Effects Of Stigma Research Articles

Exploring perceptions of self-stigma of substance use and current alcohol and marijuana use patterns among college students.

While research has examined the effect of stigma from others towards individuals with substance use disorders, few studies have examined the relationship between perceived self-stigma and engagement in substance use more broadly, especially among non-clinical samples. The present study examined the relationships between perceptions of self-stigma if one were to develop a substance use disorder, consisting of negative self-esteem and negative self-efficacy, and alcohol or marijuana use behaviors and outcomes. Participants (n = 2,243; 71.5% female) were college students within the U.S. recruited to participate in an online survey on substance use with a special focus on alcohol and marijuana. Results indicated no significant differences in stigma scores across individuals with different lifetime alcohol and marijuana use. Stigma ratings did differ between individuals with different profiles of last 30-day alcohol and marijuana use where, generally, individuals with lifetime use but no use in the last 30-day reported higher levels of self-stigma. Correlation analyses indicated that perceived impact of substance use disorder on sense of self-efficacy and self-esteem related negatively to nearly all observed factors of alcohol and marijuana use. Though self-stigma, and stigma more broadly, has been shown to have negative implications for people with substance use disorders, the present study suggests that for non-clinical populations there may be some protective association between perceived self-stigma and alcohol or marijuana use engagement. This is not to say that self-stigma is a positive clinical intervention. Rather, we interpret these findings to indicate that negative perceptions of substance use disorder on the sense of self may be associated with distinct alcohol and marijuana use behaviors among young adults.

Effects of stigma on the quality of life in patients with epilepsy

BackgroundThis study was aimed to evaluate the stigma and quality of life (QoL) in adult patients with epilepsy (PWEs) and explore the relationship between stigma and QoL.MethodsTwo hundred and ninety-eight PWEs admitted to the Epilepsy Center of the First Affiliated Hospital of Chongqing Medical University during September 2020 and March 2021 were enrolled in this study. All participants completed self-reported questionnaires including the Stigma Scale for Epilepsy and the Quality of Life in Epilepsy Inventory-31 (QOLIE-31).ResultsA total of 146 (49%) PWEs reported an experience of stigma. The total score of QOLIE-31 and the individual scores of seven subscales (worry about new seizures, emotion, well-being, energy and fatigue, cognitive impairment, medication effect, and social function) were significantly decreased in these patients (P < 0.001). Multivariate stepwise linear regression analysis showed that the annual household income per capita, the number of antiseizure medications and stigma had statistically significant effects on QoL (P < 0.05). Among them, stigma had the most significant negative effect.ConclusionsNearly half of PWEs have experienced stigma. Stigma, lower household income per capita, and polypharmacy treatment are associated with poorer QoL. Stigma has the most obvious negative impact.

215 Weight Stigma as an Ongoing Challenge for Mental Health Post-Bariatric Surgery

OBJECTIVES/GOALS: The objective for this study was to evaluate the associations between weight stigma and symptoms of depression, anxiety, and binge eating following bariatric surgery. METHODS/STUDY POPULATION: Bariatric surgery is the leading evidence-based treatment for severe obesity; however, mental health challenges can compromise long-term improvements in quality of life. Weight stigma is a major contributor to mental health challenges for individuals with obesity generally; however, the role of weight stigma post-operatively after significant weight loss is poorly understood.148 patients underwent pre-bariatric surgery psychological evaluation and completed a follow-up study approximately 2 years after. Measures included the Stigmatizing Situations Inventory-Brief, Patient Health Questionnaire, Generalized Anxiety Questionnaire, and Binge Eating Scale. RESULTS/ANTICIPATED RESULTS: In regression models controlling for demographic covariates (sex, age, education, race), body mass index, and baseline measure of each outcome (e.g., depressive symptoms pre-surgery in models predicting depression post-surgery), weight stigma was independently associated with depression (p=.023), anxiety (p &lt;.001), and binge eating (p=.008) symptoms post-surgery.Above and beyond weight, demographics, and pre-surgery measurements of mental health, weight stigma continues to influence mental health outcomes in the years following bariatric surgery. Despite weight loss after bariatric surgery, this data suggests the cumulative experiences of stigma and discrimination continue to negatively impact mental health. DISCUSSION/SIGNIFICANCE: Interventions for bariatric surgery patients must consider the effects of weight stigma, at both the societal and individual levels. Interventions countering stigma could optimize long-term quality of life and associated outcomes.

