AIDS Stigma Research Articles

Challenges experienced by grandparents caring for AIDS orphans in the Western Cape province, South Africa.

There is limited understanding of the difficulties and experiences faced by grandparents who assume the responsibility of caring for AIDS orphans. The objective of the study was to investigate and depict the difficulties encountered by grandparents who provide care for AIDS orphans in the Western Cape province of South Africa. The study was conducted in the City of Cape Town Metropolitan and the Overberg Municipality. The study used qualitative approach with an exploratory-descriptive design. A purposive sampling technique was utilised to select 25 grandparents. Semi-structured interviews were conducted, audio-recorded, transcribed verbatim, and analysed thematically using ATLAS.ti, version 7. Financial difficulties, a lack of support, HIV and/or AIDS stigma, and dealing with rebellious teenagers were primary challenges affecting the well-being of grandparents. The study found that while financial challenges were significant, other factors such as poor family support contributed to the decline in the well-being of grandparents caring for AIDS orphans. The study's results can lead to improved public health programmes that address the identified challenges and health needs of grandparents providing care to AIDS orphans and the orphans under their care.

HIV & AIDS Stigma and the Media in Namibia

HIV & AIDS Stigma and the Media in Namibia

“Some Days It’s the Best Thing . . . Some Days It’s the Worst”: Gay College Men Living With HIV Navigating the Meanings of AIDS

Abstract: This queer narrative study examined the stories of two gay college men living with HIV and their relationship to HIV/AIDS. Foucault’s technologies of the self served as the conceptual framework. Technologies of the self are practices, strategies, and narratives participants used to resist the stigma-tizing symbolic violence of AIDS. The men practiced different yet interlocking technologies of the self. They took partial control of the meaning of HIV/AIDS in ways that improved their lives and helped them navigate college. However, homophobic AIDS signifiers resulted in them taking personal responsibility for HIV/AIDS rather than understanding it as a structural inequity, which limited them personally and academically. Higher education environments were a place of stigma and support, leaving the men unsure of how to navigate oppressive environments on campus. Implications for reframing college student identity theory, addressing AIDS stigma on campus and beyond, and supporting students living with HIV are provided.

Antenatal depression and associated factors among HIV-positive pregnant women in South Gondar zone public health facilities, northwest Ethiopia, a cross-sectional study

IntroductionDepression and HIV/AIDS are estimated to be the world's two leading causes of burden of disease by 2030. Depression during pregnancy is a significant public health problem because it has negative effects on the health of the mother and her fetus. However, evidence on antenatal depression and associated factors among HIV-positive women is scarce in the study area. ObjectiveThis study was aimed to assess antenatal depression and associated factors among HIV-positive pregnant women attending prevention of mother to child transmission service in South Gondar zone public health facilities, northwest Ethiopia. MethodsInstitutional-based cross-sectional study was conducted on 606 HIV-positive pregnant women. The data were collected by face-to-face interviews and chart review. Edinburgh Perinatal Depression Scale was used to assess antenatal depression. Data were entered into Epi-Data version 4.6 and analyzed by SPSS version 23. Multivariable logistic regression model was fitted and AOR with 95% CI was computed to determine the level of significance. ResultsThe prevalence of antenatal depression was 36.4% (95% CI: 32.7, 40.2). Being unmarried (AOR = 2.77, 95% CI: 1.26, 6.07), experienced intimate partner violence during this pregnancy (AOR = 1.50, 95% CI: 1.05, 2.15), ART non -adherence (AOR = 2.18, 95% CI: 1.50, 3.18), and experienced internalized AIDS stigma (AOR = 1.46, 95% CI: 1.02, 2.09) were significantly associated with antenatal depression. Conclusion and recommendationIn this study, more than one-thirds of HIV-positive pregnant women had antenatal depression. Screening HIV-positive pregnant women for depression and provision of intervention is recommended.

Stigma and its Associated Factors among People Living with HIV/AIDS (PLHA) Attending ART Centre in a Tertiary Care Institute in Kolkata

