Identifying Strategies to Cope with HIV-Related Stigma in a Group of Women Living with HIV/AIDS in the Dominican Republic: A Qualitative Study

Abstract

Internalized HIV-related stigma negatively impacts the mental and physical health of women living with HIV/AIDS (WLWHA). Yet, some women can successfully confront stigma. The present work uses qualitative methods to investigate the successful stigma coping strategies displayed by 19 WLWHA who reported the least internalized stigma possible on the Internalized AIDS-Related Stigma Scale out of a larger pool of 233 WLWHA in San Felipe de Puerto Plata, Dominican Republic. Such strategies included, HIV disclosure control; preemptive disclosure of HIV-status; educating oneself/others about HIV; viewing HIV as a manageable condition; and looking to family, friends and partners for support. Our findings add to current knowledge about how WLWHA successfully manage internalized stigma, particularly in the context of the Dominican Republic. Clinicians should work closely with WLWHA to counsel them about the stigma coping strategies that best fit their life context.

Frequency of HIV status disclosure, associated factors and outcomes among HIV positive pregnant women at Mbarara Regional Referral Hospital, southwestern Uganda

“…Among postpartum mothers, disclosure is associated with adherence to safer infant feeding practices, exclusive breast feeding, exclusive replacement feeding, creates awareness about HIV risk for the untested sexual partners, supports risk reduction, promotes safer sexual behavior, increased retention in eMTCT programs, leads to better clinical outcomes such as CD4+ count increases and higher rates of retention in treatment programs [3-12]. Studies also show that disclosure is a potential strategy for dealing with stigma among patients receiving antiretroviral therapy [13]. Despite these potential benefits, studies indicate the frequency of non-disclosure remains relatively high.…”

Community-Based Antiretroviral Therapy (ART) Delivery for Female Sex Workers in Tanzania: 6-Month ART Initiation and Adherence

“…This suggests that ART services need to adopt strategies to develop a healthy self-perception in relation to their HIV diagnosis and cope psychologically. Such strategies include linkage to peer educators/supporters who understand their lifestyle, peer support groups, educating oneself/others about HIV, viewing HIV as a manageable condition, and controlled and pre-emptive HIV disclosure [38][39][40][41].…”

What the Rest of the World Should Know About HIV: Perceptions From Adults Living With HIV in the Dominican Republic

“…That almost 20% of participants chose not to share anything with the rest of the world because of profound feelings of betrayal and fear of discovery, even in a confidential situation, emphasized the extent and impact of the negative experiences with which these individuals must cope. Health care settings that provide care to PLWH should consider providing opportunities to their patients to share experiences in meaningful ways, such as in safe collected spaces or in group therapy sessions, where their input and ideas are valued (Carrasco et al, 2016; Rael et al, 2016). Additionally, researchers and clinicians should further identify methods in which patient input can enhance education and generate positive change in wider society on topics such as stigma.…”

“…Suggestions from the research have included expanding the scope of interventions to reach multiple societal levels and wider populations (Brown, Macintyre, & Trujillo, 2003; Sengupta et al, 2011; Stangl et al, 2013). Similarly, the authors of one recent study conducted in the Dominican Republic found that educating the larger community was a necessary component of HIV-related stigma reduction (Rael et al, 2016). Another recent study in the Dominican Republic considered using social cohesion as a method to reduce stigma by combating societal norms (Carrasco et al, 2016).…”