Stigma and its impact on Quality of Life among Early Career Mental Health Professionals

IntroductionStigma towards mental health has been described as a major obstacle to seek help and access to mental health services. This could result in a worsened Quality of Life (QoL). There is a little evidence of stigma in Mental Health Professionals and its consequences, especially in Early Career ones (ECMPH), who can be a more vulnerable group. There is even more lack of studies with multicultural approaches. Exploring stigma, support systems and access to these, and the link of these factors with QoL is essential to develop effective strategies to support ECMHP, for both their own mental health and providing care to patients.ObjectivesThis study aims to explore the association between ECMHP’s stigma towards mental health and their QoL, and to identify predictors of QoL among this population.MethodsIn this cross-sectional study, we designed an online survey to collect data among ECMHP, identified as having completed training since less than 7 years. QoL was assessed using the WHO-QoL. Stigma towards mental health was measured with the Opening Minds Stigma Scale for Health Care Providers (OMS-HC). Other general sociodemographic data were also collected. Descriptive results are resumed in absolute and relative frequencies for categorical variables. Student’s t-test and ANOVA were used to analyse scores in WHO-QoL and OMS-HC according to categorical variables. Pearson’s correlation coefficient was used to assess the association between WHO-QoL and OMS-HC. Simple and multiple linear regression were used to study the effect of stigma on QoL, taking into account potential confounders.ResultsWe collected data from 277 ECMHP from Europe (54.15%) and Asia (45.85%). Only 20% of our sample knew that their workplace has staff dedicated for mental health practitioners support, and among those, only 44% had visited it. OMS-HC total scores were significantly higher (p&lt;0,05) in nurses and practitioners without a sufficient support system and without a mental disorder. WHO-QoL total scores were significantly higher in participants with sufficient support systems, and without a mental or physical illness. There was a negative correlation between OMS-HC and WHO-QoL total scores. Univariate analysis showed that OMS-HC total scores predicted WHO-QoL total scores. In the multivariate analysis, OMS-HC total scores, having a mental illness and having sufficient support, independently predicted WHO-QoL total scores, even when adjusted for sociodemographic variables.ConclusionsStigma towards mental health is related to QoL in ECMHP. Also, having sufficient support in the workplace improves QoL in this population. More studies are needed to help clarify the relationship between stigma and QoL using a longitudinal design.Disclosure of InterestNone Declared

Barriers to healthcare access and experiences of stigma: Findings from a coproduced Long Covid case-finding study.

Long Covid is often stigmatised, particularly in people who are disadvantaged within society. This may prevent them from seeking help and could lead to widening health inequalities. This coproduced study with a Community Advisory Board (CAB) of people with Long Covid aimed to understand healthcare and wider barriers and stigma experienced by people with probable Long Covid. An active case finding approach was employed to find adults with probable, but not yet clinically diagnosed, Long Covid in two localities in London (Camden and Merton) and Derbyshire, England. Interviews explored the barriers to care and the stigma faced by participants and were analysed thematically. This study forms part of the STIMULATE-ICP Collaboration. Twenty-three interviews were completed. Participants reported limited awareness of what Long Covid is and the available pathways to management. There was considerable self-doubt among participants, sometimes reinforced by interactions with healthcare professionals (HCPs). Participants questioned their deservedness in seeking healthcare support for their symptoms. Hesitancy to engage with healthcare services was motivated by fear of needing more investigation and concerns regarding judgement about the ability to carry out caregiving responsibilities. It was also motivated by the complexity of the clinical presentation and fear of all symptoms being attributed to poor mental health. Participants also reported trying to avoid overburdening the health system. These difficulties were compounded by experiences of stigma and discrimination. The emerging themes reaffirmed a framework of epistemic injustice in relation to Long Covid, where creating, interpretingand conveying knowledge has varied credibility based on the teller's identity characteristics and/or the level of their interpretive resources. We have codeveloped recommendations based on the findings. These include early signposting to services, dedicating protected time to listening to people with Long Covid, providing a holistic approach in care pathways, and working to mitigate stigma. Regardless of the diagnosis, people experiencing new symptoms must be encouraged to seek timely medical help. Clear public health messaging is needed among communities already disadvantaged by epistemic injustice to raise awareness of Long Covid, and to share stories that encourage seeking care and to illustrate the adverse effects of stigma. This study was coproduced with a CAB made up of 23 members including HCPs, people with lived experience of Long Covid and other stakeholders.

