrum disorders: a systematic review of prevalence rates, correlates, impact and interventions

    PubMed Central

    Gerlinger, Gabriel; Hauser, Marta; De Hert, Marc; Lacluyse, Kathleen; Wampers, Martien; Correll, Christoph U

    2013-01-01

    A systematic electronic PubMed, Medline and Web of Science database search was conducted regarding the prevalence, correlates, and effects of personal stigma (i.e., perceived and experienced stigmatization and self-stigma) in patients with schizophrenia spectrum disorders. Of 54 studies (n=5,871), published from 1994 to 2011, 23 (42.6%) reported on prevalence rates, and 44 (81.5%) reported on correlates and/or consequences of perceived or experienced stigmatization or self-stigma. Only two specific personal stigma intervention studies were found. On average, 64.5% (range: 45.0–80.0%) of patients perceived stigma, 55.9% (range: 22.5–96.0%) actually experienced stigma, and 49.2% (range: 27.9–77.0%) reported alienation (shame) as the most common aspect of self-stigma. While socio-demographic variables were only marginally associated with stigma, psychosocial variables, especially lower quality of life, showed overall significant correlations, and illness-related factors showed heterogeneous associations, except for social anxiety that was unequivocally associated with personal stigma. The prevalence and impact of personal stigma on individual outcomes among schizophrenia spectrum disorder patients are well characterized, yet measures and methods differ significantly. By contrast, research regarding the evolution of personal stigma through the illness course and, particularly, specific intervention studies, which should be conducted utilizing standardized methods and outcomes, are sorely lacking. PMID:23737425

  15. Stigma and psychiatric morbidity among mothers of children with epilepsy in Zambia

    PubMed Central

    Elafros, Melissa A.; Sakubita-Simasiku, Claire; Atadzhanov, Masharip; Haworth, Alan; Chomba, Elwyn; Birbeck, Gretchen L.

    2013-01-01

    Background Epilepsy-associated stigma contributes substantially to the social, medical, and economic burden of disease for people with epilepsy (PWE), but little is known about its impact on caregivers of PWE. Methods To better understand stigma experienced by caregivers of PWE, factors that influence caregiver stigma, and the effect of stigma on a caregiver's psychologic well being, we interviewed 100 caregivers of children with epilepsy in Zambia. Questions assessed maternal knowledge, attitudes, and practices related to epilepsy, maternal stigma, mother's proxy report of child stigma, and maternal psychiatric morbidity. Results Of 100 mothers, 39 (39%) indicated that their child was stigmatized because of his or her epilepsy. Maternal proxy report of child stigma was highly correlated with maternal stigma (OR: 5.4, p=0.04), seizure frequency (p=0.03) and seizure severity (p=0.01). One in five of 100 mothers (20%) reported feeling stigmatized because of their child's epilepsy. Higher maternal stigma was associated with lower familial and community support (ORs: 65.2 and 34.7, respectively; both p<0.0001) as well as higher psychiatric morbidity (OR: 1.2; p=0.002). Formal education and epilepsy knowledge were associated with decreased maternal stigma (ORs: 0.8 and 0.7, respectively; both p<0.001). Conclusions One in five mothers of PWE feel stigmatized because of their child's epilepsy. As maternal stigma is associated with psychiatric morbidity, educating caregivers about epilepsy and screening for anxiety and depression are warranted. PMID:24214528

  16. Resisting and challenging stigma in Uganda: the role of support groups of people living with HIV

    PubMed Central

    Mburu, Gitau; Ram, Mala; Skovdal, Morten; Bitira, David; Hodgson, Ian; Mwai, Grace W; Stegling, Christine; Seeley, Janet

    2013-01-01

    Introduction Global scale up of antiretroviral therapy is changing the context of HIV-related stigma. However, stigma remains an ongoing concern in many countries. Groups of people living with HIV can contribute to the reduction of stigma. However, the pathways through which they do so are not well understood. Methods This paper utilizes data from a qualitative study exploring the impact of networked groups of people living with HIV in Jinja and Mbale districts of Uganda. Participants were people living with HIV (n=40), members of their households (n=10) and their health service providers (n=15). Data were collected via interviews and focus group discussions in 2010, and analyzed inductively to extract key themes related to the approaches and outcomes of the groups’ anti-stigma activities. Results Study participants reported that HIV stigma in their communities had declined as a result of the collective activities of groups of people living with HIV. However, they believed that stigma remained an ongoing challenge. Gender, family relationships, social and economic factors emerged as important drivers of stigma. Challenging stigma collectively transcended individual experiences and united people living with HIV in a process of social renegotiation to achieve change. Groups of people living with HIV provided peer support and improved the confidence of their members, which ultimately reduced self-stigma and improved their ability to deal with external stigma when it was encountered. Conclusions Antiretroviral therapy and group-based approaches in the delivery of HIV services are opening up new avenues for the collective participation of people living with HIV to challenge HIV stigma and act as agents of social change. Interventions for reducing HIV stigma should be expanded beyond those that aim to increase the resilience and coping mechanisms of individuals, to those that build the capacity of groups to collectively cope with and challenge HIV stigma. Such

  17. Consensus on context-specific strategies for reducing the stigma of human immunodeficiency virus/acquired immunodeficiency syndrome in Zambézia Province, Mozambique

    PubMed Central

    Mukolo, Abraham; Torres, Isabel; Bechtel, Ruth M.; Sidat, Mohsin; Vergara, Alfredo E.

    2014-01-01

    Stigma has been implicated in poor outcomes of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) care. Reducing stigma is important for HIV prevention and long-term treatment success. Although stigma reduction interventions are conducted in Mozambique, little is known about the current nature of stigma and the efficacy and effectiveness of stigma reduction initiatives. We describe action research to generate consensus on critical characteristics of HIV stigma and anti-stigma interventions in Zambézia Province, Mozambique. Qualitative data gathering methods, including indepth key-informant interviews, community interviews and consensus group sessions, were utilized. Delphi methods and the strategic options development analysis technique were used to synthesize qualitative data. Key findings are that stigma enacted by the general public might be declining in tandem with the HIV/AIDS epidemic in Mozambique, but there is likely excessive residual fear of HIV disease and community attitudes that sustain high levels of perceived stigma. HIV-positive women accessing maternal and child health services appear to shoulder a disproportionate burden of stigma. Unintentional biases among healthcare providers are currently the critical frontier of stigmatization, but there are few interventions designed to address them. Culturally sensitive psychotherapies are needed to address psychological distress associated with internalized stigma and these interventions should complement current supports for voluntary counseling and testing. While advantageous for defining stakeholder priorities for stigma reduction efforts, confirmatory quantitative studies of these consensus positions are needed before the launch of specific interventions. PMID:24527744

  18. Responding to AIDS-related bereavement in the South African context.

    PubMed

    Demmer, Craig

    2007-10-01

    AIDS continues to be a death sentence for many individuals living in South Africa where it remains the leading cause of death. Little is currently known about what it is like to experience the loss of a loved one to AIDS from the South African perspective and how to assist individuals who are living in a context vastly different from similarly bereaved individuals in the West. The purpose of this article is to discuss contextual issues that may affect individuals in South Africa who are grieving AIDS-related deaths and to offer preliminary suggestions on how to help these individuals. The author draws on his experience in the province of KwaZulu-Natal working with people affected by the HIV/AIDS epidemic, as well as discussions with practitioners involved in HIV/AIDS care in this region. PMID:17886413

  19. Bio-ethical and legal issues in relation to HIV/AIDS: the Uganda experience.

    PubMed

    Yusuf, N K

    1998-01-01

    In Uganda, as in many other countries, there is a vacuum regarding an appropriate legal and ethical response to the HIV/AIDS pandemic. Whereas much has been done to address the HIV/AIDS pandemic in a multidisciplinary way, very little has been done regarding legal and ethical issues. Hence, cases of claimants to have cures for AIDS, spiritual healers and sale of fake drugs plus unauthorized vaccine and drug trials are on the increase. The rights and needs of people infected with HIV/AIDS are not adequately addressed. The property rights of those affected by the pandemic continue to be abused. Therefore there is need to mobilize doctors, lawyers and human rights activists who should advocate and address these issues. This paper therefore highlights the critical bio-ethical and legal issues in relation to HIV/AIDS. PMID:10396922

  20. Teenage Mothers' Experiences of Stigma

    ERIC Educational Resources Information Center

    Yardley, Elizabeth

    2008-01-01

    This article is concerned with exploring the impact of stigma upon teenage mothers. Drawing upon the findings of in-depth interviews with 20 teenage mothers, the study explores the ways and contexts within which stigma is experienced and identifies differential effects and coping mechanisms reported by the participants. Thereafter, it is suggested…

  1. Rethinking Theoretical Approaches to Stigma

    PubMed Central

    Martin, Jack K; Lang, Annie; Olafsdottir, Sigrun

    2008-01-01

    A resurgence of research and policy efforts on stigma both facilitates and forces a reconsideration of the levels and types of factors that shape reactions to persons with conditions that engender prejudice and discrimination. Focusing on the case of mental illness but drawing from theories and studies of stigma across the social sciences, we propose a framework that brings together theoretical insights from micro, meso and macro level research: Framework Integrating Normative Influences on Stigma (FINIS) starts with Goffman’s notion that understanding stigma requires a language of social relationships, but acknowledges that individuals do not come to social interaction devoid of affect and motivation. Further, all social interactions take place in a context in which organizations, media and larger cultures structure normative expectations which create the possibility of marking “difference”. Labelling theory, social network theory, the limited capacity model of media influence, the social psychology of prejudice and discrimination, and theories of the welfare state all contribute to an understanding of the complex web of expectations shaping stigma. FINIS offers the potential to build a broad-based scientific foundation based on understanding the effects of stigma on the lives of persons with mental illness, the resources devoted to the organizations and families who care for them, and policies and programs designed to combat stigma. We end by discussing the clear implications this framework holds for stigma reduction, even in the face of conflicting results. PMID:18436358

  2. An Examination of the Impact of a Biological Anti-Stigma Message for Depression on College Students

    ERIC Educational Resources Information Center

    Boucher, Laura A.; Campbell, Duncan G.

    2014-01-01

    Stigma is one reason that some people avoid seeking mental health treatment. This study tested whether a biologically based anti-stigma message affected various stigma-related outcomes in college students. One hundred eighty-two undergraduate participants were randomly assigned to see a billboard presenting the message, "Depression is a brain…

  3. Exploring intentions to discriminate against patients living with HIV/AIDS among future healthcare providers in Malaysia

    PubMed Central

    Earnshaw, Valerie A.; Jin, Harry; Wickersham, Jeffrey; Kamarulzaman, Adeeba; John, Jacob; Altice, Frederick L.

    2015-01-01

    OBJECTIVES Stigma towards people living with HIV/AIDS (PLWHA) is strong in Malaysia. Although stigma has been understudied, it may be a barrier to treating the approximately 81 000 Malaysian PLWHA. The current study explores correlates of intentions to discriminate against PLWHA among medical and dental students, the future healthcare providers of Malaysia. METHODS An online, cross-sectional survey of 1296 medical and dental students was conducted in 2012 at seven Malaysian universities; 1165 (89.9%) completed the survey and were analysed. Sociodemographic characteristics, stigma-related constructs and intentions to discriminate against PLWHA were measured. Linear mixed models were conducted, controlling for clustering by university. RESULTS The final multivariate model demonstrated that students who intended to discriminate more against PLWHA were female, less advanced in their training, and studying dentistry. They further endorsed more negative attitudes towards PLWHA, internalised greater HIV-related shame, reported more HIV-related fear and disagreed more strongly that PLWHA deserve good care. The final model accounted for 38% of the variance in discrimination intent, with 10% accounted for by sociodemographic characteristics and 28% accounted for by stigma-related constructs. CONCLUSIONS It is critical to reduce stigma among medical and dental students to eliminate intentions to discriminate and achieve equitable care for Malaysian PLWHA. Stigma-reduction interventions should be multipronged, addressing attitudes, internalised shame, fear and perceptions of deservingness of care. PMID:24666546

  4. Stigma and intimacy in same-sex relationships: a narrative approach.

    PubMed

    Frost, David M

    2011-02-01

    Lesbian, gay, and bisexual individuals in romantic relationships experience stigma, prejudice, and discrimination stemming from widespread social devaluation of same-sex relationships. Research on same-sex couples has demonstrated a negative association between experiences of stigma and relationship quality. However, critical questions remain unanswered regarding how experiences of stigma become more or less meaningful within the context of same-sex relationships. This paper presents a study of the stories that a purposive sample of 99 individuals in same-sex relationships wrote about their relational high points, low points, decisions, and goals, as well as their experiences of stigma directly related to their relationships. Narrative analysis of these stories revealed that participants utilized several psychological strategies for making meaning of their experiences of stigma within the context of their relationships. Some participants framed stigma as having a negative impact on their relationships, while others framed stigma as relevant, but external to their lives. Some participants saw stigma as providing an opportunity to (re)define notions of commitment and relational legitimacy. Additionally, many participants framed stigma as bringing them closer to their partners and strengthening the bond within their relationships. The results of this study illuminate the psychological strategies individuals in same-sex couples use to make meaning of, cope with, and overcome societal devaluation thereby furthering understandings of the association between stigma and intimacy within marginalized relationships. PMID:21355641

  5. Multiple dimensions of HIV stigma and psychological distress among Asians and Pacific Islanders living with HIV illness.

    PubMed

    Kang, Ezer; Rapkin, Bruce D; Remien, Robert H; Mellins, Claude Ann; Oh, Alina

    2005-06-01

    Asians and Pacific Islanders (APIs) living with HIV/AIDS in the US are particularly vulnerable to HIV-related stigma largely due to ingrained socio-cultural norms that strongly associate HIV transmission with activities perceived to be immoral. This cross-sectional study examined the relationship between five HIV-stigma factors and psychological distress among 54 HIV-seropositive APIs. Social Rejection, Negative Self-Worth, Perceived Interpersonal Insecurity, and Financial Security were all significantly associated with psychological distress. Results from hierarchical multiple regression analyses indicated that Social Rejection, Negative Self-Worth, and Perceived Interpersonal Insecurity significantly predicted psychological distress after control for physical symptoms and country of birth. Undocumented Asians endorsed higher levels of Social Rejection, Negative Self-Worth and Perceived Interpersonal Insecurity than documented APIs. Future studies examining mechanisms of psychological distress among HIV-seropositive APIs are needed. PMID:15933834

  6. Influenza Stigma during the 2009 H1N1 Pandemic

    PubMed Central

    Earnshaw, Valerie A.; Quinn, Diane M.