Background: AIDS stigma exists in a variety of ways, including ostracism, rejection, discrimination, and avoidance of HIV-infected people. Some people are rejected by family and community, whereas others face poor treatment in healthcare and educational settings, erosion of their rights, and psychologic damage. All these limit access to HIV testing, treatment, and other HIV services. Objectives: This study was undertaken to determine the proportion of patients with severe stigma among people living with HIV/AIDS (PLHA) and to identify the factors associated with it. Materials and methods: It was a cross-sectional study conducted among 444 PLHA, attending ART center of a tertiary care institute of Kolkata, chosen by systematic random sampling. Berger scale was used to classify stigma as no, mild, and severe stigma. Logistic regression analyses were performed to identify the risk factors. Results: About 32.7% of PLHA had experienced severe forms of stigma. These were severe forms of personalized stigma (33.8%), negative self-image (25.9%), perceived public attitude (27.5%), and disclosure concerns (30.0%). Overall severe stigma was higher in females (33.3%) than males (31.8%). After binary logistic regression, factors significantly associated with severe stigma included age [adjusted odds ratio (AOR) 1.564 (1.071–2.285), sig: 0.021], socioeconomic status [AOR 0.748 (0.574–0.974), sig: 0.031], HIV status known to the partner [AOR 19.965 (3.3673–78.357), sig: <0.0001], presence of comorbidities [AOR 8.497 (3.541–20.389), sig: <0.0001], and possible mode of transmission not known by the patient [AOR 0.615 (0.380–0.993), sig: 0.047]. Conclusion: Study found that those who were older, who were from lower socioeconomic group, whose partner knew their disease status, who were having comorbidities, and who do not know their mode of infection experienced a higher level of HIV-related stigma.

HIV-AIDS Stigma in Burundi: A Qualitative Descriptive Study.

HIV/AIDS stigma is a global issue and a serious problem in African countries. Although prevalence remains high in this region, no detailed study has yet been carried out to determine and characterize this problem in Burundi. Using a qualitative analysis based on an extensive series of 114 interviews, we describe the main characteristics of HIV stigma in the country. The results of our study indicate that the problem of HIV/AIDS stigma is widespread in Burundian society, as all participants in the research reported having experienced some kind of HIV stigma. The seven dimensions of stigma identified in people living with HIV/AIDS (PLWHA) in Burundi are physical violence, verbal violence, marginalization, discrimination, self-stigma, fear and insecurity, and healthcare provider stigma. These dimensions of stigma can be experienced through different manifestations, which have been characterized in this study, revealing that the problem of stigma in PLWHA is still an important issue in Burundi.

A pandemic anniversary: 40 years of HIV/AIDS

A pandemic anniversary: 40 years of HIV/AIDS

HUBUNGAN TINGKAT PENGETAHUAN MASYARAKAT TENTANG HIV/AIDS DENGAN STIGMA TERHADAP ODHA DI WILAYAH KERJA PUSKESMAS II DENPASAR SELATAN

ABSTRACTBackground: HIV/AIDS is one of an infected disease. Until now days, there is not find an effective medicine or treatment to cure this diseases. The last six years, this disease shows an incretion rapidly either in the world or Indonesia. Often in the community people with HIV/AIDS has an alienated stigma. Purpose: To determine correlation level of public knowledge about HIV / AIDS stigma to the people with HIV / AIDSMethod: The study design was descriftive correlational survey with crossectionamethod. Sample of the study was 100 respondents was taken by simple random sampling technique, Data was collected by a questionnaire and analyze by Spearman Rho statistical test with SPSS version 20. Result: The study Findings shows; 79% respondances classified into good categoriey, 85% classified into sufficient category poor. There is a significan correlation with negative direction between knowledge with stigma with the correlation value p= 0,000 (r = -0,543). Conclussion: Communit y Knowledge level has a closed correlation with stigma. More higer community knowledge level they will perform a low stigma. The community hope to find more information about HIV/AIDS in other to decriese stigma to the people with HIV/AIDS. Keywords: Knowledge, Public, HIV/AIDS, Stigma, ODHA.

Deploying performance poetry in dispelling HIV and AIDS stigma: An applied theatre approach

Abstract The article is based on an applied theatre project facilitated by Cletus Moyo at the University of the Witwatersrand, Johannesburg, South Africa from 2009 to 2010. We argue that performance poetry deployed within an applied theatre paradigm has the potential to unlock the silence around HIV and AIDS issues in a way that opens up these issues for discussion and makes them accessible for exploration, even in contexts where speaking about these issues is taboo. The project targeted young people belonging to the age group that is most heavily hit by the HIV and AIDS pandemic. Notably, the young generation is also more open to performance poetry as an artform, making it more appropriate in dealing with issues affecting them. Performance poetry is a language of emotions and an artform that emphasizes speaking out. These two qualities render performance poetry a powerful medium for addressing HIV and AIDS stigma, a phenomenon that is embedded in the culture of silence.