Introduction: social movements and radicalisation in Europe

ABSTRACT This Special Issue (SI) provides a nuanced understanding of the root causes of radicalisation among European youth with both nativist and religious affiliations. The contributions challenge the civilisational paradigm and the reductionist interpretations that often conflate it with extremism, terrorism, and violence. Our contributors contend that the rise of populist rhetoric across Europe, alongside the notable strengthening of grassroots resistance, has led to a pronounced polarisation of public opinion. Drawing on the literature in Social Movement Studies, each contributor provides an analysis of various processes of youth radicalisation across different European nations. They illuminate that both nativist and Islamist forms of radicalisation among European youth function as frames for justification and alternative political expressions – almost akin to a form of anti-politics. This serves as a means for them to protect themselves from the destabilising effects of deindustrialisation, discrimination, alienation, humiliation, and stigmatisation. The findings underscore that radicalised youth tend to employ unconventional forms of political expression to articulate their knowledge and garner public attention to their marginalised status. This stems from their lack of trust in political centers, which they perceive as failing to provide remedies for disenfranchised youths experiencing socio-economic, political, spatial, and nostalgic deprivation in the era of globalisation.

The roles of protective factors in facing gender-related interpersonal stigma among Chinese transgender and gender diverse individuals: A mixed-method study

Background Transgender and gender diverse (TGD) individuals report high rates of mistreatment in the form of interpersonal stigma. These experiences can negatively impact their mental health. However, few studies have explored this relationship within a Chinese context. This study aims to investigate the connection between various forms of interpersonal stigma and mental health among Chinese TGD individuals. It also seeks to understand the role of collective and personal protective factors in mitigating the effects of interpersonal stigma. Methods This study used explanatory sequential mixed methods, combining primary quantitative research with supplementary qualitative research. A total of 398 Chinese TGD individuals participated in an online questionnaire survey, with seven of these participants also taking part in semi-structured interviews. Results Of the Chinese TGD participants, 48.7% reported experiencing mild or more severe depressive symptoms, while 42.2% of them reported a low level of well-being status. The interpersonal stigma was found to be positively associated with depression and negatively associated with well-being status. Among the examined protective factors, the interactions of community consciousness and identity pride with the interpersonal stigma aggravated the relationships between the interpersonal stigma and well-being status. The qualitative interviews confirmed the widespread presence of interpersonal stigma and provided additional insights into the exacerbating effects of community consciousness and identity pride. Conclusions This study highlighted the existence of pervasive interpersonal stigma and its negative impact on the mental health of Chinese TGD individuals. The community consciousness and identity pride should be questioned for the validity of acting as protective factors. Such findings provided evidence for further developing intervention programs and clinical instructions for healthcare providers.

Lived Experiences of Suicide-Bereaved Siblings in Pakistan: A Qualitative Approach

The perspective of siblings who are suicide-bereaved in Pakistan denote a rather underexplored but significant part of mental wellbeing. This qualitative research reconnoiters the feeling of people whose siblings have been lost in the event of a suicide while also aiming to bring light to the different facets of the grieving journey that they have navigated through. Using techniques of thematic analysis, data was collected using semi-structured interviews involving 8 participants who were siblings and belonging to a wide range of backgrounds, each of them offering a different and unique viewpoint that was shaped by their experiences and backgrounds. The analysis discovered seven predominant themes, each of which contained several subthemes. From these, a universal and main aspect of the bereavement process was emotional distress which was interlinked with coping mechanisms and resilience portrayed by siblings while undergoing that journey of grief. Furthermore, posttraumatic growth as a phenomenon came forth as an intricate interconnection of transformation of the individual due to huge loss. The research also revealed the extensive effect of stigmatization in Pakistani society regarding suicide. Nevertheless, the significance of Environmental Reward, complexities of stressed relationships and social support dynamics came forth as important features that shaped the experience of bereavement. The discoveries highlight the need for specialized interventions and support services that cater to individualized needs of individuals in Pakistan who are suicide bereaved. By identifying and authenticating their experiences, officials involved in making policies and mental health professionals can nurture a more effective and sympathetic method for helping those who are currently experiencing loss of a sibling due to suicide. This research contributes important discernments to the increasing literature on the topic of bereavement and emphasizes the importance of cultural bound and contextual helping strategies for catering mental health problems in Pakistan.