    2012-01-01

    The current study examines the extent to which H1N1 was stigmatized at the height of the 2009 H1N1 pandemic in the U.S. and explores the role that H1N1 stigma played in people’s desire for physical distance from others with H1N1. H1N1 was the most stigmatized disease, with participants endorsing greater prejudice towards people with H1N1 than people with cancer or HIV/AIDS. Further, H1N1 stigma partially mediated the relationship between participants’ perceptions that H1N1 was threatening and their desire for physical distance from people with H1N1. Therefore, H1N1 stigma played a role in, but was not entirely responsible for, the relationship between perceptions that H1N1 was threatening and desire for distance from others with H1N1. PMID:24244047

  7. Stigma among patients with lung cancer: A patient-reported measurement model

    PubMed Central

    Hamann, Heidi A.; Ostroff, Jamie S.; Marks, Emily G.; Gerber, David E.; Schiller, Joan H.; Craddock Lee, Simon J.

    2014-01-01

    Objective Although stigma may have negative psychosocial and behavioral outcomes for patients with lung cancer, its measurement has been limited. A conceptual model of lung cancer stigma and a patient-reported outcome (PRO) measure is needed to mitigate these sequelae. This study identified key stigma-related themes to provide a blueprint for item development through thematic analysis of semi-structured interviews and focus groups with lung cancer patients. Methods Participants were recruited from two outpatient oncology clinics and included: a) 42 lung cancer patients who participated in individual interviews and, b) 5 focus groups (inclusive of 23 new lung cancer patients). Never smokers, long-term quitters, recent quitters, and current smokers participated. Individual interviews facilitated theme development and a conceptual model of lung cancer stigma, whereas subsequent focus groups provided feedback on the conceptual model. Qualitative data analyses included iterative coding and validation with existing theory. Results Two main thematic elements emerged from interviews with lung cancer patients: perceived (felt) stigma and internalized (self) stigma. Discussions of perceived stigma were pervasive, while internalized stigma was more commonly endorsed among current and recently quit smokers. Participants also discussed maladaptive (e.g., decreased disclosure) and adaptive (e.g., increased advocacy) stigma-related consequences. Conclusions Results indicate widespread acknowledgment of perceived stigma among lung cancer patients, but varying degrees of internalized stigma and associated consequences. Next steps for PRO measure development are item consolidation, item development, expert input, and cognitive interviews before field testing and psychometric analysis. Future work should address stigma-related consequences and interventions for reducing lung cancer stigma. PMID:24123664

  8. Patterns of gallium-67 scintigraphy in patients with acquired immunodeficiency syndrome and the AIDS related complex

    SciTech Connect

    Bitran, J.; Bekerman, C.; Weinstein, R.; Bennett, C.; Ryo, U.; Pinsky, S.

    1987-07-01

    Thirty-two patients with AIDS related complex (ARC) or acquired immunodeficiency syndrome (AIDS) underwent /sup 67/Ga scans as part of their evaluation. Three patterns of /sup 67/Ga biodistribution were found: lymph node uptake alone; diffuse pulmonary uptake; normal scan. Gallium-67 scans were useful in identifying clinically occult Pneumocystis carinii pneumonia in seven of 15 patients with ARC who were asymptomatic and had normal chest radiographs. Gallium scans are a useful ancillary procedure in the evaluation of patients with ARC or AIDS.

  9. Stigma: barrier to mental health care among ethnic minorities.

    PubMed

    Gary, Faye A

    2005-12-01

    This paper explicates the stigma of mental illness as it is experienced by four ethnic minority groups in the United States. Concerns about prejudice and discrimination among individuals who suffer burdens related to mental illness are delineated. It is proposed that ethnic minority groups, who already confront prejudice and discrimination because of their group affiliation, suffer double stigma when faced with the burdens of mental illness. The potency of the stigma of mental illness is one reason why some ethnic minority group members who would benefit from mental health services elect not to seek or adequately participate in treatment. The combination of stigma and membership in an ethnic minority group can impede treatment and well-being, creating preventable and treatable mortalities and morbidities. The article concludes with recommendations for research and health policy implications. PMID:16283995

  10. The Computer as an Aid to Public Relations Writing.

    ERIC Educational Resources Information Center

    Rayfield, Robert E.

    Teachers of public relations and other communication areas, with endorsement from the Association for Education in Journalism and Mass Communication (AEJMC), should request the data processing industry to develop assisted instruction programs in journalistic writing. Such action would provide a clearly defined need for a significant market and…

  11. AIDS-Related Factors Predictive of Suicidal Ideation of Low and High Intent among Gay and Bisexual Men.

    ERIC Educational Resources Information Center

    Schneider, Stephen G.; And Others

    1991-01-01

    Studied Acquired Immune Deficiency Syndrome (AIDS)-related stressors and suicidal ideation/intent among 778 gay and bisexual men (none with AIDS). Compared to those who reported no suicidal ideation over past six months, those who reported ideation (n=212) were more likely to report recent bereavement of partner, AIDS-Related Disorder (ARC)…

  12. ADHD stigma among college students.

    PubMed

    Thompson, Amanda Chi; Lefler, Elizabeth K

    2016-03-01

    The current study examined ADHD stigma within a college-enrolled young adult population, including the debate regarding the cause of stigma: label or behavior. In Phase 1, 135 college students rated stigma toward one of the four fictitious partners described as having either: the label of ADHD alone, the behaviors associated with ADHD alone, the label of ADHD and a set of behaviors associated with ADHD, or neither the label nor behaviors. In Phase 2, 48 college students rated stigma toward one of the two assigned fictitious partners described as having either: the label of ADHD and a set of behaviors associated with ADHD, or the label of Depression and a set of behaviors associated with Depression. It was hypothesized that the interaction between the label and the behaviors would cause the highest levels of ADHD stigma and that ADHD would elicit more stigma than Depression. In Phase 1, stigma was associated with the behaviors of ADHD, but not the label. In Phase 2, ADHD and Depression were found to be equally stigmatized. Implications, limitations, and future directions are discussed. PMID:26135022

  13. Perceived mental illness stigma, intimate relationships and sexual risk behavior in youth with mental illness

    PubMed Central

    Elkington, Katherine S.; Hackler, Dusty; Walsh, Tracy A.; Latack, Jessica A.; McKinnon, Karen; Borges, Cristiane; Wright, Eric R.; Wainberg, Milton L.

    2014-01-01

    The current study examines the role of mental illness-related stigma on romantic or sexual relationships and sexual behavior among youth with mental illness (MI), including youths’ experiences of stigma, the internalization of these experiences, and the behavior associated with managing stigma within romantic and sexual relationships. We conducted in-depth interviews with N=20 youth with mental illness (MI) (55% male, 16-24 years, 75% Latino) from 4 psychiatric outpatient clinics in New York City. We conducted a thematic analysis to investigate shared experiences of MI stigma and its impact on youth’s sexual or romantic relationships and associated behaviors. Our analysis revealed four main themes: 1) societal perceptions of those with MI as partners (societal stigma); 2) individual experiences of stigma within relationships (individual level); 3) internalized stigma of self as a partner (social-psychological processes); and 4) managing a stigmatized identity, of which some of the behaviors directly placed them at increased risk for HIV. We found that just under half of the sample (n=9/20) endorsed all themes, including engaging in HIV/STI sexual risk behaviors as a method to manage a stigmatize identity, which suggests that MI stigma and sexual risk may be linked. We discuss differences by gender and diagnosis. Findings provide new information for providers and researchers to address on the role of stigma experiences in the romantic and sexual behavior of youth in psychiatric treatment. Implications for stigma and HIV/STI prevention interventions are discussed. PMID:25477706

  14. Cervical Cancer Stigma in Rural Kenya: What Does HIV Have to Do with It?

    PubMed

    Rosser, Joelle I; Njoroge, Betty; Huchko, Megan J

    2016-06-01

    Cervical cancer is a leading cause of cancer-related death amongst women in sub-Saharan Africa, largely due to the lack of early screening and treatment. In addition to poor access to screening services, inadequate uptake of available services is a barrier to early identification of precancerous lesions. Given that cervical cancer is caused by a sexually transmitted virus and is associated with HIV positivity, stigma is one of the potential barriers to the utilization of cervical cancer programs in sub-Saharan Africa. We conducted a cross-sectional survey of 419 women attending health facilities in rural western Kenya to measure levels of cervical cancer and HIV stigma and to measure the associations between cervical cancer stigma, HIV stigma, and HIV status. Women who qualified for cervical cancer screening were asked to complete an oral questionnaire using a modified 9-point HIV stigma scale. Low cervical cancer stigma was reported in this study, with only 85/419 (20.3 %) of respondents answering yes to at least one cervical cancer stigma question. However, cervical cancer stigma was highly correlated with HIV stigma (correlation coefficient 0.72) and was significantly lower in HIV-positive women (p < 0.001). Reducing cervical cancer stigma in the general population is an important part of promoting screening in sub-Saharan Africa. PMID:25982550

  15. Components of implicit stigma against mental illness among Chinese students.

    PubMed

    Wang, Xiaogang; Huang, Xiting; Jackson, Todd; Chen, Ruijun

    2012-01-01

    Although some research has examined negative automatic aspects of attitudes toward mental illness via relatively indirect measures among Western samples, it is unclear whether negative attitudes can be automatically activated in individuals from non-Western countries. This study attempted to validate results from Western samples with Chinese college students. We first examined the three-component model of implicit stigma (negative cognition, negative affect, and discriminatory tendencies) toward mental illness with the Single Category Implicit Association Test (SC-IAT). We also explored the relationship between explicit and implicit stigma among 56 Chinese university college students. In the three separate SC-IATs and the combined SC-IAT, automatic associations between mental illness and negative descriptors were stronger relative to those with positive descriptors and the implicit effect of cognitive and affective SC-IATs were significant. Explicit and implicit measures of stigma toward mental illness were unrelated. In our sample, women's overall attitudes toward mental illness were more negative than men's were, but no gender differences were found for explicit measures. These findings suggested that implicit stigma toward mental illness exists in Chinese students, and provide some support for the three-component model of implicit stigma toward mental illness. Future studies that focus on automatic components of stigmatization and stigma-reduction in China are warranted. PMID:23029366

  16. Risk and protective factors for depression symptoms among children affected by HIV/AIDS in rural China: a structural equation modeling analysis.

    PubMed

    Wang, Bo; Li, Xiaoming; Barnett, Douglas; Zhao, Guoxiang; Zhao, Junfeng; Stanton, Bonita

    2012-05-01

    Previous research has revealed a negative impact of orphanhood and HIV-related stigma on the psychological well-being of children affected by HIV/AIDS. Little is known about psychological protective factors that can mitigate the effect of orphanhood and HIV-related stigma on psychological well-being. This research examines the relationships among several risk and protective factors for depression symptoms using structural equation modeling. Cross-sectional data were collected from 755 AIDS orphans and 466 children of HIV-positive parents aged 6-18 years in 2006-2007 in rural central China. Participants reported their experiences of traumatic events, perceived HIV-related stigma, perceived social support, future orientation, trusting relationships with current caregivers, and depression symptoms. We found that the experience of traumatic events and HIV-related stigma had a direct contributory effect on depression among children affected by HIV/AIDS. Trusting relationships together with future orientation and perceived social support mediated the effects of traumatic events and HIV-related stigma on depression. The final model demonstrated a dynamic interplay among future orientation, perceived social support and trusting relationships. Trusting relationships was the most proximate protective factor for depression. Perceived social support and future orientation were positively related to trusting relationships. We conclude that perceived social support, trusting relationships, and future orientation offer multiple levels of protection that can mitigate the effect of traumatic events and HIV-related stigma on depression. Trusting relationships with caregivers provides the most immediate source of psychological support. Future prevention interventions seeking to improve psychological well-being among children affected by HIV/AIDS should attend to these factors. PMID:22405505

  17. Risk and Protective Factors for Depression Symptoms among Children Affected by HIV/AIDS in Rural China: A Structural Equation Modeling Analysis

    PubMed Central

    Wang, Bo; Li, Xiaoming; Barnett, Douglas; Zhao, Guoxiang; Zhao, Junfeng; Stanton, Bonita

    2012-01-01

    Previous research has revealed a negative impact of orphanhood and HIV-related stigma on the psychological well-being of children affected by HIV/AIDS. Little is known about psychological protective factors that can mitigate the effect of orphanhood and HIV-related stigma on psychological well-being. This research examines the relationships among several risk and protective factors for depression symptoms using structural equation modeling. Cross-sectional data were collected from 755 AIDS orphans and 466 children of HIV-positive parents aged 6–18 years in 2006–2007 in rural central China. Participants reported their experiences of traumatic events, perceived HIV-related stigma, perceived social support, future orientation, trusting relationships with current caregivers, and depression symptoms. We found that the experience of traumatic events and HIV-related stigma had a direct contributory effect on depression among children affected by HIV/AIDS. Trusting relationships together with future orientation and perceived social support mediated the effects of traumatic events and HIV-related stigma on depression. The final model demonstrated a dynamic interplay among future orientation, perceived social support and trusting relationships. Trusting relationships was the most proximate protective factor for depression. Perceived social support and future orientation were positively related to trusting relationships. We conclude that perceived social support, trusting relationships, and future orientation offer multiple levels of protection that can mitigate the effect of traumatic events and HIV-related stigma on depression. Trusting relationships with caregivers provides the most immediate source of psychological support. Future prevention interventions seeking to improve psychological well-being among children affected by HIV/AIDS should attend to these factors. PMID:22405505

  18. AAPI college students' willingness to seek counseling: the role of culture, stigma, and attitudes.

    PubMed

    Choi, Na-Yeun; Miller, Matthew J

    2014-07-01

    This study tested 4 theoretically and empirically derived structural equation models of Asian, Asian American, and Pacific Islanders' willingness to seek counseling with a sample of 278 college students. The models represented competing hypotheses regarding the manner in which Asian cultural values, European American cultural values, public stigma, stigma by close others, self-stigma, and attitudes toward seeking professional help related to willingness to seek counseling. We found that Asian and European American cultural values differentially related to willingness to seek counseling indirectly through specific indirect pathways (public stigma, stigma by close others, self-stigma, and attitudes toward seeking professional help). Our results also showed that the magnitude of model-implied relationships did not vary as a function of generational status. Study limitations, future directions for research, and implications for counseling are discussed. PMID:25019538

