A conceptual model of HIV/AIDS stigma from five African countries

Abstract

Title. A conceptual model of HIV/AIDS stigma from five African countries Aim. This paper is a report on the development of a conceptual model delineating contexts and processes of HIV/AIDS stigma as reported by persons living with HIV/AIDS and nurses from African countries. It is part of a larger study to increase understanding of HIV/AIDS stigma. Background. Researchers have defined stigma, explored determinants and outcomes of stigma and attempted to measure its multiple dimensions. This literature is difficult to synthesize, and often does not distinguish adequately between experiences of stigma and its causes and outcomes. Method. Forty‐three focus groups were held with persons living with HIV/AIDS and nurses in five African countries in 2004. Focus group recordings were transcribed and coded. The data were organized into a conceptual model of HIV/AIDS stigma. Findings. Two components were identified in the data: contextual factors – environment, healthcare system, agents – that influence and affect stigma and the stigma process itself. The stigma process included four dimensions: triggers of stigma, stigmatizing behaviours, types of stigma and the outcomes of stigma. Conclusion. A conceptual model is presented that delineates the dynamic nature of stigma as reported by study participants. The model may be used to identify areas appropriate for the design and testing of stigma reduction interventions that have a goal of reducing the burden of HIV/AIDS stigma.

Is HIV-1 infection associated with endothelial dysfunction in a population of African ancestry in South Africa?

“…A limitation of the study was that unfortunately, probably due to stigmatisation, which still exists among South African individuals49,50 and other aspects such as the illness itself and poverty,51 the participants did not visit the local clinic or hospital for follow up and CD 4 cell count determinations. Therefore the sample size of the nadir CD 4 cell count group was very small and those results should be interpreted with caution.…”

Moral distress among Ugandan nurses providing HIV care: A critical ethnography

“…Other obstacles for health care providers include stigma and discrimination (Holzemer et al, 2007;Mwinituo and Mill, 2006;Okafor and Holder, 2004), inadequate knowledge (Walusimbi and Okonsky, 2004), frustration and stress related to heavy workloads (Mavhandu-Mudzusi et al, 2007;Turan et al, 2008), and negative attitudes (Mbanya et al, 2001). Few authors acknowledge a specific association between such barriers and moral distress, however.…”

Perceptions of HIV and Fertility Among Adolescents in Soweto, South Africa: Stigma and Social Barriers Continue to Hinder Progress

“…Lastly, agents include the individual who may self-stigmatize, family members, work colleagues and community members. Particularly of interest to the research presented in this adolescent study however, is the relationship between the negative attitudes 27 perceived by healthcare workers in Soweto and the contextual framework proposed by Holzemer et al (Holzemer et al, 2007). This relationship should be explored and this framework considered as future research continues in the field of HIV and fertility related stigma.…”

“…Environmental factors consider cultural, economic, political, legal and the policy arena. Holzemer et al (Holzemer et al, 2007) suggest the healthcare system is a unique contextual factor because of its importance in health care and as a potential site for anti-stigma interventions. Lastly, agents include the individual who may self-stigmatize, family members, work colleagues and community members.…”

“…Additionally, Holzemer and colleagues (Holzemer et al, 2007) proposed a model for the stigma process that includes triggers of stigma, stigmatizing behaviours, types of stigma and the outcomes of stigma. While previous research has focus greatly on testing and disclosure as potential stigma triggers, little research, thus far, has investigated pregnancy in the context of HIV as a potential stigma trigger.…”