The Effects of Family Function, Nurse-Patient Communication, and Stigma on Depression Symptoms in Tuberculosis Patients at the DOTS Pulmonary Outpatient Clinic of RSUD Banyumas

Background: Tuberculosis (TB) and mental illness are prevalent worldwide and often coexist. Poor mental health has been linked to alterations in immune function. Through social, behavioral, and biological mechanisms, depression and tuberculosis together amplify the burden of disease. Collaboration from all parties is needed to alleviate depression in TB patients, including support from family function and positive societal stigma. Method: This was a descriptive correlational study, and data collection was carried out using a cross-sectional method. A total of 72 respondents who met the inclusion and exclusion criteria were selected as the sample using a non-probability sampling technique, specifically accidental sampling. Results: The results of the multiple regression test showed that only the variables of family function and stigma had a significant correlation with p-values of 0.00005 and 0.009 0.05, respectively. Meanwhile, the variable of nurse-patient communication had a p-value of 0.633 0.05, indicating no significant correlation. Additionally, the calculated F-value was 18.662, and the tabled F-value was 3.136, with a probability value of 0.000. Since the probability value was less than 0.05, the regression model could be used to predict depression symptoms. It can be stated that the three independent variables, namely family function, nurse-patient communication, and stigma, collectively influence depression symptoms in patients. Conclusion: There is a significant relationship between family function and stigma towards depression symptoms in Tuberculosis patients at the DOTS Pulmonary Clinic of Banyumas Regional Public Hospital in 2023.

Intersectional Stigma, Fear of Negative Evaluation, Depression, and ART Adherence Among Women Living with HIV Who Engage in Substance Use: A Latent Class Serial Mediation Analysis.

Women Living with HIV (WLHIV) who use substances face stigma related to HIV and substance use (SU). The relationship between the intersection of these stigmas and adherence to antiretroviral therapy (ART), as well as the underlying mechanisms, remains poorly understood. This study aimed to examine the association between intersectional HIV and SU stigma and ART adherence, while also exploring the potential role of depression and fear of negative evaluation (FNE) by other people in explaining this association. We analyzed data from 409 WLHIV collected between April 2016 and April 2017, Using Multidimensional Latent Class Item Response Theory analysis. We identified five subgroups (i.e., latent classes [C]) of WLHIV with different combinations of experienced SU and HIV stigma levels: (C1) low HIV and SU stigma; (C2) moderate SU stigma; (C3) higher HIV and lower SU stigma; (C4) moderate HIV and high SU stigma; and (C5) high HIV and moderate SU stigma. Medication adherence differed significantly among these classes. Women in the class with moderate HIV and high SU stigma had lower adherence than other classes. A serial mediation analysis suggested that FNEand depression symptoms are mechanisms that contribute to explaining the differences in ART adherence among WLHIV who experience different combinations of intersectional HIV and SU stigma. We suggest that FNE is a key intervention target to attenuate the effect of intersectional stigma on depression symptoms and ART adherence, and ultimately improve health outcomes among WLHIV.

Patient-Centered Approaches for Designing Destigmatizing Sexual Pain-Related Web-Based Platforms: Qualitative Study.

Sexual pain is a common but neglected disorder that affects approximately 3% to 18% of women and an unmeasured number of gender-diverse people worldwide. Despite its wide prevalence, many people feel reluctant to visit conventional health care services or disclose their symptoms due to the fear of stigmatization. To alleviate this stigma, various web-based interventions have been developed to complement and, in some cases, replace conventional sexual health interventions. However, the way these web-based interventions are developed could inadvertently reproduce, perpetuate, or exacerbate stigma among end user patients. The purpose of this study was to understand patients' perspectives on how sexual pain-related web platforms can be designed to alleviate stigma or prevent the unintended effects of stigma among patients who use web-based interventions. Individual semistructured interviews were conducted among 16 participants with lived experiences of painful sex in a large urban city in Western Canada. Participants were recruited via social media platforms, newsletters, and a provincial health volunteer website. Using a sample sexual pain website to provide context, participants were interviewed about their experiences of stigma and how they think web platforms could be designed to address stigma. The interviews were conducted via Zoom (Zoom Technologies Inc) and analyzed using thematic analysis. The findings revealed 4 overarching themes that represented participants' perspectives on designing web platforms that may alleviate or prevent the unintended effects of stigma. These findings suggested the design of inclusive web platforms, having a nonprovocative and calming user interface, having features that facilitate connections among users and between users and providers, and displaying personal testimonials and experiences of sexual pain. This study highlighted patient-centered design approaches that could serve as a reference guide in developing web platforms that alleviate or prevent the unintended effects of stigma, particularly among nonheterosexual and gender-diverse people. While this study was conducted in the context of sexual pain, the results might also apply to web platforms on other potentially stigmatizing health-related disorders or conditions.