  19. Perception and coping with stigma of mental illness: Arab families' perspectives.

    PubMed

    Dalky, Heyam F

    2012-07-01

    Family stigma is well documented in the research literature; however, it has only been recently that efforts have been undertaken to discuss the perception of stigma as reported by Arab families of relatives with mental illness. This clinical paper aims to identify families' perception of stigma related to mental illness, and to compare Arab families' approaches with various aspects of caring from different countries. Further, this paper discusses, in-depth, specific areas related to families' perceptions of stigma: What impacts does stigma perception have on those families and on their relatives' care outcomes and what are coping strategies are used to handle stigma and its impacts in such countries? This paper emphasizes that chronic mental illness contributes the most to families' perception of stigma. In this study, Arab families perceived the experience of caring for a family member with a mental illness with fear, loss, embarrassment, and disgrace of family reputations. Further, secrecy, isolation, despair, and helplessness were reported the most among different family groups in Jordan and Morocco. This paper reminds us that cultural norms and beliefs shape family members' perception of coping and their ability to manage caring for relatives with mental illnesses. Thus, more studies are needed concerning coping and management strategies that are culturally relevant. This could eventually guide the establishment of stigma reduction initiatives and expand understanding of stigma from different cultural perspectives. PMID:22757601

  20. Challenges to successful implementation of HIV and AIDS-related health policies in Cartagena, Colombia.

    PubMed

    Djellouli, Nehla; Quevedo-Gómez, María Cristina

    2015-05-01

    The Caribbean region presents the highest prevalence of HIV/AIDS worldwide after sub-Saharan Africa; leading to serious social, economic and health consequences at the local scale but also at the regional and global levels. In Colombia, a national plan to tackle the epidemic was formulated with little evidence that its implementation in the local context is effective. This study focused on Cartagena - one of Colombia's largest cities and an international touristic hub - that presents one of the highest HIV prevalences in the country, to investigate whether the national plan accounts for local specificities and what are the barriers to local implementation. Based on the Contextual Interaction Theory (CIT), this qualitative research relied upon 27 interviews and 13 life stories of local inhabitants and stakeholders, collected in a first fieldwork in 2006-2007. A follow-up data collection took place in 2013 with 10 participants: key policymakers and implementers, NGO representatives and local inhabitants. Barriers identified by the participants included: local population's understandings and beliefs on condom use; stigma and discrimination; lack of collaboration from the Church, the education sector and local politicians; corruption; high staff turnover; frequent changes in leadership; lack of economic and human resources; and barriers to health care access. The findings suggest that global influences also have an impact on the CIT framework (e.g. international organisations as a major financier in HIV prevention). The participants put forward several feasible solutions to implementation barriers. We discuss how several of the proposed solutions have been applied in other Latin American and Caribbean countries and yielded positive results. However, further research is needed to find possible ways of overcoming certain barriers identified by this study such as corruption, the lack of collaboration of the Church and barriers to health care access. PMID:25840048

  1. Knowledge levels of pre-school teachers related with basic first-aid practices, Isparta sample*

    PubMed Central

    Sönmez, Yonca; Uskun, Ersin; Pehlivan, Azize

    2014-01-01

    Aim: The aim of this study was to evaluate the levels of knowledge of pre-school teachers working in the province center of Isparta related with basic first-aid practices and some factors which affected these levels of knowledge. Material and Methods: In this cross-sectional, analytic study, 110 pre-school teachers working in the province center of Isparta constituted the population. A questionnaire questioning sociodemographic properties and the level of knowledge related with first-aid practices was applied under supervision. The level of knowledge was evaluated on a 20-point scale. In the analyses, Kruskal-Wallis and Mann-Whitney U tests and Spearman’s rank correlation were used. The study was approved by the Ethical Committee for Clinical Studies of Süleyman Demirel University School of Medicine (registration number: 105). Results: The mean score of first-aid knowledge of the pre-school teachers was found to be 11.9±2.9. The least known issues included washing the wound by soap and water after a dog bite, information related with the necessity of immobilization of a child who has fallen from a high level and the phone number of National Poison Information Center (16.4%, 20.9% and 22.7%, respectively). The scores of the subjects whose knowledge of first-aid was evaluated to be well were higher compared to the subjects whose knowledge of first-aid was evaluated to be moderate (p=0.009) and poor (p=0.001). It was found that first-aid scores did not show significant difference in terms of age, working period, having received first-aid training and having faced with a condition requiring first-aid previously (p>0.05, for all comparisons). Conclusions: It was found that pre-school teachers had insufficient first-aid knowledge. Since the first-aid knowledge scores of the subjects who reported that they received first-aid training before did not show significant difference, it was thought that the quality of training was as important as receiving training. PMID

  2. Age, Stigma, Adherence and Clinical Indicators in HIV-Infected Women

    PubMed Central

    McCoy, Katryna; Higgins, Melinda; Zuñiga, Julie Ann; Holstad, Marcia McDonnell

    2016-01-01

    Stigma has become a gendered phenomenon that affects increasing numbers of HIV-infected women worldwide. This study examined the role of age as a possible moderator of the relationship between stigma and antiretroviral therapy adherence, CD4% and viral load among 120 HIV-infected women. A secondary analysis was conducted using data from the Keeping Healthy and Active with Risk Reduction and Medication Adherence (KHARMA) Project, an National Institutes of Health (NIH) funded randomized controlled trial to improve Antiretroviral treatment (ART) adherence and reduce risky behaviors in HIV-infected women at five clinical sites in a South-eastern city from 2005 to 2008. Stigma was measured using the Perceived Personal Stigma of Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome (HIV/AIDS) scale. Among participants <50 years old (n=90), age was significantly associated with viral load (rho=−.24, p=.02) and stigma was negatively associated with CD4% (r =−.26, p=.02). For the 30 participants >50 years old, age was not significantly associated with viral load, stigma or CD4%, and there was no significant association between stigma and CD4% (r=.07, p=.70). These findings indicate the need for further study regarding this potential moderating effect and possible interventions to address the susceptibility of younger women to the harmful effects of stigma. PMID:27200416

  3. Accounts from the field: a public relations perspective on global AIDS/HIV.

    PubMed

    Bardhan, Nilanjana R

    2002-01-01

    This study is a theoretical as well as empirical exploration of the power and cultural differentials that mark and construct various intersecting discourses, specifically media discourse, on global AIDS/HIV. It applies the language and concepts of public relations to understand how the press coverage of the pandemic is associated with the variables that impact the newsmaking process as well as the public and policy implications of macro news frames generated over time. Theoretical work in the areas of agenda setting and news framing also instruct the conceptual framework of this analysis. Narrative analysis is used as a methodology to qualitatively analyze three pools of accounts-from people either living with AIDS/HIV, involved in AIDS/HIV work, or discursively engaged in the media construction of the pandemic; from transnational wire service journalists who cover the issue at global and regional levels; and policy shapers and communicators who are active at the global level. These three communities of respondents represent important stakeholders in the AIDS/HIV issue. The findings are analyzed from a public relations standpoint. Perhaps the most important finding of this study is that the public relations approaches used to address AIDS/HIV related issues need to be grounded in context-specific research and communicative practices that bring out the lived realities of AIDS/HIV at grassroots levels. The findings also posit that those situated at critical junctions between various stakeholders need to cultivate a finely balanced understanding of the etic and emic intersections and subjectivities of global/local AIDS/HIV. PMID:12166875

  4. Structural Stigma and Sexual Orientation Disparities in Adolescent Drug Use

    PubMed Central

    Hatzenbuehler, Mark L.; Jun, Hee-Jin; Corliss, Heather L.; Austin, S. Bryn

    2015-01-01

    Although epidemiologic studies have established the existence of large sexual orientation disparities in illicit drug use among adolescents and young adults, the determinants of these disparities remain understudied. This study sought to determine whether sexual orientation disparities in illicit drug use are potentiated in states that are characterized by high levels of stigma surrounding sexual minorities. State-level structural stigma was coded using a previously established measure based on a 4-item composite index: (1) density of same-sex couples; (2) proportion of Gay-Straight Alliances per public high school; (3) 5 policies related to sexual orientation discrimination (e.g., same-sex marriage, employment non-discrimination); and (4) public opinion toward homosexuality (aggregated responses from 41 national polls). The index was linked to individual-level data from the Growing Up Today Study, a prospective community-based study of adolescents (2000–2010). Sexual minorities report greater illicit drug use than their heterosexual peers. However, for both men and women, there were statistically significant interactions between sexual orientation status and structural stigma, such that sexual orientation disparities in marijuana and illicit drug use were more pronounced in high-structural stigma states than in low-structural stigma states, controlling for individual- and state-level confounders. For instance, among men, the risk ratio indicating the association between sexual orientation and marijuana use was 24% greater in high- versus low-structural stigma states, and for women it was 28% greater in high- versus low-structural stigma states. Stigma in the form of social policies and attitudes may contribute to sexual orientation disparities in illicit drug use. PMID:25753931

  5. Structural stigma and sexual orientation disparities in adolescent drug use.

    PubMed

    Hatzenbuehler, Mark L; Jun, Hee-Jin; Corliss, Heather L; Bryn Austin, S

    2015-07-01

    Although epidemiologic studies have established the existence of large sexual orientation disparities in illicit drug use among adolescents and young adults, the determinants of these disparities remain understudied. This study sought to determine whether sexual orientation disparities in illicit drug use are potentiated in states that are characterized by high levels of stigma surrounding sexual minorities. State-level structural stigma was coded using a previously established measure based on a 4-item composite index: (1) density of same-sex couples; (2) proportion of Gay-Straight Alliances per public high school; (3) 5 policies related to sexual orientation discrimination (e.g., same-sex marriage, employment non-discrimination); and (4) public opinion toward homosexuality (aggregated responses from 41 national polls). The index was linked to individual-level data from the Growing Up Today Study, a prospective community-based study of adolescents (2001-2010). Sexual minorities report greater illicit drug use than their heterosexual peers. However, for both men and women, there were statistically significant interactions between sexual orientation status and structural stigma, such that sexual orientation disparities in marijuana and illicit drug use were more pronounced in high-structural stigma states than in low-structural stigma states, controlling for individual- and state-level confounders. For instance, among men, the risk ratio indicating the association between sexual orientation and marijuana use was 24% greater in high- versus low-structural stigma states, and for women it was 28% greater in high- versus low-structural stigma states. Stigma in the form of social policies and attitudes may contribute to sexual orientation disparities in illicit drug use. PMID:25753931

  6. 'This is a natural process': managing menstrual stigma in Nepal.

    PubMed

    Crawford, Mary; Menger, Lauren M; Kaufman, Michelle R

    2014-01-01

    Menstrual stigma has been demonstrated in many societies. However, there is little research on menstrual attitudes in South Asia, despite religiously-based menstrual restrictions imposed on women. To understand menstrual stigma in this context, we conducted qualitative research with women in Nepal. Nepali Hinduism forbids menstruating women to enter a temple or kitchen, share a bed with a husband or touch a male relative. During menstruation, women are 'untouchable'. There has been virtually no research on how Nepali women make meaning of these practices. The current study employed focus groups and individual interviews to understand how some Nepali women experience menarche and menstrual stigma. We explored how women describe their experiences and the strategies they adopt to manage age-old stigma in a rapidly modernising society where they have multiple roles as workers, wives and mothers. Participants reported they experienced menarche with little preparation, which caused distress, and were subjected to ongoing stigmatisation as menstruating women. They described coping strategies to reduce the effects of this stigma. This study provides a unique perspective on coping with menstrual stigma in South Asia. PMID:24697583

  7. The Stigma of Reproductive Health Services Utilization by Unmarried Women

    PubMed Central

    Mohammadi, Fatemeh; Kohan, Shahnaz; Mostafavi, Firoozeh; Gholami, Ali

    2016-01-01

    Background: Fear of the stigma associated with reproductive health services has always been one of the reasons why youth and unmarried individuals avoid making use of such services. This stigma imposes a great deal of mental stress, fear, and depression on patients and causes delays in the diagnosis and treatment of their conditions. Objectives: This paper explores the concept of stigma in the context of the utilization of reproductive health services by unmarried women. Patients and Methods: This study is qualitative in nature. Purposive sampling was employed, and semi-structured interviews were conducted with 16 unmarried women, five midwives, and two physicians. The data were analyzed using the conventional content analysis method. Results: Four main categories constituted the general concept concerning the stigma suffered by unmarried women for using reproductive health services, i.e., prevalent stereotypical thinking patterns in society, the fear of being judged and labeled by others, discrimination, and feeling ashamed of seeking reproductive health services. Conclusions: The findings indicated that society associates reproductive health issues with sexual relations, which in turn shapes the stigma and places limitations on unmarried women for using reproductive health services. Thus, while reproductive health services are planned and provided to unmarried women, strategies are demanded for overcoming this stigma. PMID:27247794

  8. AIDS: Implications for Families.

    ERIC Educational Resources Information Center

    Macklin, Eleanor D.

    1988-01-01

    Reviews facts about Acquired Immune Deficiency Syndrome (AIDS) and its epidemiology. Discusses implications for families (social stigma and isolation, fears of contagion, infection and abandonment, guilt, anger, grief, and economic hardship) and for human service professionals (public education, voluntary, anonymous testing with counseling, and…

  9. PHASE II AIDS MALIGNANCY CONSORTIUM TRIAL OF TOPICAL HALOFUGINONE IN AIDS-RELATED KAPOSI’S SARCOMA

    PubMed Central

    Koon, Henry B.; Fingleton, Barbara; Lee, Jeannette Y.; Geyer, Julia T.; Cesarman, Ethel; Parise, Robert A.; Egorin, Merrill J.; Dezube, Bruce J.; Aboulafia, David; Krown, Susan E.

    2010-01-01

    Using a novel blinded intra-patient vehicle control design, we conducted a phase II study of topically-administered halofuginone, an angiogenesis inhibitor that inhibits collagen type-I and matrix metalloproteinases (MMPs), in patients with AIDS-related Kaposi’s sarcoma (KS). Serial KS biopsies assessed treatment effects on angiogenic factors and KSHV-LANA. We observed marked heterogeneity of KSHV-LANA expression. Although the small number of subjects whose response could be evaluated precluded definitive assessment of halofuginone’s efficacy, we observed a significant decrease in type-I collagen only in halofuginone-treated lesions, but no effect on MMP-2. The trial design is applicable to future studies of topical agents. PMID:21068672

  10. IgM, IgG and IgA rheumatoid factors and circulating immune complexes in patients with AIDS and AIDS-related complex with serological abnormalities.

