HIV stigma experiences and stigmatisation before and after an intervention

Chidrawi, Helena Christa; Greeff, Minrie; Temane, Q. Michael; Doak, Colleen M.

doi:10.4102/hsag.v21i0.953

Cited by 10 publications

(12 citation statements)

References 24 publications

(35 reference statements)

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“…His work on the types of stigma continue to inform the sociological understanding of stigma as a serious determinant of health and healthcare (24). Previous studies of stigma in patients with HIV/AIDS and tuberculosis have demonstrated loss of livelihood due to stigma (25,26). A similar loss of livelihood was found in this study due to stigma related to Covid-19.…”

Section: Discussionsupporting

confidence: 89%

A qualitative inquiry into stigma among patients with Covid-19 in Chennai, India

Gopichandran¹,

Subramaniam²

2021

IJME

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ntroduction: The Covid-19 pandemic has left a serious impact on the lives of people globally. One key social consequence of the infection has been the stigma associated with it. Objectives: This study was conducted to explore the lived experiences of stigma among persons who have recovered from Covid-19 in Chennai, India. Methods: In depth telephonic interviews were conducted among 12 persons who had recovered from Covid-19 in Chennai. The participants were encouraged to narrate their experiences of stigma. The telephonic interviews were transcribed and coded by both the researchers. The codes were then grouped into meaningful themes and the lived experiences of stigma described with the help of rich narrative quotes. Results: The common manifestations of stigma were exclusion from public spaces and essential services, loss of livelihood, loss of social support and, in an extreme case, physical violence. The stigma was also manifested in health facilities in the form of neglect, and rude and insensitive treatment of patients. The factors that aggravated the stigma included fear of infection, lack of information, legitimisation of segregation by forced public health interventions, involvement of police in contact tracing, and isolation. Stigma was associated with psychosocial consequences such as loneliness, uncertainty, anxiety, anger, and humiliation. Demonstration of empathy, advances in communication technology, solidarity in communities and protecting confidentiality could potentially mitigate stigma. The intersectionality of age, gender, poverty, and disability worsened the experience of stigma. Conclusions: People who had recovered from Covid-19 experienced various degrees of social stigma. The future impact of the pandemic will depend strongly on the ability of health systems to address stigma.

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Section: Discussionsupporting

confidence: 89%

A qualitative inquiry into stigma among patients with Covid-19 in Chennai, India

Gopichandran¹,

Subramaniam²

2021

IJME

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“…Brown 2009 [18]Faith-based mental health education: A service-learning opportunity for nursing studentsUSMental illness (MI)55 nursing students, 38 community membersEducation; 90-min workshopInterpersonalCommunityMulti-Country Validated Measure of Mental Illness Stigma at pre- and post-workshopSignificant;CI not given;ES d = 0.45. Chidrawi, Greeff, Termane, Doak 2016 [30]HIV stigma experiences and stigmatisation before and after an interventionSouth AfricaHIV18 PLWH, 60 caregivers/familyEducation, contact, problem solving; 5-month intervention with workshops and group projectsIntrapersonal,InterpersonalMulti-country Validated HIV Stigma Measure at pre-intervention and quarterly for 1 yearSignificant;CI not given; ES d = 0.11 (caregivers) d = 2.51 (PLWH)6. Dadun, Van Brakel, Peters, Lusli, Zweekhorst, Bunders, Irwanto 2017 [14]Impact of socio-economic development, contact and peer counselling on stigma against persons affected by leprosy in Cirebon, Indonesia - a randomized controlled trialIndonesiaLeprosy237 PW leprosy, 213 and 375 communityContactSocio-economicCoping/counseling; 5 counseling sessions; 2 years with communityIntrapersonalInterpersonalCommunityMulti-country Validated Leprosy Stigma Scale at pre- and post-interventionSignificant;CI not given; ES d = 1.577.…”

Section: Resultsmentioning

confidence: 99%

A systematic review of multi-level stigma interventions: state of the science and future directions