Behaviour Modification for Stigma Reduction and Psychological Functioning Among People Living With HIV/AIDS

HIV/AIDS stigma is still pervasive and continues to negatively impact the psychological functioning of PLWHA in South African communities. The aim of this study was to design, implement, and to empirically evaluate the efficacy of an HIV/AIDS stigma reduction intervention. Adopting a two-phase study approach, the study was anchored on a cross-sectional design for phase I, and a pre-test post-test control group design for phase II. Phase I study was a baseline assessment of HIV and AIDS stigma experiences as well as psychological functioning among PLWHA, while phase II focused on empirically tailoring an HIV/AIDS stigma reduction intervention - the Stigma Coping Skills Intervention (SCSI). The HIV/AIDS stigma scale was used to determine HIV/AIDS stigma, while the GHQ-28 was used to determine psychological functioning. The sample comprised of 300 PLWHA. Purposive sampling method was employed for phase I study. Phase II study comprised a total of 24 participants equally assigned to experimental and control groups. Simple random sampling method was used for the phase II study.  Findings indicated that the intervention was significant on stigma, and was also significant on psychological functioning. The SCSI demonstrated efficacy in HIV and AIDS stigma reduction, as well as improving psychological functioning.

Antiretroviral Therapies: Old Attitudes and New Perspectives in Dentistry

Antiretroviral Therapies: Old Attitudes and New Perspectives in Dentistry

Age Is Not a Condom: HIV and Sexual Health for Older Adults

This review was conducted to illustrate how the emerging recognition of sexual health in the older adult is informed by research on the growing aging HIV population in the USA and globally. Assessing the sexual health needs of the older adult through the prism of HIV prevention is not ideal. But, there are data and “lessons learned” that advance our understanding of the barriers and needs of older adults’ sexual health. Data confirm many of these older adults with HIV remain sexually active and do engage in risky behaviors as do their younger counterparts. HIV and other STI testing in older adults is not being done adequately as these individuals carry the disproportionate burden of AIDS diagnoses in the USA. Under the duress of persistent HIV and AIDS stigma, marginalized older adults living with HIV try to embrace that most elemental human characteristic of sexuality.

Predictors of burnout among HIV nurses in the Western Cape.

BackgroundBurnout has been implicated as one of the reasons for key healthcare personnel, such as nurses, leaving their profession, resulting in insufficient staff to attend to patients.ObjectiveWe investigated the predictors of three dimensions of burnout, namely emotional exhaustion, depersonalisation and personal accomplishment, among nurses in South Africa attending to patients living with HIV.MethodParticipants were recruited at a large tertiary hospital in the Western Cape region, with the help of the assistant director of nursing at the hospital. They completed the Maslach Burnout Inventory, the Quantitative Workload Inventory, the Interpersonal Conflict at Work Scale, the Organisational Constraints Scale, the Death and Dying subscale of the Nursing Stress Scale, and the HIV and AIDS Stigma Instrument – Nurse.ResultsWe found elevated levels of burnout among the sample. Workload, job status and interpersonal conflict at work significantly explained more than one-third of the variance in emotional exhaustion (R² = 0.39, F(7, 102) = 9.28, p = 0.001). Interpersonal conflict, workload, organisational constraints and HIV stigma significantly explained depersonalisation (R² = 0.33, F(7, 102) = 7.22, p = 0.001). Job status and organisational constraints significantly predicted personal accomplishment (R² = 0.18, F(7, 102) = 3.12, p = 0.001).ConclusionFactors such as workload, job status and interpersonal conflict in the work context, organisational constraints and stigma associated with HIV were found to be predictors of burnout in the sample of nurses. Our recommendations include developing and testing interventions aimed at reducing burnout among nurses, including reducing workload and creating conditions for less interpersonal conflict at work.

Population Density and AIDS-Related Stigma in Large-Urban, Small-Urban, and Rural Communities of the Southeastern USA.

AIDS stigmas delay HIV diagnosis, interfere with health care, and contribute to mental health problems among people living with HIV. While there are few studies of the geographical distribution of AIDS stigma, research suggests that AIDS stigmas are differentially experienced in rural and urban areas. We conducted computerized interviews with 696 men and women living with HIV in 113 different zip code areas that were classified as large-urban, small-urban, and rural areas in a southeast US state with high-HIV prevalence. Analyses conducted at the individual level (N = 696) accounting for clustering at the zip code level showed that internalized AIDS-related stigma (e.g., the sense of being inferior to others because of HIV) was experienced with greater magnitude in less densely populated communities. Multilevel models indicated that after adjusting for potential confounding factors, rural communities reported greater internalized AIDS-related stigma compared to large-urban areas and that small-urban areas indicated greater experiences of enacted stigma (e.g., discrimination) than large-urban areas. The associations between anticipated AIDS-related stigma (e.g., expecting discrimination) and population density at the community-level were not significant. Results suggest that people living in rural and small-urban settings experience greater AIDS-related internalized and enacted stigma than their counterparts living in large-urban centers. Research is needed to determine whether low-density population areas contribute to or are sought out by people who experienced greater AIDS-related stigma. Regardless of causal directions, interventions are needed to address AIDS-related stigma, especially among people in sparsely populated areas with limited resources.