    PubMed Central

    Procaccia, S; Lazzarin, A; Colucci, A; Gasparini, A; Forcellini, P; Lanzanova, D; Foppa, C U; Novati, R; Zanussi, C

    1987-01-01

    To investigate some humoral aspects which may reflect the involvement of B lymphocytes in the acquired immunodeficiency syndrome (AIDS), we used an enzyme-linked immunoassay (ELISA) to determine the levels of IgM, IgG and IgA rheumatoid factors (RF) in 16 patients suffering from full-blown AIDS and 32 patients with AIDS-related complex (ARC), in the clinical form of lymphoadenopathy syndrome (LAS), compared with 40 healthy, young heterosexual subjects. Both AIDS and ARC patients showed a greater incidence of high IgM RF levels, with mean values significantly higher than controls, but with no differences between the two pathological groups. IgG RF behaviour was similar in the two patient populations and the healthy subjects. IgA RF were significantly raised in AIDS and ARC. Further information on RF was obtained by determination of the immunoglobulin levels of the respective isotypes in the same patients. Mean IgG levels were above normal in AIDS and ARC patients, but the latter group showed a higher incidence of increased values and higher mean levels. The IgA isotype was significantly increased mainly in AIDS patients. The behaviour of IgM was virtually the same in the three groups studied. A difference between AIDS and ARC patients was established by the detection of circulating immune-complexes (IC) by the C1q-binding and CIC-conglutinin assays. IC were significantly high, by both methods, only in the ARC group, but normal or very low in AIDS. These overall findings suggest once again the impairment of B cell function in AIDS, with prevalent hyperactivation in ARC and exhaustion in full-blown AIDS, and apparent preservation, in the latter group, of the antibody responses which are more closely related to the activity of subsets of T helper cells. PMID:3608224

  11. 33 CFR 209.325 - Navigation lights, aids to navigation, navigation charts, and related data policy, practices and...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 3 2012-07-01 2012-07-01 false Navigation lights, aids to... ADMINISTRATIVE PROCEDURE § 209.325 Navigation lights, aids to navigation, navigation charts, and related data... procedure to be used by all Corps of Engineers installations and activities in connection with aids...

  12. 33 CFR 209.325 - Navigation lights, aids to navigation, navigation charts, and related data policy, practices and...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 3 2013-07-01 2013-07-01 false Navigation lights, aids to... ADMINISTRATIVE PROCEDURE § 209.325 Navigation lights, aids to navigation, navigation charts, and related data... procedure to be used by all Corps of Engineers installations and activities in connection with aids...

  13. 33 CFR 209.325 - Navigation lights, aids to navigation, navigation charts, and related data policy, practices and...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 3 2014-07-01 2014-07-01 false Navigation lights, aids to... ADMINISTRATIVE PROCEDURE § 209.325 Navigation lights, aids to navigation, navigation charts, and related data... procedure to be used by all Corps of Engineers installations and activities in connection with aids...

  14. 33 CFR 209.325 - Navigation lights, aids to navigation, navigation charts, and related data policy, practices and...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 3 2011-07-01 2011-07-01 false Navigation lights, aids to... ADMINISTRATIVE PROCEDURE § 209.325 Navigation lights, aids to navigation, navigation charts, and related data... procedure to be used by all Corps of Engineers installations and activities in connection with aids...

  15. Implementing a stigma reduction intervention in healthcare settings

    PubMed Central

    Li, Li; Lin, Chunqing; Guan, Jihui; Wu, Zunyou

    2013-01-01

    Introduction Globally, HIV-related stigma is prevalent in healthcare settings and is a major barrier to HIV prevention and treatment adherence. Some intervention studies have showed encouraging outcomes, but a gap continues to exist between what is known and what is actually delivered in medical settings to reduce HIV-related stigma. Methods This article describes the process of implementing a stigma reduction intervention trial that involved 1760 service providers in 40 hospitals in China. Guided by Diffusion of Innovation theory, the intervention identified and trained about 15–20% providers as popular opinion leaders (POLs) to disseminate stigma reduction messages in each intervention hospital. The intervention also engaged governmental support in the provision of universal precaution supplies to all participating hospitals in the trial. The frequency of message diffusion and reception, perceived improvement in universal precaution practices and reduction in the level of stigma in hospitals were measured at 6- and 12-month follow-up assessments. Results Within the intervention hospitals, POL providers reported more frequent discussions with their co-workers regarding universal precaution principles, equal treatment of patients, provider-patient relationships and reducing HIV-related stigma. Service providers in the intervention hospitals reported more desirable intervention outcomes than providers in the control hospitals. Our evaluation revealed that the POL model is compatible with the target population, and that the unique intervention entry point of enhancing universal precaution and occupational safety was the key to improved acceptance by service providers. The involvement of health authorities in supporting occupational safety was an important element for sustainability. Conclusions This report focuses on explaining the elements of our intervention rather than its outcomes. Lessons learned from the intervention implementation will enrich the development

  16. Risk factors for HIV infection in male sexual contacts of men with AIDS or an AIDS-related condition.

    PubMed

    Coates, R A; Calzavara, L M; Read, S E; Fanning, M M; Shepherd, F A; Klein, M H; Johnson, J K; Soskolne, C L

    1988-10-01

    A total of 246 healthy male sexual contacts of men with either acquired immunodeficiency syndrome (AIDS) or an AIDS-related condition were recruited into a prospective study in Toronto, Canada between July 1984 and July 1985. At induction, data were collected on the sexual relationship between the contact and his primary case, sexual activities with other men, history of sexually transmitted diseases and other diseases, and use of recreational drugs. At recruitment, 144 sexual contacts had antibodies to human immunodeficiency virus (HIV); 102 of the contacts were seronegative at induction and at three months following recruitment. No association between HIV seropositivity and total number of sexual partners could be demonstrated. In univariate and multivariate analyses, receptive and insertive anal intercourse with the primary cases, and activities which either indicated or potentially caused anorectal mucosal injury (rectal douching, perianal bleeding, receipt of objects in ano, and receptive fisting) were strongly associated with HIV seropositivity. In the final multiple logistic regression model, two significant interaction effects were observed: the interaction between receptive anal intercourse and insertive anal intercourse and that between receptive anal intercourse and the anorectal mucosal injury index. These two interaction terms had negative regression coefficients which suggested that change in one sexual activity would not decrementally reduce risk of HIV infection without a comparable modification in the other activity. No association could be demonstrated between oral-genital and oral-anal sexual contact and odds ratios for these sexual activities declined to levels below 1.0 when adjusted for frequency of receptive anal intercourse. PMID:3421239

  17. AIDS: Psychosocial Dimensions

    PubMed Central

    Stapleton, Dan

    1986-01-01

    In order to provide comprehensive care to patients who have AIDS, it is important for the family physician to understand the psychosocial elements of the disease. Homosexual men who have AIDS face particular problems, such as the disclosure of sexual orientation to family and friends. Issues discussed in this article include the reactions of the patient, family and friends to the diagnosis, the stigma of AIDS, the patient's support network, and preparations for disability and death. The facts about AIDS are discussed briefly, and the psychosocial implications of the illness for patients and their “significant others” are examined. The role of the family physician is highlighted. PMID:21267233

  18. Perceptions of people living with HIV/AIDS regarding access to health care.

    PubMed

    Vaswani, Vina; Vaswani, Ravi

    2014-04-01

    Although the health care is replete with technology in the present day, it is not freely accessible in a developing country. The situation could be even more compromised in the case of people living with HIV/AIDS, with the added dimension of stigma and discrimination. What are the factors that act as barriers to health care? This study was conducted to look into perceptions of people living with HIV/AIDS with regard to access to health care. The study looked into accessibility of general health vis-à-vis access to antiretroviral therapy. Demographic variables like age, gender, income were studied in relation to factors such as counseling, confidentiality, stigma and discrimination, which are known to influence access to health care. People living with HIV/AIDS perceive general health care as more accessible than care for HIV treatment. Discrimination by health care workers causes a barrier to accessibility. PMID:24946513

  19. Measuring HIV stigma for PLHAs and nurses over time in five African countries.

    PubMed

    Holzemer, William L; Makoae, Lucy N; Greeff, Minrie; Dlamini, Priscilla S; Kohi, Thecla W; Chirwa, Maureen L; Naidoo, Joanne R; Durrheim, Kevin; Cuca, Yvette; Uys, Yvette R

    2009-09-01

    The aim of this article is to document the levels of HIV stigma reported by persons living with HIV infections and nurses in Lesotho, Malawi, South Africa, Swaziland and Tanzania over a 1-year period. HIV stigma has been shown to negatively affect the quality of life for people living with HIV infection, their adherence to medication, and their access to care. Few studies have documented HIV stigma by association as experienced by nurses or other health care workers who care for people living with HIV infection. This study used standardised scales to measure the level of HIV stigma over time. A repeated measures cohort design was used to follow persons living with HIV infection and nurses involved in their care from five countries over a 1-year period in a three-wave longitudinal design. The average age of people living with HIV/AIDS (PLHAs) (N=948) was 36.15 years (SD=8.69), and 67.1% (N=617) were female. The average age of nurses (N=887) was 38.44 years (SD=9.63), and 88.6% (N=784) were females. Eighty-four per cent of all PLHAs reported one or more HIV-stigma events at baseline. This declined, but was still significant 1 year later, when 64.9% reported experiencing at least one HIV-stigma event. At baseline, 80.3% of the nurses reported experiencing one or more HIV-stigma events and this increased to 83.7% 1 year later. The study documented high levels of HIV stigma as reported by both PLHAs and nurses in all five of these African countries. These results have implications for stigma reduction interventions, particularly focused at health care providers who experience HIV stigma by association. PMID:19936409

  20. Oral health-related quality of life of paediatric patients with AIDS

    PubMed Central

    2011-01-01

    Background Children with Acquired Immune Deficiency Syndrome (AIDS) exhibit impaired dental status, which can affect their quality of life. This study assessed the oral health-related quality of life of these patients and associated factors. Methods The "Child Perceptions Questionnaire 11-14", rating overall and domain-specific (oral symptoms, functional limitations, emotional well being, and social well being) oral health-related quality of life (OHR-QoL) was completed by 88 children with AIDS assisted in the Child Institute, Sao Paulo, Brazil. Parents or guardians provided behavioural and socio-demographic information. The clinical status was provided by hospital records. OHR-QoL covariates were assessed by Poisson regression analysis. Results The most affected OHR-QoL subscale concerned oral symptoms, whose rate was 23.9%. The direct answer for oral health and well being made up a rate of 47.7%. Brushing the teeth less than two times a day and viral load exceeding 10,000 HIV-RNA copies per millilitre of plasma were directly associated (p < 0.05) with a poorer oral health-related quality of life. Conclusions Children with more severe AIDS manifestations complained of poorer status of oral symptoms, functional limitations, emotional and social well being related to their oral health. Recognizing the factors that are associated with poorer OHR-QoL in children with AIDS may contribute to the planning of dental services for this population. PMID:21208437

  1. Evaluation of a health setting-based stigma intervention in five African countries.

    PubMed

    Uys, Leana; Chirwa, Maureen; Kohi, Thecla; Greeff, Minrie; Naidoo, Joanne; Makoae, Lucia; Dlamini, Priscilla; Durrheim, Kevin; Cuca, Yvette; Holzemer, William L

    2009-12-01

    The study aim is to explore the results of an HIV stigma intervention in five African health care settings. A case study approach was used. The intervention consisted of bringing together a team of approximately 10 nurses and 10 people living with HIV or AIDS (PLHA) in each setting and facilitating a process in which they planned and implemented a stigma reduction intervention, involving both information giving and empowerment. Nurses (n = 134) completed a demographic questionnaire, the HIV/AIDS Stigma Instrument-Nurses (HASI-N), a self-efficacy scale, and a self-esteem scale, both before and after the intervention, and the team completed a similar set of instruments before and after the intervention, with the PLHA completing the HIV/AIDS Stigma Instrument for PLHA (HASI-P). The intervention as implemented in all five countries was inclusive, action-oriented, and well received. It led to understanding and mutual support between nurses and PLHA and created some momentum in all the settings for continued activity. PLHA involved in the intervention teams reported less stigma and increased self-esteem. Nurses in the intervention teams and those in the settings reported no reduction in stigma or increases in self- esteem and self-efficacy, but their HIV testing behavior increased significantly. This pilot study indicates that the stigma experience of PLHA can be decreased, but that the stigma experiences of nurses are less easy to change. Further evaluation research with control groups and larger samples and measuring change over longer periods of time is indicated. PMID:20025515

  2. Evaluation of a Health Setting-Based Stigma Intervention in Five African Countries

    PubMed Central

    Uys, Leana; Chirwa, Maureen; Kohi, Thecla; Greeff, Minrie; Makoae, Lucia; Dlamini, Priscilla; Durrheim, Kevin; Cuca, Yvette; Holzemer, William L.

    2009-01-01

    Abstract The study aim is to explore the results of an HIV stigma intervention in five African health care settings. A case study approach was used. The intervention consisted of bringing together a team of approximately 10 nurses and 10 people living with HIV or AIDS (PLHA) in each setting and facilitating a process in which they planned and implemented a stigma reduction intervention, involving both information giving and empowerment. Nurses (n = 134) completed a demographic questionnaire, the HIV/AIDS Stigma Instrument-Nurses (HASI-N), a self-efficacy scale, and a self-esteem scale, both before and after the intervention, and the team completed a similar set of instruments before and after the intervention, with the PLHA completing the HIV/AIDS Stigma Instrument for PLHA (HASI-P). The intervention as implemented in all five countries was inclusive, action-oriented, and well received. It led to understanding and mutual support between nurses and PLHA and created some momentum in all the settings for continued activity. PLHA involved in the intervention teams reported less stigma and increased self-esteem. Nurses in the intervention teams and those in the settings reported no reduction in stigma or increases in self- esteem and self-efficacy, but their HIV testing behavior increased significantly. This pilot study indicates that the stigma experience of PLHA can be decreased, but that the stigma experiences of nurses are less easy to change. Further evaluation research with control groups and larger samples and measuring change over longer periods of time is indicated. PMID:20025515

  3. AIDS-related knowledge, attitudes, and behaviors among juvenile delinquents in Israel.

    PubMed

    Slonim-Nevo, V

    Fifty-six Israeli adolescents under the care of probation officers were interviewed about their AIDS-related knowledge, attitudes, and behaviors. The results suggest that these adolescents put themselves at risk of HIV infection. A substantial proportion of the sample demonstrated a lack of knowledge on issues relevant for AIDS prevention. The majority held negative attitudes toward condoms but were also sexually active, and some had experienced unprotected sexual intercourse, anal sex, and drug use. Most of the respondents, moreover, showed a lack of competence in handling situations that pressure them to act unsafely. Implications for practice are discussed. PMID:1343361