Rao

Elshafei

Nguyen

et al. 2019

BMC Med

202

188

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Background Researchers have long recognized that stigma is a global, multi-level phenomenon requiring intervention approaches that target multiple levels including individual, interpersonal, community, and structural levels. While existing interventions have produced modest reductions in stigma, their full reach and impact remain limited by a nearly exclusive focus targeting only one level of analysis. Methods We conducted the first systematic review of original research on multi-level stigma-reduction interventions. We used the following eligibility criteria for inclusion: (1) peer-reviewed, (2) contained original research, (3) published prior to initiation of search on November 30, 2017, (4) evaluated interventions that operated on more than one level, and (5) examined stigma as an outcome. We stratified and analyzed articles by several domains, including whether the research was conducted in a low-, middle-, or high-income country. Results Twenty-four articles met the inclusion criteria. The articles included a range of countries (low, middle, and high income), stigmatized conditions/populations (e.g., HIV, mental health, leprosy), intervention targets (e.g., people living with a stigmatized condition, health care workers, family, and community members), and stigma reduction strategies (e.g., contact, social marketing, counseling, faith, problem solving), with most using education-based approaches. A total of 12 (50%) articles examined community-level interventions alongside interpersonal and/or intrapersonal levels, but only 1 (4%) combined a structural-level intervention with another level. Of the 24 studies, only 6 (25%) were randomized controlled trials. While most studies (17 of 24) reported statistically significant declines in at least one measure of stigma, fewer than half reported measures of practical significance (i.e., effect size); those that were reported varied widely in magnitude and were typically in the small-to-moderate range. Conclusions While there has been progress over the past decade in the development and evaluation of multi-level stigma interventions, much work remains to strengthen and expand this approach. We highlight several opportunities for new research and program development.

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“…Internalized and enacted stigma association clearly demonstrates that persons living with HIV experience numerous mental and psychological sequela of stigma, including stress, fear, anxiety, decreased self-esteem, and depression ( 7 , 9 ). HIV remains a complex concept associated with blame, shame, disgrace, and social unacceptability ( 48 ).…”

Section: Discussionmentioning

confidence: 99%

Burden of HIV-Related Stigma and Post-Partum Depression: A Cross-Sectional Study of Patients Attending Prevention of Mother-to-Child Transmission Clinic at Kenyatta National Hospital in Nairobi

Yator

Mathai

Tele³

et al. 2021

Front. Psychiatry

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Background: We look at how various HIV-related stigma subtypes, especially internalizing types, interact with postpartum depression (PPD) among women living with HIV. Additionally, we identify key psychosocial risk factors that influence stigma and PPD among women attending Prevention of Mother-to-Child Transmission (PMTCT) clinics.Methods: In this cross-sectional design, 123 women living with HIV were recruited. Participants ages between 18 and 50, who were at least 8 weeks postpartum seeking PMTCT services at Kenyatta National Hospital (KNH), between June and September 2014 participated in the study. HIV/AIDS Stigma Instrument—PLWHA (HASI–P) was used to assesses stigma and Postpartum depression was assessed by Edinburgh Postnatal Depression Scale (EPDS). Bivariate and multivariate regression models were used to determine the individual characteristics associated with the HIV-related stigma Scale. Post survey a few in-depth-interviews were conducted to explore individuals' stigma and depression experiences.Results: The mean age was 31.2 years (SD = 5.2). Fifty-nine (48%) women screened positive for significant depressive symptoms. Post-partum depression was a significant predictor of internalized stigma, enacted, and total stigma (P < 0.05). Older age was associated with less internalized stigma. Living with a partner was associated with more internalized stigma. Having an income above 100 USD per month was protective against stigma. Having good family social support was protective against internalized stigma. A higher educational level was protective against enacted stigma. Being treated for STIs was a risk factor for both enacted and overall stigma.Conclusions: HIV-related stigma needs to be addressed through integrated mental health care programs in PMTCT. Postpartum depression requires comprehensive management to improve short- and long-term outcomes of women living with HIV.

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HIV stigma experiences and stigmatisation before and after an intervention

Cited by 10 publications

References 24 publications

A qualitative inquiry into stigma among patients with Covid-19 in Chennai, India

A qualitative inquiry into stigma among patients with Covid-19 in Chennai, India

A systematic review of multi-level stigma interventions: state of the science and future directions

Burden of HIV-Related Stigma and Post-Partum Depression: A Cross-Sectional Study of Patients Attending Prevention of Mother-to-Child Transmission Clinic at Kenyatta National Hospital in Nairobi

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