Deterrent or Stimulus? How Perceived Societal Stigma Affects Participation in Populist Radical Right Parties

While the effects of political stigma on populist radical right parties have been extensively investigated, we know little about the impact of societal stigma on populist radical right sympathisers. To examine this, I focus on a key group of populist radical right supporters, party members, and ask: How does perceived societal stigma affect the participation of populist radical right party members? Drawing on stigma research from social psychology and sociology, I develop the following three hypotheses: that stigma will work as a deterrent, as a stimulus, or that it will depend on where populist radical right rank-and-file live. I test these on the League in Italy and the Sweden Democrats, using original membership surveys of over 7800 grassroots members and interviews with 56 of them. The survey shows that perceived societal stigma has a consistent negative correlation with members’ participation. Furthermore, the interviews reveal that this negative relationship is due to stigma deterring participation, rather than participation reducing stigma.

The Effect of Stigma on Family Planning and HIV Pre-exposure Prophylaxis Decisions of Young Women Accessing Post-Abortion Care in Kenya

Adolescent girls and young women (AGYW) in Eastern and Southern Africa face parallel epidemics of unintended pregnancy and HIV. Their sexual health decisions are often dominated by intersecting stigmas. In an implementation science project integrating delivery of daily, oral pre-exposure prophylaxis (PrEP) for HIV prevention into 14 post-abortion care (PAC) clinics in Kenya, we enrolled a subset of PrEP initiating AGYW (aged 15 to 30 years) into a research cohort. Utilizing log binomial models, we estimated the effect of PrEP stigma on PrEP continuation (measured via self-report and urine assay for tenofovir) and abortion stigma on contraceptive initiation. Between April 2022 and February 2023, 401 AGYW were enrolled after initiating PrEP through their PAC provider, of which 120 (29.9%) initiated highly-effective contraception. Overall, abortion and PrEP stigmas were high in this cohort. Abortion stigma was more prevalent among those that were adolescents, unmarried, and reported social harm. Among 114 AGYW returning for the month 1 follow-up visit, 83.5% reported continuing PrEP and 52.5% had tenofovir detected. In this subset, higher levels of PrEP stigma were significantly associated with greater likelihood of PrEP adherence, but not PrEP continuation. For abortion stigma, greater scores in the subdomain of isolation were significantly associated with greater likelihood of initiating a highly-effective contraception, while greater scores in the subdomain of community condemnation were significantly associated with reduced likelihood of initiating a highly-effective contraception. Given the burden of stigma documented by our work, PAC settings are a pivotal space to integrate stigma-informed counseling and to empower young women to optimize contraceptive and PrEP decisions.

Retribution versus Rehabilitation for Children within Insurgency: Public Attitudes Toward ISIS-Affiliated Youth in Mosul, Iraq

ABSTRACT In the aftermath of insurgent violence, how do people view the treatment of insurgent youth, from adolescent fighters to very young children? Using an original survey, we examine public opinion regarding adolescent/child soldiers and young children in the Islamic State (ISIS) in Mosul, Iraq. Focusing retrospectively, we inquire about rehabilitative versus retributive preferences for minors who fought and worked for the Islamic State relative to adults. We find that retributive preferences toward minors are conditioned on their participation in violence, beliefs about the determinants of adulthood, and the role of agency versus coercion in the recruitment process. Looking prospectively, we find the public divided between fears over the threat posed by radicalized children within insurgency and hope for their rehabilitation and reintegration. Our results raise concerns about the detrimental effects of retributive justice and social stigma on the well-being of insurgent youth and children both now and later into adulthood.