  4. Internalized societal attitudes moderate the impact of weight stigma on avoidance of exercise.

    PubMed

    Vartanian, Lenny R; Novak, Sarah A

    2011-04-01

    Experiences with weight stigma negatively impact both psychological outcomes (e.g., body dissatisfaction, depression) and behavioral outcomes (e.g., dieting, exercise). However, not everyone is equally affected by experiences with weight stigma. This study examined whether internalized societal attitudes about weight moderated the impact of weight stigma. Adult participants (n = 111) completed measures of experiences with weight stigma, as well as two indexes of internalized societal attitudes (the moderators): Internalized anti-fat attitudes and internalization of societal standards of attractiveness. Psychological outcomes included self-esteem, body dissatisfaction, drive for thinness, and bulimic symptoms; behavioral outcomes included avoidance of exercise and self-reported exercise behavior. Weight stigma was positively correlated with body dissatisfaction, drive for thinness, and bulimic symptoms, and was negatively correlated with state and trait self-esteem. Both indexes of internalized attitudes moderated the association between weight stigma and avoidance of exercise: Individuals high in anti-fat attitudes and high in internalization of societal standards of attractiveness were more motivated to avoid exercise if they also experienced a high degree of weight stigma; individuals low in anti-fat attitudes and low in internalization were relatively unaffected. Avoidance of exercise was negatively correlated with self-reported strenuous exercise. These findings suggest that weight stigma can negatively influence motivation to exercise, particularly among individuals who have internalized societal attitudes about weight. Reducing internalization might be a means of minimizing the negative impact of weight stigma and of facilitating healthy weight management efforts. PMID:20948515

  5. Managing and resisting stigma: a qualitative study among people living with HIV in South Africa

    PubMed Central

    Abrahams, Naeemah; Jewkes, Rachel

    2012-01-01

    Background Living with HIV is of daily concern for many South Africans and poses challenges including adapting to a chronic illness and continuing to achieve and meet social expectations. This study explored experiences of being HIV-positive and how people manage stigma in their daily social interactions. Methods Using qualitative methods we did repeat interviewed with 42 HIV-positive men and women in Cape Town and Mthatha resulting in 71 interviews. Results HIV was ubiquitous in our informants’ lives, and almost all participants reported fear of stigma (perceived stigma), but this fear did not disrupt them completely. The most common stigma experiences were gossips and insults where HIV status was used as a tool, but these were often resisted. Many feared the possibility of stigma, but very few had experiences that resulted in discrimination or loss of social status. Stigma experiences were intertwined with other daily conflicts and together created tensions, particularly in gender relations, which interfered with attempts to regain normality. Evidence of support and resistance to stigma was common, and most encouraging was the evidence of how structural interventions such as de-stigmatizing policies impacted on experiences and transference into active resistance. Conclusions The study showed the complex and shifting nature of stigma experiences. These differences must be considered when we intensify stigma reduction with context- and gender-specific strategies focussing on those not yet on ARV programmes. PMID:22905361

  6. Pathways between stigma and suicidal ideation among people at risk of psychosis.

    PubMed

    Xu, Ziyan; Müller, Mario; Heekeren, Karsten; Theodoridou, Anastasia; Metzler, Sibylle; Dvorsky, Diane; Oexle, Nathalie; Walitza, Susanne; Rössler, Wulf; Rüsch, Nicolas

    2016-04-01

    Mental illness stigma may contribute to suicidality and is associated with social isolation and low self-esteem among young people at risk of psychosis. However, it is unclear whether mental illness stigma contributes to suicidality in this population. We therefore examined the associations of self-labeling and stigma stress with suicidality among young people at risk. Self-labeling as "mentally ill", stigma stress, social isolation, self-esteem, symptoms and suicidal ideation were assessed in 172 individuals at risk of psychosis. Self-labeling and stigma stress were examined as predictors of suicidality by path analysis. Increased self-labeling as "mentally ill" was associated with suicidality, directly as well as indirectly mediated by social isolation. More stigma stress was related to social isolation which in turn was associated with low self-esteem, depression and suicidal ideation. Social isolation fully mediated the link between stigma stress and suicidal ideation. Interventions to reduce the public stigma associated with risk of psychosis as well as programs to facilitate non-stigmatizing awareness of at-risk mental state and to reduce stigma stress among young people at risk of psychosis might strengthen suicide prevention in this population. PMID:26843510

  7. Self-stigma, personality traits, and willingness to seek treatment in a community sample.

    PubMed

    Ingram, Paul B; Lichtenberg, James W; Clarke, Erik

    2016-08-01

    Stigma has received attention as a major barrier toward effective mental health service delivery, and previous research has demonstrated that the Five-Factor Model (FFM) domain of Openness to Experience is negatively correlated with stigmatized views of mental health. However, a lack of established relationships between personality and self-stigma, as well as how these concepts affect an individual's treatment-seeking intentions, has left a gap in the literature. To address this, our study recruited a low-income community sample and tested (a) the relationship between self-stigma of mental health treatment and the FFM, (b) the relationship between self-stigma and treatment-seeking intentions, and (c) the incremental validity of FFM personality beyond stigma in the prediction of treatment seeking. Results suggest that there is some incongruence with previous research on personality's relationship to stigma, personality does not act as an additive component in the prediction of the relationship between stigma and treatment seeking, and stigma is related only to the perceived need for mental health treatment but not to an individual's openness to seek that treatment. The discussion concludes with implications for the contextualization and treatment of stigma as a barrier for mental health treatment and a general synthesis of the personality trait profiles for those holding stigmatizing views of mental health. (PsycINFO Database Record PMID:27253319

  8. Gender and AIDS-related psychosocial processes: a study of perceived susceptibility, social distance, and homophobia.

    PubMed

    Schieman, S

    1998-06-01

    Over the past decade, researchers have accumulated evidence that suggests six main factors are associated with AIDS-related risk reduction behavior: (a) perceived susceptibility (Dolcini et al., 1995; van der Plight & Richard, 1994); (b) attitudes toward condoms (Catania et al., 1994; Maticka-Tynadale, 1991); (c) personally knowing someone with HIV/AIDS (Joseph et al., 1987); (d) perceived peer norms about risk-reduction (Maticka-Tyndale, 1991); (e) previous sexual activity (Joseph et al., 1987); and (f) self-efficacy (Aspinwall, Kemeny, Taylor, & Schneider, 1991; van der Plight & Richard, 1994). Furthermore, there is some suggestion that the epidemiology and sociocultural constructions of the disease has led to considerable gender, racial, and class differences in awareness of AIDS, perception of HIV threat, and HIV-relevant behavior (Cohan & Atwood, 1994; Dolcini et al., 1995; Gillies, 1994). PMID:9642424

  9. The relationships between HIV stigma, emotional status, and emotional regulation among HIV-affected children in rural China

    PubMed Central

    Wei, Wei; Li, Xiaoming; Harrison, Sayward; Zhao, Junfeng; Zhao, Guoxiang

    2016-01-01

    ABSTRACT Children affected by HIV/AIDS have unique psychosocial needs that often go unaddressed in traditional treatment approaches. They are more likely than unaffected peers to encounter stigma, including overt discriminatory behaviors, as well as stereotyped attitudes. In addition, HIV-affected children are at risk for experiencing negative affect, including sadness and depression. Previous studies have identified a link between HIV stigma and the subsequent emotional status of children affected by HIV/AIDS. However, limited data are available regarding protective psychological factors that can mitigate the effects of HIV stigma and thus promote resiliency for this vulnerable population. Utilizing data from 790 children aged 6–17 years affected by parental HIV in rural central China this study aims to examine the association between HIV stigma, including both enacted and perceived stigma, and emotional status among HIV-affected children, as well as to evaluate the mediating effects of emotional regulation on the relationship between HIV stigma and emotional status. In addition, the moderating role of age is tested. Multiple regression was conducted to test the mediation model. We found that the experience of HIV stigma had a direct positive effect on negative emotions among children affected by HIV. Emotional regulation offers a level of protection, as it mediated the impact of HIV stigma on negative emotions. Moreover, age was found to moderate the relationship between perceived stigma and negative emotions. A significant interaction between perceived stigma and age suggested that negative emotions increase with age among those who perceived a higher level of stigmatization. Results suggest that children affected by HIV may benefit from interventions designed to enhance their capacity to regulate emotions and that health professionals should be aware of the link between stigma and negative emotion in childhood and adolescence and use the knowledge to inform

  10. HIV stigma intervention in a low-HIV prevalence setting: a pilot study in an Egyptian healthcare facility.

    PubMed

    Lohiniva, Anna-Leena; Benkirane, Manal; Numair, Tarek; Mahdy, Abdelrahman; Saleh, Hanan; Zahran, Amin; Okasha, Omar; Talaat, Maha; Kamal, Walid

    2016-05-01

    This pilot study is the first to evaluate stigma-reduction intervention in a healthcare setting in Egypt and in the Middle East and North Africa region. It also contributes to knowledge on how to address stigma in low-HIV prevalence settings. A quasi-experimental study design was used to evaluate the effect of anti-HIV stigma intervention in one hospital in Egypt. A control hospital was selected and matched to the intervention hospital by type, size and location. The intervention focused on HIV-related stigma, infection control and medical ethics. Stigma was measured at baseline and at three months post-intervention. A standardized, 10-point scale was developed to measure stigmatizing attitudes and fear-based stigma among participants. Comparisons of overall and job-stratified stigma scores were made across the intervention and control hospitals, before and after the intervention, using two-sample t-test and multivariate regression analysis. Mean stigma scores did not reveal significant differences between the intervention and control hospitals at baseline. After intervention, the overall value-based and fear-based stigma scores were significantly lower in the intervention hospital compared to the control hospital (2.1 and 1.1 compared to 3.8 and 3.2, respectively; p < .001). Context-specific and culturally appropriate HIV stigma-reduction interventions in low-HIV prevalence settings can reduce fear-based and value-based stigma among physicians and nurses. PMID:26717980

  11. Family Stigma and Caregiver Burden in Alzheimer's Disease

    ERIC Educational Resources Information Center

    Werner, Perla; Mittelman, Mary S.; Goldstein, Dovrat; Heinik, Jeremia

    2012-01-01

    Purpose: The stigma experienced by the family members of an individual with a stigmatized illness is defined by 3 dimensions: caregiver stigma, lay public stigma, and structural stigma. Research in the area of mental illness suggests that caregivers' perception of stigma is associated with increased burden. However, the effect of stigma on…

  12. Social Stigma and Sexual Minorities’ Romantic Relationship Functioning: A Meta-Analytic Review

    PubMed Central

    Doyle, David Matthew; Molix, Lisa

    2015-01-01

    To bolster knowledge of determinants of relationship functioning among sexual minorities, the current meta-analysis aimed to quantitatively review evidence for the association between social stigma and relationship functioning as well as examine potential moderators. Thirty-five studies were identified, including 130 effect sizes (39 independent; N = 10,745). Across studies, evidence was found for a small but significant inverse association between social stigma and relationship functioning. Furthermore, this association was moderated by stigma type (with more deleterious associations for internalized relative to perceived stigma) and dimension of relationship functioning (with more deleterious associations for affective relative to cognitive and negative relative to positive). Evidence for demographic moderators (region, sex, race, age) was generally mixed although important limitations related to unique characteristics of study samples are discussed. We conclude by highlighting the importance of social stigma for relationship functioning and point toward directions for future research and policy action. PMID:26199218

  13. Social Stigma and Sexual Minorities' Romantic Relationship Functioning: A Meta-Analytic Review.

    PubMed

    Doyle, David Matthew; Molix, Lisa

    2015-10-01

    To bolster knowledge of determinants of relationship functioning among sexual minorities, the current meta-analysis aimed to quantitatively review evidence for the association between social stigma and relationship functioning as well as examine potential moderators. Thirty-five studies were identified, including 130 effect sizes (39 independent; N = 10,745). Across studies, evidence was found for a small but significant inverse association between social stigma and relationship functioning. Furthermore, this association was moderated by stigma type (with more deleterious associations for internalized relative to perceived stigma) and dimension of relationship functioning (with more deleterious associations for affective relative to cognitive and negative relative to positive). Evidence for demographic moderators (region, sex, race, age) was generally mixed although important limitations related to unique characteristics of study samples are discussed. We conclude by highlighting the importance of social stigma for relationship functioning and point toward directions for future research and policy action. PMID:26199218

  14. Patient-related barriers to pain management in ambulatory AIDS patients.

    PubMed

    Breitbart, W; Passik, S; McDonald, M V; Rosenfeld, B; Smith, M; Kaim, M; Funesti-Esch, J

    1998-05-01

    A number of studies have demonstrated that pain is dramatically undertreated among patients with AIDS and that opioids in particular are rarely prescribed. To date, however, there has been no systematic attempt to examine patient-related barriers to the management of pain in AIDS. This study examines potential patient-related barriers to pain management in patients with AIDS using the Barriers Questionnaire (Ward et al., Pain, 52 (1993) 319-324), and assesses gender, racial, and other demographic differences in the endorsement of these barriers. We surveyed 199 ambulatory patients with AIDS, recruited from numerous sites in New York City, as part of an ongoing study of pain and quality of life in ambulatory AIDS patients. In addition to obtaining demographic and medical data, we administered a number of self-report questionnaires including the Brief Pain Inventory (BPI), the Brief Symptom Index (BSI), the Beck Depression Inventory (BDI), and the Memorial Symptom Assessment Scale (MSAS). Barriers to pain management were assessed using a modified version of the Barriers Questionnaire (BQ), including the original 27 questions from this self-report instrument along with an additional 12 items developed for an AIDS population. Results indicated that the most frequently endorsed BQ items were those concerning the addiction potential of pain medications and physical discomfort associated with opioid administration (e.g. injections) or side effects (e.g. nausea, constipation). There were no associations between age, gender, or HIV transmission risk factor and total scores on the BQ; however, Caucasian patients endorsed significantly fewer BQ items than did non-Caucasian patients and years of education was negatively correlated with BQ scores. Scores on the BQ were also significantly correlated with number of physical symptoms (MSAS) and scores on several self-report measures of psychological distress (the BSI Global Distress Index, BDI total scores). Patient-related

  15. STIGMA AROUND HIV IN DENTAL CARE: PATIENTS' EXPERIENCES.

    PubMed

    Brondani, Mario A; Phillips, J Craig; Kerston, R Paul; Moniri, Nardin R

    2016-02-01

    Tooth decay and other oral diseases can be highly prevalent among people living with HIV/AIDS (PLWHA). Even though dental professionals are trained to provide equal and non-judgemental services to all, intentional or unintentional biases may exist with regard to PLWHA. We conducted qualitative descriptive research using individual interviews to explore the experiences of PLWHA accessing dental care services in Vancouver, Canada. We interviewed 25 PLWHA, aged 23-67 years; 21 were men and 60% reported fair or poor oral health. Thematic analysis showed evidence of both self-stigma and public stigma with the following themes: fear, self-stigma and dental care; overcoming past offences during encounters with dental care professionals; resilience and reconciliation to achieve quality care for all; and current encounters with dental care providers. Stigma attached to PLWHA is detrimental to oral care. The social awareness of dental professionals must be enhanced, so that they can provide the highest quality care to this vulnerable population. PMID:27548661