Un/Detectability in Times of “Equality”: HIV, Queer Health, and Homonormativity

As medical advances have made HIV survival possible, narratives of “undetectable” viral loads often fail to account for the multiple layers of racial and political privilege that animate and sustain them. For example, African American men who have sex with men are eight times more likely than whites to be diagnosed with HIV, and one in two gay black men will likely be diagnosed with HIV in his lifetime—and African Americans face low rates of access to and retention in HIV care. Drawing on dis/ability and queer theory, this article critiques the ways in which “undetectability” discourses proffer AIDS erasure, whiteness, and ideologies of able-bodiedness as central to homonormative LGBT identity politics. Based in normative modes of disciplinary, hygienic sexuality, narratives and realities of carefully managed HIV infection emerge in support of LGBT desires for state recognition. In this process, an emphasis on personal, rather than systemic, responsibility has tied HIV care and survival to grids of racial, political, and ultimately individual privilege. Weighing the ethical residues of LGBT rights “victories,” this essay argues that access to the private spheres of marriage, child-rearing, and inheritance has come at the expense of the health of vulnerable populations and breathed new life into specters of homophobia and AIDS stigma.

Routine HIV testing in men who have sex with men: from risk to prevention.

We conducted a critical review of the literature on recurrent use of HIV testing in men who have sex with men (MSM). We performed a narrative review of the literature in which we analyzed the various conceptions on frequent testing over time, the implications for health programs, and the main social markers that influence the incorporation of HIV testing as routine care. Although it has existed since the 1990s, recurrent testing among MSM was frequently interpreted as increased exposure to HIV due to lack of condom use, and therefore as "unnecessary" testing. Beginning in the 2000s, periodic testing has become a programmatic recommendation and has been interpreted as a goal. Individuals' perception of their use of the test has rarely been considered in order to characterize such use as routine care. On the social and cultural level, individual aspects associated with recent or routine testing were included in contexts of favorable norms for testing and less AIDS stigma. Differences in generation, schooling, and types of affective-sexual partnerships play an important part in testing. Such differences highlight that the epidemiological category "men who have sex with men" encompasses diverse relations, identities, and practices that result in specific uses of the test as a prevention strategy. Thus, dialogue between programs, health professionals, and the persons most affected by the epidemic is crucial for building responses with real potential to confront the HIV epidemic, based on respect for human rights.

The Effect of Acquiring HIV/AIDS Information through Different Television Programs on AIDS Knowledge and AIDS Stigma - The Moderating Role of AIDS Education

본 연구는 텔레비전을 통한 정보 습득 혹은 정보를 습득한 텔레비전 프로그램 장르(설득/캠페인 vs. 시사/뉴스 vs. 교양/오락)에 따라 에이즈 지식, 감염인에 대한 태도, 감염에 대한 두려움, 낙인 규범 인식, 낙인 행동 의도가 달라지는가를 확인하고, 그 효과가 에이즈 교육에 의해 조절되는가를 분석하였다. 질병관리본부 주관으로 실시한 2015년 ‘대국민 에이즈 행태 조사’에서 수집된 자료를 분석한 결과, 텔레비전을 통한 에이즈 정보 습득에 따른 에이즈 지식과 감염인 태도의 차이가 나타났으며, 감염에 대한 두려움, 낙인 규범 인식, 낙인 행동 의도가 다르게 나타났다. 에이즈 교육은 에이즈 관련 태도 및 행동에 유의미한 영향을 주었으나, 에이즈 지식에는 유의미한 영향을 주지 못했다. 텔레비전 프로그램 장르에 따라서도 부분적으로 유의미한 결과가 나타났는데, 오락/교양 프로그램을 통한 정보 습득이 설득/캠페인이나 시사/뉴스 프로그램을 통한 정보 습득보다 에이즈 관련 부정적 신념이나 낙인 행동 의도를 낮추는 데 더 효과적인 것으로 나타났다. 또한 텔레비전 프로그램 장르가 감염인에 대한 태도에 미치는 영향은 에이즈 교육 경험에 의해 부분적으로 조절되는 것으로 나타났다.