Resisting stigma: the role of online communities in young mothers’ successful breastfeeding

BackgroundBreastfeeding initiation and continuation rates are shaped by complex and interrelated determinants across individual, interpersonal, community, organisational, and policy spheres. Young mothers, however, face a double burden of stigma, being perceived as immature and incompetent in their mothering and breastfeeding abilities. In this study, we aimed to understand the experiences of young mothers who exclusively breastfed for six months and beyond and explore their experiences of stigma and active resistance through social media.MethodsIn 2020, in-depth telephone interviews about breastfeeding experiences were conducted with 44 young mothers under age 25 in Aotearoa New Zealand who breastfed for six months or longer. Participants were recruited via social media. Interviews were audio-recorded, transcribed and analysed thematically.ResultsAnalysis yielded four themes on young mothers’ negotiation of breastfeeding and support. The first three themes revealed young mothers’ encounters with socio-cultural contexts. They faced negative judgments about maturity and competence, adverse guidance to supplement or cease breastfeeding, and an undermining of their breastfeeding efforts. The fourth theme showed how young mothers sought alternative support in online environments to avoid negative interactions. Online spaces provided anonymity, convenience, experiential knowledge and social connections with shared values. This facilitated identity strengthening, empowerment and stigma resistance.ConclusionOur research highlights the importance of online communities as a tool for young mothers to navigate and resist the societal stigmas surrounding breastfeeding. Online spaces can provide a unique structure that can help counteract the adverse effects of social and historical determinants on breastfeeding rates by fostering a sense of inclusion and support. These findings have implications for the development of breastfeeding promotion strategies for young mothers and highlight the potential of peer support in counteracting the negative impacts of stigma. The research also sheds light on the experiences of young mothers within the health professional relationship and the effects of stigma and cultural health capital on their engagement and withdrawal from services. Further research should examine how sociocultural barriers to breastfeeding stigmatise and marginalise young mothers and continue to reflect on their socio-political and economic positioning and how it can exacerbate inequities.

Longitudinal Associations of Experienced and Perceived Community Stigma With Antiretroviral Therapy Adherence and Viral Suppression in New-to-Care People With HIV: Mediating Roles of Internalized Stigma and Depression Symptoms.

Although cross-sectional studies have suggested that HIV-related stigma and depression symptoms may result in poor HIV treatment and health outcomes, few studies have investigated potential longitudinal mechanisms in these relationships. Furthermore, longitudinal effects of HIV-related stigma on health outcomes have not been examined in people with HIV (PWH) newly initiating HIV clinical care. We examined longitudinal associations between experienced and perceived community stigma and health outcomes (antiretroviral therapy [ART] adherence and viral load), mediated by internalized stigma and depression symptoms among new-to-care PWH in the United States. Data were obtained from 371 PWH who initiated HIV medical care at 4 HIV sites at baseline and 48 weeks later between December 2013 and 2018. Validated measures were used to assess experienced stigma, perceived community stigma, internalized stigma, depression symptoms, and ART adherence, and viral load was obtained from medical records at the final study visit. Serial mediation models revealed significant indirect effects of experienced stigma and perceived community stigma on ART adherence and on viral suppression, first through internalized stigma and then through depression symptoms. These results suggest that PWH may tend to internalize HIV-related stigma when they experience acts of stigmatization or perceive negative attitudes in society, which in turn may result in negative effects on psychological and physical well-being. These findings about how stigma in society may be an antecedent mechanism for PWH to develop internalized stigma, which in turn affects individual health outcomes, can be used to tailor both individual-level and community-level interventions.

Emotional Tears and Racial Stigma in Orson Welles's Othello and Vishal Bhardwaj's Omkara

Abstract On the basis of two film adaptations of Shakespeare's Othello, Orson Welles's (1952/1955) Othello and Vishal Bhardwaj's Omkara (2006), this article focuses on Othello's emotional tears, and how they mitigate, or not, the effects of racial stigmatization. The “Othello dilemma,” as I call it, refers to how Othello continues to be understood as an example of his race, rather than as an individual. How do the two films deal with this dilemma? This article draws on current research in cognitive neuroscience to underscore the pro-social function of emotional tears. Both films avoid direct views of Othello's tears but evoke lachrymal emotion to produce broader interpretations of the play, which is relevant to contemporary concerns. In black and white, Orson Welles uses Soviet montage to depict Othello's loneliness, which authenticates his grief, while Vishal Bhardwaj's colorful Bollywood film shifts attention to stigmatization on account of gender bias, invoking an array of culture-specific norms and values.