  16. Contextualizing condom use: intimacy interference, stigma, and unprotected sex.

    PubMed

    Starks, Tyrel J; Payton, Gregory; Golub, Sarit A; Weinberger, Corina L; Parsons, Jeffrey T

    2014-06-01

    Intimate relationships have received increasing attention as a context for HIV transmission. We examined the relationships among perceptions that condoms interfere with intimacy, gay-related stigma, and unprotected/protected anal intercourse. Participants included 245 single-identified men who have sex with men. Intimacy Interference was positively associated with number of unprotected anal intercourse acts, and this effect was stronger among participants who reported high levels of gay-related stigma. In contrast, Intimacy Interference was negatively associated with number of protected anal intercourse acts, and gay-related stigma was positively associated with this outcome with no evidence of interaction effects. The findings are explained in the context of rejection sensitivity theory, and implications for public health and clinical intervention are discussed. PMID:23520349

  17. Productive human immunodeficiency virus infection levels correlate with AIDS-related manifestations in the patient

    SciTech Connect

    Mathez, D.; Paul, D.; de Belilovsky, C.; Sultan, Y.; Deleuze, J.; Gorin, I.; Saurin, W.; Decker, R.; Leibowitch, J. )

    1990-10-01

    Mononuclear cells were obtained from 71 human immunodeficiency virus type 1 (HIV-1) seropositive subjects presenting and first visit either as asymptomatic or with minor symptoms and with CD4 lymphocytes greater than 550 per mm3 (group A, 35 patients) or as patients with AIDS, AIDS-related illnesses, or CD4 lymphocytes less than 400 per mm3 (group B, 36 patients). After 1-5 years of follow-up, 13 patients of group A had essentially retained their initial status (asymptomatics); the 22 others had suffered clinical or immunological deterioration (progressors). Frozen cells were thawed and submitted to lethal gamma-irradiation in vitro (4500 rads; 1 rad = 0.01 Gy) before they were cultured with normal phytohemagglutinin-stimulated lymphocytes to determine radiation-resistant HIV expression ex vivo (R-HEV). HIV antigenemia correlated with R-HEV values in 142 samples (r = 0.92, P less than 0.001) but was a less sensitive predictor of disease than R-HEV. R-HEV was detected in all specimens from patients with major AIDS-related illnesses or HIV-associated CD4 lymphopenia. In 77% of the progressors from group A, R-HEV detection preceded the onset of AIDS-associated disease or CD4 lymphopenia by 1 year (average). Conversely, R-HEV was low or was not detected in 36 sequential specimens from the 13 patients who remained asymptomatic over the following 2-5 years. Thus, persistently low HIV expression in vivo predicted a nondiseased state, whereas higher HIV expression levels seemed necessary for disease to occur. These data indicate that R-HEV is related to productive HIV infection in vivo, the latter acting as a determinant of AIDS-related illnesses. In view of this, measurement of HIV expression levels in the patient should be useful in antiviral efficacy trials.

  18. Correlates of Social Exclusion and Negative Labeling and Devaluation of People Living with HIV/AIDS in Rural Settings: Evidence from a General Household Survey in Zambézia Province, Mozambique

    PubMed Central

    Mukolo, Abraham; Blevins, Meridith; Victor, Bart; Vaz, Lara M. E.; Sidat, Mohsin; Vergara, Alfredo

    2013-01-01

    Background Increased HIV/AIDS knowledge and access to antiretroviral treatment (ART) have been hypothesized to decrease HIV stigma. However, stigma persists as a barrier to HIV services uptake. We studied the relationship between stigma, knowledge and attitudes towards HIV and its treatment, and confidence in the legal system (legal rights certitude). Methods We analyzed data from a household survey of 3749 randomly sampled female heads of households in 259 enumeration areas across 14 districts of Zambézia Province, Mozambique. The questionnaire included questions about beliefs, attitudes and behavior towards PLWHA, HIV transmission knowledge, treatment-related beliefs, and legal rights certitude. Factor analysis distinguished two stigma constructs: Negative labeling and devaluation (NLD) and social exclusion (SoE). Multivariable linear regression was used to determine the association between stigma, knowledge of HIV/AIDS, treatment-related beliefs, and legal rights certitude, while controlling for variance in socio-demographics. Results A 4-point increase in knowledge about HIV transmission was associated with more than a 3 unit decrease in NLD and SoE stigma scores (p<0.001). Given HIV transmission knowledge, a 25-point increase in legal rights certitude was associated with a 4.62 unit drop in NLD stigma (p<0.001); we did not detect an association between legal rights certitude and SoE stigma. Knowing at least one HIV positive person was associated with lower SoE (−3.17, 95% CI: −5.78, −0.56); no association with NLD (p = 0.1) was detected. ART efficacy belief was associated with higher NLD and lower SoE (2.90 increase and 6.94 decrease, respectively; p≤0.001). Conclusion Increasing knowledge about HIV transmission and access to ART are likely to reduce stigma, but neither of the two is a panacea. Raising community awareness of the legal rights of PLWHA might improve the efficacy of stigma reduction efforts. Strategies that focus on specific domains

  19. Gender, Self-Stigma, and Public Stigma in Predicting Attitudes toward Psychological Help-Seeking

    ERIC Educational Resources Information Center

    Topkaya, Nursel

    2014-01-01

    Using a sample of university students (N = 362), the role of gender and both the self-stigma and public stigma associated with one's decision to seek psychological help in predicting attitudes toward psychological helpseeking were examined. Moreover, gender differences regarding both the self-stigma and the public stigma associated with…

  20. Eugenics, genetics, and mental illness stigma in Chinese Americans

    PubMed Central

    Yang, Lawrence H.; Link, Bruce G.; Phelan, Jo C.

    2011-01-01

    Background The increasing interest in the genetic causes of mental disorders may exacerbate existing stigma if negative beliefs about a genetic illness are generally accepted. China’s history of policy-level eugenics and genetic discrimination in the workplace suggests that Chinese communities will view genetic mental illness less favorably than mental illness with non-genetic causes. The aim of this study is to identify differences between Chinese Americans and European Americans in eugenic beliefs and stigma toward people with genetic mental illness. Methods We utilized data from a 2003 national telephone survey designed to measure how public perceptions of mental illness differ if the illness is described as genetic. The Chinese American (n = 42) and European American (n = 428) subsamples were analyzed to compare their support of eugenic belief items and measures of stigma. Results Chinese Americans endorsed all four eugenic statements more strongly than European Americans. Ethnicity significantly moderated the relationship between genetic attribution and three out of five stigma outcomes; however, genetic attribution actually appeared to be de-stigmatizing for Chinese Americans while it increased stigma or made no difference for European Americans. Conclusions Our findings show that while Chinese Americans hold more eugenic beliefs than European Americans, these attributions do not have the same effect on stigma as they do in Western cultures. These results suggest that future anti-stigma efforts must focus on eugenic attitudes as well as cultural beliefs for Chinese Americans, and that the effects of genetic attributions for mental illness should be examined relative to other social, moral, and religious attributions common in Chinese culture. PMID:21079911

  1. Stigma in youth with Tourette's syndrome: a systematic review and synthesis.

    PubMed

    Malli, Melina A; Forrester-Jones, Rachel; Murphy, Glynis

    2016-02-01

    Tourette's syndrome (TS) is a childhood onset neurodevelopmental disorder, characterised by tics. To our knowledge, no systematic reviews exist which focus on examining the body of literature on stigma in association with children and adolescents with TS. The aim of the article is to provide a review of the existing research on (1) social stigma in relation to children and adolescents with TS, (2) self-stigma and (3) courtesy stigma in family members of youth with TS. Three electronic databases were searched: PsycINFO, PubMed and Web of Science. Seventeen empirical studies met the inclusion criteria. In relation to social stigma in rating their own beliefs and behavioural intentions, youth who did not have TS showed an unfavourable attitude towards individuals with TS in comparison to typically developing peers. Meanwhile, in their own narratives about their lives, young people with TS themselves described some form of devaluation from others as a response to their disorder. Self-degrading comments were denoted in a number of studies in which the children pointed out stereotypical views that they had adopted about themselves. Finally, as regards courtesy stigma, parents expressed guilt in relation to their children's condition and social alienation as a result of the disorder. Surprisingly, however, there is not one study that focuses primarily on stigma in relation to TS and further studies that examine the subject from the perspective of both the 'stigmatiser' and the recipient of stigma are warranted. PMID:26316059

  2. Perceptions of Mental Illness Stigma: Comparisons of Athletes to Nonathlete Peers

    ERIC Educational Resources Information Center

    Kaier, Emily; Cromer, Lisa DeMarni; Johnson, Mitchell D.; Strunk, Kathleen; Davis, Joanne L.

    2015-01-01

    Stigma related to mental health and its treatment can thwart help-seeking. The current study assessed college athletes' personal and perceived public mental illness stigma and compared this to nonathlete students. Athletes (N = 304) were National Collegiate Athletic Association (NCAA) Division I athletes representing 16 teams. Results indicated…

  3. Stigma, Social Context, and Mental Health: Lesbian and Gay Couples across the Transition to Adoptive Parenthood

    ERIC Educational Resources Information Center

    Goldberg, Abbie E.; Smith, JuliAnna Z.

    2011-01-01

    This is the first study to examine change in depression and anxiety across the first year of adoptive parenthood in same-sex couples (90 couples: 52 lesbian, 38 gay male). Given that sexual minorities uniquely contend with sexual orientation-related stigma, this study examined how both internalized and enacted forms of stigma affect the mental…

  4. HIV/AIDS-associated beliefs and practices relating to diet and work in southeastern Uganda

    PubMed Central

    Komwa, Maction K.; Parker, Dawn C.

    2010-01-01

    To explore beliefs relating to diet, work, and HIV/AIDS among the Busoga of rural southeastern Uganda, a cross-sectional survey of 322 adults was conducted in 2007 in Mayuge district, Uganda. Of these adults, 56 were HIV-infected, 120 had a family member with HIV/AIDS, and 146 were in households without HIV-infected members. More than 74.2% of the adults knew someone with HIV/AIDS, and more than 90% correctly identified transmission modes and prevention methods of HIV. In total, 93.2% believed that a person with HIV should work fewer hours to conserve energy but all the three participant groups reported the same working hours. Also, 91.6% believed that a person with HIV infection should eat special nutritious foods, and the participants with HIV infection reported eating more fruits (p=0.020) and vegetables (p=0.012) than other participants. The participants expressed a consistent set of health beliefs about practices relating to HIV/AIDS. PMID:20214089

  5. Crocus cancellatus subsp. damascenus stigmas: chemical profile, and inhibition of α-amylase, α-glucosidase and lipase, key enzymes related to type 2 diabetes and obesity.

    PubMed

    Loizzo, Monica R; Marrelli, Mariangela; Pugliese, Alessandro; Conforti, Filomena; Nadjafi, Farsad; Menichini, Francesco; Tundis, Rosa

    2016-01-01

    Spices are appreciated for their medicinal properties besides their use as food adjuncts to enhance the sensory quality of food. In this study, Crocus cancellatus subsp. damascenus was investigated for its antioxidant activities employing different in vitro systems. Stigma extract demonstrated a radical scavenging activity against both 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulphonic acid) (ABTS) radicals with IC50 values of 34.6 and 21.6 µg/mL and a good ferric reducing ability (53.9 µM Fe(II)/g). In order to clarify the potential functional properties of this spice, the carbohydrate-hydrolysing enzymes and pancreatic lipase inhibitory properties were investigated. Crocus cancellatus subsp. damascenus extract inhibited α-amylase and α-glucosidase with IC50 values of 57.1 and 68.6 µg/mL, respectively. The bioactivity was discussed in terms of phytochemicals content. The obtained results may be of interest from a functional point of view or as food additive and to promote the revalorization of this species. PMID:25792502

  6. A Positive Stigma for Child Labor?

    ERIC Educational Resources Information Center

    Patrinos, Harry Anthony; Shafiq, M. Najeeb

    2008-01-01

    We introduce a simple empirical model that assumes a positive stigma (or norm) towards child labor that is common in some developing countries. We then illustrate our positive stigma model using data from Guatemala. Controlling for several child- and household-level characteristics, we use two instruments for measuring stigma: a child's indigenous…

  7. Socioeconomic gradients in internalized stigma among persons with HIV in sub-Saharan Africa

    PubMed Central

    Tsai, Alexander C.

    2015-01-01

    The stigma attached to HIV is a major public health problem. HIV-associated morbidity, the specter of impending premature mortality, and reduced capacity to reciprocate within networks of mutual aid are key contributors to status loss and the social exclusion of persons with HIV in sub-Saharan Africa. The pooled dataset used in my analysis, which includes 4,314 persons with HIV surveyed in 12 different sub-Saharan African countries, represents the largest study to date of internalized stigma among persons with HIV. My findings indicate that nearly one-fifth of study participants provided survey responses consistent with internalization of stigmatizing beliefs. Furthermore, striking socioeconomic gradients in internalized stigma were observed. A clear implication of my findings is that the adverse health and psychosocial impacts of HIV stigma are likely concentrated among those with the fewest socioeconomic resources for managing and resisting it. PMID:25572833

  8. Lung Cancer Stigma as a Barrier to Medical Help-Seeking Behavior: Practice Implications

    PubMed Central

    Carter-Harris, Lisa

    2015-01-01

    Purpose The purpose of this study was to examine the relationship of perceived lung cancer stigma and timing of medical help-seeking behavior in symptomatic individuals. Data sources A convenience sample was recruited from an academic thoracic oncology clinic and community hospital-based outpatient radiation center in a large city in the southeastern United States. This descriptive, cross-sectional study used survey methodology and semi-structured interviews to examine the relationship of perceived lung cancer stigma and delayed medical help-seeking finding a statistically significant positive correlation. Additional examination revealed positive correlations between the stigma and shame, social isolation, and smoking-related stigma subscales and delay. The discrimination-related subscale was not associated with delay. In addition, smoking status was not related to perceived lung cancer stigma. Conclusions Findings support an association between lung cancer stigma and delayed medical help-seeking behavior. Therefore, lung cancer stigma is a potential barrier to timely medical help-seeking behavior in lung cancer symptoms, which can have important patient outcome implications. Implications for practice As primary care nurse practitioners, awareness that lung cancer stigma exists for patients is essential regardless of smoking status and efforts to decrease this barrier to timely healthcare are important. PMID:25736473

  9. Predicting AIDS-related events using CD4 percentage or CD4 absolute counts

    PubMed Central

    Pirzada, Yasmin; Khuder, Sadik; Donabedian, Haig

    2006-01-01

    Background The extent of immunosuppression and the probability of developing an AIDS-related complication in HIV-infected people is usually measured by the absolute number of CD4 positive T-cells. The percentage of CD4 positive cells is a more easily measured and less variable number. We analyzed sequential CD4 and CD8 numbers, percentages and ratios in 218 of our HIV infected patients to determine the most reliable predictor of an AIDS-related event. Results The CD4 percentage was an unsurpassed predictor of the occurrence of AIDS-related events when all subsets of patients are considered. The CD4 absolute count was the next most reliable, followed by the ratio of CD4/CD8 percentages. The value of CD4 percentage over the CD4 absolute count was seen even after the introduction of highly effective HIV therapy. Conclusion The CD4 percentage is unsurpassed as a parameter for predicting the onset of HIV-related diseases. The extra time and expense of measuring the CD4 absolute count may be unnecessary. PMID:16916461

  10. Anti-Stigma Programs: Stigma in Campus Police Officers

    ERIC Educational Resources Information Center

    Rafacz, Jennifer D.