‘Protective’ silence surrounding AIDS: Reasons and implications of non-disclosure among pregnant women living with HIV in Rio de Janeiro (Brazil)

ABSTRACTThe persistence of stigma surrounding AIDS remains a challenge in the epidemic’s fourth decade. Based on qualitative research, this study analyses how pregnant women living with HIV/AIDS (PWLHA) experience and cope with AIDS stigma. A total of 29 semi-structured interviews were conducted with PWLHA focusing on socioeconomic profiles, the contexts in which they discovered HIV infection, experiences with health-care sites and ways of dealing with AIDS-related stigma. We recruited PWLHA at two prevention of mother-to-child transmission sites in Rio de Janeiro, Brazil. The PWLHA’s testimony indicates that access to care and treatment has a profound effect on the deconstruction of their understanding of AIDS as a fatal disease. However, fear of AIDS stigma is still predominant. The law guarantees HIV non-disclosure, and women see it as a way to protect themselves from discrimination. We argue, however, that the silence surrounding HIV diagnosis perpetuates the psychosocial and structural mechanisms that reproduce stigma. We conclude that diverse sectors of society, including health-care facilities, must be involved in confronting stigma by demystifying AIDS, improving patients’ knowledge of their rights, and increasing their access to material and symbolic goods.

High-risk alcohol use and associated socio-demographic, health and psychosocial factors in patients with HIV infection in three primary health care clinics in South Africa

Alcohol use may have a negative impact on the course of HIV disease and the effectiveness of its treatment. We studied patients with HIV who use alcohol and associated socio-demographic, health and psychosocial factors. Outcomes from this study may help in selecting patients from clinical practice with high-risk alcohol use and who are likely to benefit most from alcohol reduction interventions. In a cross sectional study in three primary health care clinics in Pretoria, South Africa, from January 2012 to June 2012, patients with HIV infection were interviewed and patients' medical files were reviewed to obtain data on levels of alcohol use (Alcohol Use Disorder Identification Test), patients' socio-demographic characteristics, HIV-related information, health related quality of life (WHOQoL-HIVBref), internalized AIDS stigma, symptoms of depression and adherence to antiretroviral therapy. Analyses consisted of descriptive statistics, bi- and multivariate logistic regression models. A total of 2230 patients (1483 [66.5%] female) were included. The median age was 37 years (interquartile range 31-43), 99.5% were black Africans, 1975 (88.6%) had started ART and the median time on ART was 22 months (interquartile range 9-40). No alcohol was used by 64% of patients, 8.9% were low risk drinkers, 25.1% of patients were hazardous or harmful drinkers and 2.0% had possible alcohol dependence. In multivariate analysis high-risk drinking was positively associated with male gender, never being married, tobacco use, a higher score for the 'level of independence'-domain measured with the WHOQoL-HIVBref questionnaire, and with more depressive symptoms compared to low-risk drinking. This study shows a high prevalence of hazardous or harmful drinking in patients with HIV infection (especially men) attending primary health care clinics in South Africa. Routine screening for alcohol use should be introduced in these clinics and harm reduction interventions should be evaluated, taking into account associated factors.

What do we know about children living with HIV-infected or AIDS-ill adults in Sub-Saharan Africa? A systematic review of the literature

ABSTRACTMillions of children in Sub-Saharan Africa live with adults, often parents, who are HIV-infected or ill due to AIDS. These children experience social, emotional, and health vulnerabilities that overlap with, but are not necessarily the same as, those of orphans or other vulnerable children. Despite their distinctive vulnerabilities, research aimed at understanding the situation of these children has been limited until very recently. This review summarizes the state of knowledge based on a systematic search of PubMed and Web of Science that identified 47 empirical research articles that examined either the population prevalence of children living with HIV-infected or AIDS-sick adults, or the consequences of adult HIV infection or AIDS illness for child well-being. This review confirms that this population of children is substantial in size, and that the vulnerabilities they experience are multi-faceted, spanning physical and emotional health and schooling. Mechanisms were examined empirically in only a small number of studies, but encompass poverty, transmission of opportunistic infections, care for unwell adults, adult distress, AIDS stigma, lack of social support, maternal breastfeeding issues, and vertical HIV transmission. Some evidence is provided that infants, adolescents, children with infected or ill mothers, and children living with severely ill adults are particularly vulnerable. Future research would benefit from more attention to causal inference and further characterization of processes and circumstances related to vulnerability and resilience. It would also benefit from further study of variation in observed associations between adult HIV/AIDS and child well-being based on characteristics such as age, sex, kinship, severity of illness, TB co-infection, disclosure, and serostatus awareness. Almost one-quarter of the studies reviewed did not investigate variation based on any of these factors. More nuanced understanding of the short- and long-term effects of adult HIV on children’s needs and circumstances will be important to ongoing discussions about equity in policies and interventions.