Building Community for Those Living With HIV: Co-Empowerment and Participatory Action Research

The Calgary HIV Social Society (CHSS) self-determined and organized several social-recreational monthly events to reduce and understand the effects of social isolation and stigma that people living with HIV face every day. It has been found that COVID-19 had impacted the lives of people living with HIV by creating significant isolation for those already stigmatized because of living with HIV. Using a Participatory Action Research (PAR) methodology and focus group at the end of the events, the research showed how COVID 19, and the related concurring isolation has impacted the lives of people living with HIV. The research included three in-person social gatherings with a total of 60 participants living with HIV attending and a focus group with 10 participants. The social gatherings around the city of Calgary, Alberta showed how the possibility of having a safe space and being supported by people who live with similar systematic barriers, buffers the detrimental, social stigmatization of living with HIV and its secrecy. The research brought forth a better understanding on how social connection (including on-line support) during COVID-19 for persons living with HIV increased their general sense of belonging, reduced stigma and was a protective factor for their overall mental health.

Psychological Distress and Behavioral Vigilance in Response to Minority Stress and Threat among Members of the Asian American and Pacific Islander Community during the COVID-19 Pandemic.

Stigmatization, hostility, and violence towards the Asian American and Pacific Islander (AAPI) community have increased sharply during the COVID-19 pandemic. It is important to conduct research to promote understanding of the effects of such stigmatization on the AAPI community. Accordingly, the present study used a combined minority stress and integrated threat framework to examine whether factors related to AAPI identity would moderate the relationship between stigmatization/threat associated with AAPI identity and increased psychological distress and behavioral vigilance. AAPI individuals were recruited online from both Turk Prime and Reddit and completed measures of perceived stigmatization; integrated threat; depression, anxiety, and stress; and behavioral vigilance. Perceptions of stigmatization and threat predicted relevant outcomes both as individual predictors and in multivariate analyses. However, factors relating to the strength of AAPI identification did not moderate the effects of stigmatization and threat on psychological distress and behavioral vigilance, which is a result that failed to support this aspect of the broader conceptual model on which this project was based. Instead, these proposed moderators were themselves predicted by stigmatization and threat variables. The implications of these findings for effective interventions to alleviate the negative consequences of anti-Asian stigmatization are discussed.

Racial discrimination, knowledge, and health outcomes: The mediating role of hepatitis B-related stigma among patients with chronic hepatitis B.

It is well described in current literature that Hepatitis B virus (HBV) affects Asian Americans more than any other racial group in the United States and that there is a stigma attached to this condition. The effects of stigma can be lasting, penetrating physiologically and psychologically, yet few studies have focused on the consequences of this phenomenon. The purpose of this study was to examine the mediating role of stigma in the effect of racial discrimination and knowledge (of HBV sequelae) on health status of Korean Americans with chronic hepatitis B (CHB). Three hundred sixty-five CHB patients were recruited and enrolled from two clinics in Philadelphia and Los Angeles. Depressive symptoms were measured using the Patient Health Question-9 (PHQ-9), physical health via self-rated health survey and stigma via hepatitis B quality of life (HBQOL)-stigma survey. Perceived racial discrimination and knowledge of CHB sequelae were independent variables. The cohort had an average age of 60.1 years (range 19-84, SD 10.7), 56% were male and 94% were born in South Korea. Mediational analysis found that stigma was a significant mediator between both racial discrimination (indirect effect = .037, Bootstrap 95% CI = [.010-.064]) and sequelae knowledge (indirect effect = .097, Bootstrap 95% CI = [.018-.176]) and depressive symptoms. Stigma also had a direct effect on depressive symptoms (β = .136, p < .01) and self-rated health (β = .018, p < .05). In addition, age, gender, education and employment were related to health outcomes. The findings of this study indicate that HBV-related stigma is an important mediator of mental health outcomes in this population. Future studies should identify other psychosocial factors to develop effective intervention programs to reduce stigma and improve quality of life among CHB patients.