    2012-01-01

    It has been proposed that the most effective way to combat mental illness stigma is to focus on power groups who have a direct impact on the lives of persons with serious mental illness. With the increase of violence and need for mental health services on college campuses, campus police officers are seen as an important power group for persons…

  11. Dyadic Effects of Stigma and Discrimination on Distress in Chinese HIV Discordant Couples.

    PubMed

    Yu, Nancy Xiaonan; Chan, Cecilia L W; Zhang, Jianxin

    2016-08-01

    The present study investigated the dyadic effects of stigma and discrimination on distress in Chinese couples affected by HIV. Chinese people living with HIV (PLHIV) and their seronegative spouses (N = 119 couples) participated in this study. The PLHIV completed measures on stigma beliefs about being better off dead and dignity-related distress. The spouses completed measures on perceived discrimination and exclusion and caregiver distress. The results showed that there was no significant correlation between the PLHIV's stigma beliefs and the spouses' perceived discrimination and exclusion. The couples showed significant associations in their dignity-related distress and caregiver distress. Analyses using the actor-partner interdependence model showed that PLHIV's stigma beliefs and the spouses' perceived discrimination and exclusion both had significant actor and partner effects on distress within the dyad. Psychosocial interventions aiming for distress reduction in the context of HIV should tackle stigma and discrimination and target the couples rather than solely the patient or spouse. PMID:27427923

  12. Brief Report: Role of Thymic Reconstitution in the Outcome of AIDS-Related PML.

    PubMed

    Chalkias, Spyridon G; Gheuens, Sarah; Bord, Evelyn; Batson, Stephanie; Koralnik, Igor J

    2015-12-01

    Implications of thymopoiesis in AIDS-related opportunistic infections remain unexplored. We used progressive multifocal leukoencephalopathy (PML), caused by JC virus (JCV), as an opportunistic infection model, and we simultaneously investigated thymic output and T-cell responses against JCV in 22 patients with PML treated with combined antiretroviral therapy. Thymic output was significantly associated with JCV-specific CD4⁺ and CD8⁺ T-cell responses and improved survival. Our data suggest that patients with AIDS-related PML and impaired thymopoiesis are less likely to develop a robust JCV-specific cellular immune response and consequently are at an increased risk for a poor clinical outcome. PMID:26181821

  13. Chinese Culture, Homosexuality Stigma, Social Support and Condom Use: A Path Analytic Model

    PubMed Central

    Liu, Hongjie; Feng, Tiejian; Ha, Toan; Liu, Hui; Cai, Yumao; Liu, Xiaoli; Li, Jian

    2011-01-01

    Purpose The objective of this study was to examine the interrelationships among individualism, collectivism, homosexuality-related stigma, social support, and condom use among Chinese homosexual men. Methods A cross-sectional study using the respondent-driven sampling approach was conducted among 351 participants in Shenzhen, China. Path analytic modeling was used to analyze the interrelationships. Results The results of path analytic modeling document the following statistically significant associations with regard to homosexuality: (1) higher levels of vertical collectivism were associated with higher levels of public stigma [β (standardized coefficient) = 0.12] and self stigma (β = 0.12); (2) higher levels of vertical individualism were associated with higher levels self stigma (β = 0.18); (3) higher levels of horizontal individualism were associated with higher levels of public stigma (β = 0.12); (4) higher levels of self stigma were associated with higher levels of social support from sexual partners (β = 0.12); and (5) lower levels of public stigma were associated with consistent condom use (β = −0.19). Conclusions The findings enhance our understanding of how individualist and collectivist cultures influence the development of homosexuality-related stigma, which in turn may affect individuals’ decisions to engage in HIV-protective practices and seek social support. Accordingly, the development of HIV interventions for homosexual men in China should take the characteristics of Chinese culture into consideration. PMID:21731850

  14. Reducing stigma and discrimination: Candidate interventions

    PubMed Central

    Thornicroft, Graham; Brohan, Elaine; Kassam, Aliya; Lewis-Holmes, Elanor

    2008-01-01

    This paper proposes that stigma in relation to people with mental illness can be understood as a combination of problems of knowledge (ignorance), attitudes (prejudice) and behaviour (discrimination). From a literature review, a series of candidate interventions are identified which may be effective in reducing stigmatisation and discrimination at the following levels: individuals with mental illness and their family members; the workplace; and local, national and international. The strongest evidence for effective interventions at present is for (i) direct social contact with people with mental illness at the individual level, and (ii) social marketing at the population level. PMID:18405393

  15. Assessing the Consequences of Stigma for Tuberculosis Patients in Urban Zambia

    PubMed Central

    Cremers, Anne Lia; de Laat, Myrthe Manon; Kapata, Nathan; Gerrets, Rene; Klipstein-Grobusch, Kerstin; Grobusch, Martin Peter

    2015-01-01

    Background Stigma is one of the many factors hindering tuberculosis (TB) control by negatively affecting hospital delay and treatment compliance. In Zambia, the morbidity and mortality due to TB remains high, despite extended public health attempts to control the epidemic and to diminish stigma. Study Aim To enhance understanding of TB-related stigmatizing perceptions and to describe TB patients’ experiences of stigma in order to point out recommendations to improve TB policy. Methods We conducted a mixed method study at Kanyama clinic and surrounding areas, in Lusaka, Zambia; structured interviews with 300 TB patients, multiple in-depth interviews with 30 TB patients and 10 biomedical health workers, 3 focus group discussions with TB patients and treatment supporters, complemented by participant observation and policy analysis of the TB control program. Predictors of stigma were identified by use of multivariate regression analyses; qualitative analysis of the in-depth interviews, focus group discussions and participant observation was used for triangulation of the study findings. Results We focused on the 138/300 patients that described TB-related perceptions and attitudes, of whom 113 (82%) reported stigma. Stigma provoking TB conceptions were associated with human immunodeficiency virus (HIV)-infection, alleged immoral behaviour, (perceived) incurability, and (traditional) myths about TB aetiology. Consequences of stigma prevailed both among children and adults and included low self-esteem, insults, ridicule, discrimination, social exclusion, and isolation leading to a decreased quality of life and social status, non-disclosure, and/or difficulties with treatment compliance and adherence. Women had significantly more stigma-related problems than men. Conclusions The findings illustrate that many TB patients faced stigma-related issues, often hindering effective TB control and suggesting that current efforts to reduce stigma are not yet optimal. The content

  16. Too similar, too different: the paradoxical dualism of psychiatric stigma.

    PubMed

    Gergel, Tania Louise

    2014-08-01

    Challenges to psychiatric stigma fall between a rock and a hard place. Decreasing one prejudice may inadvertently increase another. Emphasising similarities between mental illness and 'ordinary' experience to escape the fear-related prejudices associated with the imagined 'otherness' of persons with mental illness risks conclusions that mental illness indicates moral weakness and the loss of any benefits of a medical model. An emphasis on illness and difference from normal experience risks a response of fear of the alien. Thus, a 'likeness-based' and 'unlikeness-based' conception of psychiatric stigma can lead to prejudices stemming from paradoxically opposing assumptions about mental illness. This may create a troubling impasse for anti-stigma campaigns. PMID:25237534

  17. Felt stigma and obesity: introducing the generalized other.

    PubMed

    Barlösius, Eva; Philipps, Axel

    2015-04-01

    People with a big body are tainted in western societies. Although most research on obesity occurs in the medical context, few studies investigate characteristics and effects of feelings and fears related to the fat stigma in the absence of overt discrimination. By linking Norbert Elias's and George H. Mead's theoretical frameworks, this paper offers a different approach to understanding and investigating felt stigma. The study is based on secondary data (25 semistructured interviews with children and adolescents). It explores internalized societal perspectives on overweight and obesity and inquires into the way in which interviewees handle the blame frame of personal responsibility during their interview. The preliminary findings suggest that specific forms of managing one's self-presentation in interviews indicate felt stigma. Consequently, the paper argues for an analytical approach that extends the focus on the content of interviews to include its dynamics. PMID:25658623

  18. Too similar, too different: the paradoxical dualism of psychiatric stigma

    PubMed Central

    Gergel, Tania Louise

    2014-01-01

    Challenges to psychiatric stigma fall between a rock and a hard place. Decreasing one prejudice may inadvertently increase another. Emphasising similarities between mental illness and ‘ordinary’ experience to escape the fear-related prejudices associated with the imagined ‘otherness’ of persons with mental illness risks conclusions that mental illness indicates moral weakness and the loss of any benefits of a medical model. An emphasis on illness and difference from normal experience risks a response of fear of the alien. Thus, a ‘likeness-based’ and ‘unlikeness-based’ conception of psychiatric stigma can lead to prejudices stemming from paradoxically opposing assumptions about mental illness. This may create a troubling impasse for anti-stigma campaigns. PMID:25237534

  19. The Stigma of Hearing Loss

    ERIC Educational Resources Information Center

    Wallhagen, Margaret I.

    2010-01-01

    Purpose: To explore dimensions of stigma experienced by older adults with hearing loss and those with whom they frequently communicate to target interventions promoting engagement and positive aging. Design and Methods: This longitudinal qualitative study conducted interviews over 1 year with dyads where one partner had hearing loss. Participants…

  20. Youth Homelessness and Social Stigma

    ERIC Educational Resources Information Center

    Kidd, Sean A.

    2007-01-01

    Building upon previous exploratory qualitative research (Kidd S.A. (2003) "Child Adol. Social Work J." 20(4):235-261), this paper examines the mental health implications of social stigma as it is experienced by homeless youth. Surveys conducted with 208 youths on the streets and in agencies in New York City and Toronto revealed significant…

  1. Attempted suicide in Ghana: motivation, stigma, and coping.

    PubMed

    Osafo, Joseph; Akotia, Charity Sylvia; Andoh-Arthur, Johnny; Quarshie, Emmanuel Nii-Boye

    2015-01-01

    To understand the experiences of suicidal persons in Ghana, 10 persons were interviewed after they attempted suicide. Thematic analysis of data showed that motivation for suicidal behavior included social taunting, hopelessness, and partner's infidelity. Suicidal persons reported stigma expressed through physical molestation and social ostracism, which left them traumatized. However, they coped through social support from relations, religious faith, and use of avoidance. Community-wide sensitive education should target reducing stigma and also increase mental health education on suicidal behavior in Ghanaian communities. PMID:25562343

  2. Creating and sustaining an effective coaching culture in home care: one organization's performance improvement related to aides and aide retention.

    PubMed

    Flannery, Marki

    2011-05-01

    Relationships between aides and their supervisors are often challenging. Unproductive disciplinary conversations lead to increased dissatisfaction, low morale, high turnover, and stress levels among staff. This cycle can continue to spiral if not effectively addressed and aimed in a positive direction. This article shares the experience of an organization that addressed this concern through a performance improvement initiative. PMID:21543917

  3. Perceptions of stigma among medical and nursing students and tuberculosis and diabetes patients at a teaching hospital in southern India.

    PubMed

    Vaz, Manjulika; Travasso, Sandra M; Vaz, Mario

    2016-01-01

    Stigma has a significant impact on the diagnosis of a variety of illnesses, patients' compliance with treatment and their recovery from these diseases. However, the Indian medical and nursing curriculum has given relatively little attention to recognising and addressing the issue of stigma. This study compared the perception of stigma with respect to tuberculosis (TB) and diabetes mellitus (DM) among medical and nursing students to that among patients with these diseases. The Explanatory Model Interview Catalogue (EMIC) questionnaire was used for all patients and student groups. Focus group discussions were held with only the students to understand their concept of stigma and the challenges they face while addressing stigma, and to explore their role in addressing stigma. The data showed that patients with TB prefer not to disclose their illness, while DM is not perceived of as stigmatising by patients. As a group, medical and nursing students attached excessive stigma to patients with both DM and TB, and this may mean that medical professionals subconsciously do harm through their interactions with patients and the attitudes they project to society. The perceptions of stigma were linked to the patient's socioeconomic background, apart from the medical condition itself. The students recognised that they lacked the skills to understand and address stigma. We recommend that the subject of stigma be integrated into the curriculum of medical and nursing students. PMID:26826655

  4. Anxiety and Stigma in Dementia: A Threat to Aging in Place

    PubMed Central

    Riley, Rebecca J.; Burgener, Sandy

    2014-01-01

    Synopsis The number of Americans with dementia is expected to increase as the population ages. Developing dementia is feared by many older adults and may result in anxiety in persons with dementia (PwD). This article focuses on anxiety, one of the least understood symptoms associated with dementia in community-dwelling older adults, the stigma of dementia, and the relationship between anxiety and stigma in dementia. When undetected and untreated, anxiety and associated stigma can adversely affect quality of life and the ability to age in place. The paper begins by describing dementia-related anxiety. Next, based on research by the authors and others, the association between stigma and anxiety is examined. The paper concludes with recommendations for assessment and treatment of anxiety and stigma in persons with dementia that will better allow them to age in place. PMID:24846469

  5. Human papillomavirus-related cancers among people living with AIDS in Puerto Rico.

    PubMed

    Ortiz, Ana Patricia; Pérez-Irizarry, Javier; Soto-Salgado, Marievelisse; Suárez, Erick; Pérez, Naydi; Cruz, Maritza; Palefsky, Joel; Tortolero-Luna, Guillermo; Miranda, Sandra; Colón-López, Vivian

