Abstract
Background: The diagnosis of HIV is life-changing that requires people not only to deal with the disease but also to cope with the stigma attached to HIV. People living with HIV (PLWH) as well as their close family members (CFM) are stigmatised; however, CFM also stigmatise PLWH. This interaction affects the relationship between PLWH and their CFM.Aim: To explore and describe the experiences of PLWH and CFM during and after a community-based HIV stigma reduction intervention in both an urban and rural setting in the North-West.Method: A qualitative description approach through in-depth interviews was used in both settings. Purposive sampling was used for the PLWH and snowball sampling for the CFM. Data was analysed using open coding.Results: Both urban and rural groups gained a richer understanding of HIV stigma and how to cope with it. The relationships were enriched by PLWH feeling more supported and CFM realising how they stigmatised PLWH and that they should be more supportive. Leadership was activated in PLWH and CFM through the stigma reduction project that they participated in.Conclusion: No significant differences were found between rural and urban communities, thus the intervention can be implemented with similar results in both settings. The intervention showed positive outcomes for both PLWH and CFM. Bringing PLWH and CFM together during an intervention in an equalised relationship proved to be useful as PLWH felt more supported and CFM showed much more compassion towards PLWH after the intervention.
Highlights
This study was part of a bigger comprehensive communitybased HIV stigma reduction and wellness enhancement intervention study in an urban and rural setting in the NorthWest of South Africa, and included people living with HIV (PLWH) and people living close to them
Experienced loneliness Initial fear to attend the workshop Non-disclosure lea to isolation Workshop a safe environment to disclose Leaving the safe environment to return home was stressful Experienced pride and happiness to be part of the group Gained a positive self-image A message of hope and a meaningful life Did not know the word “stigma” Realised stigma happened in different contexts and ways Stigma is discriminating Helped to understand and cope with stigma Experienced the workshop as positive Experiences of stigmatisation, trauma and neglect Gained hope, acceptance and understanding Proud to be part of the group Participating in the project gave them hope and strength Excited to see change in the community Some community members came forward to join them
No noteworthy differences were noted between the expressed experiences of People living with HIV (PLWH) and close family members (CFM) living in rural and those living in urban areas after they had undergone the HIV stigma reduction intervention
Summary
This study was part of a bigger comprehensive communitybased HIV stigma reduction and wellness enhancement intervention study in an urban and rural setting in the NorthWest of South Africa, and included people living with HIV (PLWH) and people living close to them (partner, child, close family member, close friend, spiritual leader and community member). PLWH, those close to them, as well as their healthcare providers are affected by stigma and discrimination, in Southern Africa, where so many are infected and the burden of the disease is significant (Greeff et al, 2010). It has become all the more urgent to find a way to address HIV-related stigma in the South African context (Forsyth, Vandormael, Kershaw, & Grobbelaar, 2008; Nicolay, 2008). People living with HIV (PLWH) as well as their close family members (CFM) are stigmatised; CFM stigmatise PLWH This interaction affects the relationship between PLWH and their CFM. Bringing PLWH and CFM together during an intervention in an equalised relationship proved to be useful as PLWH felt more supported and CFM showed much more compassion towards PLWH after the intervention
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