    2014-01-01

    The objective of this study was to estimate the incidence of cancer and human papillomavirus (HPV)-related cancers and the risk of death (by cancer status) among people living with AIDS (PLWA) in Puerto Rico. We used data from the Puerto Rico AIDS Surveillance Program and Central Cancer Registry (1985-2005). Cancers with highest incidence were cervix (299.6/100,000) for women and oral cavity/oropharynx for men (150.0/100,000); the greatest excess of cancer incidence for men (standardized incidence ratio, 86.8) and women (standardized incidence ratio, 52.8) was for anal cancer. PLWA who developed a cancer had decreased survival and increased risk of death compared with those who did not have cancer. Cancer control strategies for PLWA will be essential for improving their disease survival. PMID:24831284

  6. Internalized stigma and sterile syringe use among people who inject drugs in New York City, 2010-2012

    PubMed Central

    Rivera, Alexis V.; DeCuir, Jennifer; Crawford, Natalie D.; Amesty, Silvia; Lewis, Crystal Fuller

    2014-01-01

    Background Little is known on the effect of stigma on the health and behavior of people who inject drugs (PWID). PWID may internalize these negative attitudes and experiences and stigmatize themselves (internalized stigma). With previous research suggesting a harmful effect of internalized stigma on health behaviors, we aimed to determine socio-demographic characteristics and injection risk behaviors associated with internalized PWID-related stigma in New York City (NYC). Methods Three NYC pharmacies assisted in recruiting PWID. Pharmacy-recruited PWID syringe customers received training in recruiting up to three of their peers. Participants completed a survey on injection behaviors and PWID-related stigma. Among HIV-negative PWID (n=132), multiple linear regression with GEE (to account for peer network clustering) was used to examine associations with internalized PWID-related stigma. Results Latinos were more likely to have higher internalized stigma, as were those with lower educational attainment. Those with higher internalized stigma were more likely to not use a syringe exchange program (SEP) recently, although no association was found with the recent use of pharmacies for syringes. Lastly, higher internalized stigma was related to less than 100% use of pharmacies or SEPs for syringe needs. Conclusions These data suggest that PWID with higher internalized stigma are less likely to consistently use sterile syringe sources in urban settings with multiple sterile syringe access points. These results support the need for individual-and structural-level interventions that address PWID-related stigma. Future research is needed to examine why PWID with higher internalized stigma have less consistent use of public syringe access venues. PMID:25307745

  7. Circulating Mediators of Inflammation and Immune Activation in AIDS-Related Non-Hodgkin Lymphoma

    PubMed Central

    Nolen, Brian M.; Breen, Elizabeth Crabb; Bream, Jay H.; Jenkins, Frank J.; Kingsley, Lawrence A.; Rinaldo, Charles R.; Lokshin, Anna E.

    2014-01-01

    Background Non-Hodgkin lymphoma (NHL) is the most common AIDS-related malignancy in developed countries. An elevated risk of developing NHL persists among HIV-infected individuals in comparison to the general population despite the advent of effective antiretroviral therapy. The mechanisms underlying the development of AIDS-related NHL (A-NHL) are not fully understood, but likely involve persistent B-cell activation and inflammation. Methods This was a nested case-control study within the ongoing prospective Multicenter AIDS Cohort Study (MACS). Cases included 47 HIV-positive male subjects diagnosed with high-grade B-cell NHL. Controls were matched to each case from among participating HIV-positive males who did not develop any malignancy. Matching criteria included time HIV+ or since AIDS diagnosis, age, race and CD4+ cell count. Sera were tested for 161 serum biomarkers using multiplexed bead-based immunoassays. Results A subset of 17 biomarkers, including cytokines, chemokines, acute phase proteins, tissue remodeling agents and bone metabolic mediators was identified to be significantly altered in A-NHL cases in comparison to controls. Many of the biomarkers included in this subset were positively correlated with HIV viral load. A pathway analysis of our results revealed an extensive network of interactions between current and previously identified biomarkers. Conclusions These findings support the current hypothesis that A-NHL develops in the context of persistent immune stimulation and inflammation. Further analysis of the biomarkers identified in this report should enhance our ability to diagnose, monitor and treat this disease. PMID:24922518

  8. Help-seeking for AIDS-related concerns: a comparison of gay men with various HIV diagnoses.

    PubMed

    Hays, R B; Catania, J A; McKusick, L; Coates, T J

    1990-10-01

    Examined help-seeking and psychological distress among four groups of gay men (30 AIDS-diagnosed, 107 HIV-seropositive, 149 HIV-seronegative, 244 untested) in the AIDS Behavioral Research Project, a longitudinal survey of San Francisco gay men. The men reported high levels of anxiety, depression, and help-seeking from their social networks. AIDS-diagnosed and HIV-positives reported the most AIDS worry and were the most likely to seek help. High percentages of AIDS-diagnosed men sought help from all sources (peers, professionals, family), whereas nondiagnosed men were more likely to seek help from peers. Regardless of the men's HIV status, peers were perceived to be the most helpful source. Family members were less likely sought and perceived as least helpful. The strengths and limitations of peers as social support providers for AIDS-related concerns are discussed, including implications for the design of community programs to enhance the abilities of peer helpers. PMID:2075900

  9. Stigma for Seeking Therapy: Self-Stigma, Social Stigma, and Therapeutic Processes

    ERIC Educational Resources Information Center

    Owen, Jesse; Thomas, LeKeldric; Rodolfa, Emil

    2013-01-01

    The current study examined the associations among clients' perceptions of self- and social stigma for seeking help, session outcomes, and working alliance. Ninety-one clients were treated by 26 therapists, at a large university counseling center. All clients were currently in therapy. We expected that clients' perceptions of self- and…

  10. Community reaction to persons with HIV/AIDS and their parents: an analysis of recent evidence from Thailand.

    PubMed

    VanLandingham, Mark J; Im-Em, Wassana; Saengtienchai, Chanpen

    2005-12-01

    We systematically examine community reaction to persons living with HIV/AIDS (PHAs) and their older parents in Thailand. We focus on parents as well as PHAs because parents are major providers of care for their ill adult children. Our analyses are based on several sources of recently collected survey and qualitative data from a wide range of perspectives. We find important variations in community reaction to PHAs and their families, but overall these reactions are much more positive than is widely assumed. We conclude that much existing research on community reaction to AIDS neglects both a rich body of social theory on stigma and a strong tradition of population-based empirical research in sociology. Much existing research also fails to adequately distinguish between key aspects of the social settings where most AIDS cases occur and the social settings where most of the stereotypes surrounding AIDS-related stigma have originated. A closer marriage between empirical and theoretical approaches to social stigma is required to advance our understanding of this critically important dimension of the AIDS epidemic. PMID:16433283

  11. Adult Learners and AIDS Artwork: Conceptual Suggestions for Adult Education Practice

    ERIC Educational Resources Information Center

    Collins, Joshua C.

    2012-01-01

    Significant stigma exists to marginalize persons living with HIV/AIDS (PLWHA). Research has demonstrated it is possible to reduce stigma and prejudice through the development of meaningful and innovative education. The purpose of this article is to explore the ways in which the creative and purposeful use of AIDS Artwork as an educational tool may…

  12. Stigma Consciousness, Social Constraints, and Lesbian Well-Being

    ERIC Educational Resources Information Center

    Lewis, Robin J.; Derlega, Valerian J.; Clarke, Eva G.; Kuang, Jenny C.

    2006-01-01

    Stigma consciousness, the expectation of prejudice and discrimination, has been associated with negative psychological outcomes for lesbians. This research examined the moderating role of social constraints or difficulty lesbians experience in talking with others about sexual orientation-related issues. One hundred five, predominantly out,…

  13. HIV/AIDS-Related Knowledge and Behaviors Among Most-at-Risk Populations in Vietnam

    PubMed Central

    Vian, Taryn; Semrau, Katherine; Hamer, Davidson H; Loan, Le Thi Thanh; Sabin, Lora L

    2012-01-01

    The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) has supported the Vietnamese Ministry of Health (MOH) in implementing behavior change strategies to slow the HIV epidemic. These programs target commercial sex workers (CSW), injection drug users (IDU), and men who have sex with men (MSM). Using data from a program evaluation to assess effectiveness of the PEPFAR intervention, we conducted a sub-analysis of HIV/AIDS knowledge, sexual behaviors, and injection drug risk behaviors among 2,199 Vietnamese respondents, including those reporting recent contact with an outreach worker and those who did not report contact. We found overall high levels of HIV/AIDS knowledge, low rates of needle sharing, and moderate to high rates of inconsistent condom use. Average knowledge scores of IDU were significantly higher than non-IDU for antiretroviral treatment knowledge, while MSM had significantly less knowledge of treatment compared to non-MSM. HIV/AIDS-related knowledge was not significantly associated with needle-sharing practices. Knowledge was modestly but significantly associated with more consistent use of condoms with primary and commercial sex partners, even after controlling for contact with an outreach worker. Contact with an outreach worker was also an independent predictor of more consistent condom use. Outreach programs appear to play a meaningful role in changing sexual behavior, though the effect of outreach on IDU risk behaviors was less clear. More research is needed to understand the relationship between outreach programs and skill development, motivation, and use of referral services by most-at-risk populations in Vietnam. PMID:23173025

  14. AIDS and the workplace: signs of hope from Zimbabwe.

    PubMed

    Williams, G; Ray, S

    1994-01-01

    Strategies for Hope is a series of booklets and videos about innovative and practical approaches to AIDS management and prevention in developing countries. It is published by the UK development agency ACTIONAID and the African Medical and Research Foundation with technical and financial support from the World Health Organization Global Program on AIDS. More than 500,000 booklets and 5000 videos have been distributed worldwide. The authors describe what they learned while researching the eighth booklet in the series, Work Against AIDS, analyzing seven workplace-based AIDS programs in Zimbabwe. They argue that the workplace can play a far greater role in AIDS awareness and prevention than is generally realized. AIDS is already affecting the health and productivity of the workforce in Zimbabwe, where in some areas more than 15% of adults are estimated to be HIV-positive. Morbidity and mortality are rising with concomitant worker absenteeism, yet most workplaces in Zimbabwe do not have even a poster about AIDS on display. There are, however, some impressive education programs under way. These programs, run by a significant number of volunteer peer educators, are working to reduce the stigma attached with sexually transmitted diseases and promote low-cost or free treatment. The authors also note as most promising the program of the Zimbabwe Congress of Trade Unions training 700 Health and Safety representatives at shop-floor and branch levels in AIDS-related human rights issues at the workplace as well as AIDS awareness and prevention. PMID:12318814

  15. Correlates and Experiences of HIV Stigma in Prisoners Living With HIV in Indonesia: A Mixed-Method Analysis.

    PubMed

    Culbert, Gabriel J; Earnshaw, Valerie A; Wulanyani, Ni Made Swasti; Wegman, Martin P; Waluyo, Agung; Altice, Frederick L

    2015-01-01

    In Indonesia, the syndemic nature of HIV, drug use, and incarceration may influence experiences of stigma for HIV-infected prisoners. This mixed-method study explores HIV stigma in prisoners living with HIV in Indonesia. Randomly selected male HIV-infected prisoners (n = 102) from two large prisons in Jakarta completed in-depth interviews and a structured HIV stigma survey. Quantitative results found four groups of HIV-infected prisoners with significantly higher HIV stigma levels, including those: (a) with drug-related offenses, (b) seeking help to decrease drug use, (c) diagnosed with HIV before the current incarceration, and (d) who had not disclosed their HIV status to family members or friends. Qualitative results highlighted the prominent role of HIV stigma in decisions to disclose HIV status to family members, partners, and other prisoners. Interventions should address HIV stigma in HIV-infected prisoners in Indonesia to achieve HIV treatment as prevention goals. PMID:26304049

  16. Experiences and Impact of Stigma and Discrimination among People on Antiretroviral Therapy in Dar es Salaam: A Qualitative Perspective.

    PubMed

    Mhode, Maisara; Nyamhanga, Tumaini

    2016-01-01

    Background. The impact of stigma on adherence to antiretroviral therapy (ART) has been less studied in Tanzania. Recent studies indicate that people on ART still experience stigma. Qualitative information on the subject matter is especially insufficient. Objective. This paper reports on the dimensions of stigma and discrimination and their impact on adherence to ART as experienced by people living with HIV (PLHIV). Design. A phenomenological approach was used to gather information on the lived experiences of stigma and discrimination. The sample size was determined according to the saturation principle. Results. Respondents experienced different forms of HIV-related stigma such as verbal, social, and perceived stigma. Various forms of discrimination were experienced, including relational discrimination, mistreatment by health care workers, blame and rejection by spouses, and workplace discrimination. HIV-related stigma and discrimination compromised ART adherence by reinforcing concealment of HIV status and undermining social suppport. Conclusion. After nearly a decade of increasing the provision of ART in Tanzania, PLHIV still experience stigma and discrimination; these experiences still appear to have a negative impact on treatment adherence. Efforts to reduce stigma and discrimination remain relevant in the ART period and should be given more impetus in order to maximize positive treatment outcomes. PMID:27110395

  17. Experiences and Impact of Stigma and Discrimination among People on Antiretroviral Therapy in Dar es Salaam: A Qualitative Perspective

    PubMed Central

    Mhode, Maisara; Nyamhanga, Tumaini

    2016-01-01

    Background. The impact of stigma on adherence to antiretroviral therapy (ART) has been less studied in Tanzania. Recent studies indicate that people on ART still experience stigma. Qualitative information on the subject matter is especially insufficient. Objective. This paper reports on the dimensions of stigma and discrimination and their impact on adherence to ART as experienced by people living with HIV (PLHIV). Design. A phenomenological approach was used to gather information on the lived experiences of stigma and discrimination. The sample size was determined according to the saturation principle. Results. Respondents experienced different forms of HIV-related stigma such as verbal, social, and perceived stigma. Various forms of discrimination were experienced, including relational discrimination, mistreatment by health care workers, blame and rejection by spouses, and workplace discrimination. HIV-related stigma and discrimination compromised ART adherence by reinforcing concealment of HIV status and undermining social suppport. Conclusion. After nearly a decade of increasing the provision of ART in Tanzania, PLHIV still experience stigma and discrimination; these experiences still appear to have a negative impact on treatment adherence. Efforts to reduce stigma and discrimination remain relevant in the ART period and should be given more impetus in order to maximize positive treatment outcomes. PMID:27110395

  18. How does susceptibility to proactive interference relate to speech recognition in aided and unaided conditions?

    PubMed Central

    Ellis, Rachel J.; Rönnberg, Jerker

    2015-01-01

    Proactive interference (PI) is the capacity to resist interference to the acquisition of new memories from information stored in the long-term memory. Previous research has shown that PI correlates significantly with the speech-in-noise recognition scores of younger adult