Lived Experiences of Internalized Stigma Among HIV-Positive Adults in Delhi, India

Abstract

The HIV infection is deeply associated with fear, stigma, discrimination, and internalization of the stigma. The ignorance around modes of transmission has led to many myths and misconceptions surrounding the infection. There is a stigma of contagion, along with the stigma of morality. Being ill and facing death is a situation that affects day to day living of the infected. It is not the virus but the stigmatizing environment around the infected that makes life with the virus a difficult journey. The infection leads to many behavioral issues and challenges for the infected as well as affected. In a mixed-method research, 105 HIV-positive consenting adults were recruited through the snowball method. They were interviewed using a semi-structured interview schedule in a confidential environment. Focus group discussions were conducted with infected males, females, men having sex with men (MSM), and uninfected partners of the infected respondents to understand the interpersonal issues and challenges. The current research explores and describes the impact of HIV and resultant internalized stigma upon the life of the infected in the background of moralistic values governing sexual behavior.

A scoping review of lesbian, gay, bisexual, transgender, queer, and intersex (LGBTQI+) people’s health in India

“…Over one-fourth of the articles (27%; n = 48) [ 95 – 142 ] reported on stigma, discrimination, violence, and their associations with physical and mental health. Among these, 16 articles focused on stigma-related aspects of LGBTQI+ health [ 96 , 100 – 102 , 109 , 110 , 112 , 114 , 119 , 124 – 126 , 129 , 132 , 137 , 140 ], 3 on violence [ 97 , 103 , 118 ], 17 on mental health and its correlates, such as quality of life [ 95 , 99 , 105 , 106 , 108 , 111 , 115 , 123 , 127 , 128 , 130 , 131 , 135 , 136 , 138 , 139 , 142 ], two on resilience [ 122 , 133 ] and one article each on coping skills [ 141 ] and promoting LGBTQI+ acceptance [ 134 ]. Three articles reported on stress [ 116 ], perceived psychological impact [ 120 ] and violence [ 121 ] associated with Section-377 of the Indian Penal Code, which until September 2018 criminalised adult consensual same-sex relationships.…”

“…Several studies highlighted various types of stigma and discrimination experienced by MSM and TGW, which include perceived stigma, felt normative stigma, HIV-related stigma, family-enacted stigma, gender non-conformity stigma, and internalized stigma [ 96 , 100 , 101 , 109 , 124 – 126 , 129 , 132 , 138 ], gender discrimination, workplace discrimination [ 137 , 139 ] and polyvictimization [ 140 ]. Perpetrators of discrimination and violence against MSM and TGW, including those living with HIV, included peers, sexual partners, family members, healthcare providers, and police [ 98 , 102 , 103 , 109 , 112 , 118 , 119 , 129 , 130 , 137 , 139 ].…”

A scoping review of lesbian, gay, bisexual, transgender, queer, and intersex (LGBTQI+) people’s health in India

“…Over one-fourth of the articles (27%; n=48) [95–142] reported on stigma, discrimination, violence, and their associations with physical and mental health. Among these, 16 articles focused on stigma-related aspects of LGBTQI+ health [96, 100–102, 109, 110, 112, 114, 119, 124–126, 129, 132, 137, 140], 3 on violence [97, 103, 118], 17 on mental health and its correlates, such as quality of life [95, 99, 105, 106, 108, 111, 115, 123, 127, 128, 130, 131, 135, 136, 138, 139, 142], two on resilience [122, 133] and one article each on coping skills [141] and promoting LGBTQI+ acceptance [134]. Three articles reported on stress [116], perceived psychological impact [120] and violence [121] associated with Section-377 of the Indian Penal Code, which until September 2018 criminalised adult consensual same-sex relationships.…”

“…Several studies highlighted various types of stigma and discrimination experienced by MSM and TGW, which include perceived stigma, felt normative stigma, HIV-related stigma, family- enacted stigma, gender non-conformity stigma, and internalized stigma [96, 100, 101, 109, 124–126, 129, 132, 138], gender discrimination, workplace discrimination [137, 139] and polyvictimization [140]. Perpetrators of discrimination and violence against MSM and TGW, including those living with HIV, included peers, sexual partners, family members, healthcare providers, and police [98, 102, 103, 109, 112, 118, 119, 129, 130, 137, 139].…”

“I hope I die. That is what I hope for”: Qualitative study of lived experiences of mental health of Indian women living with HIV experiencing intersectional stigma

“…Only a few studies from India have reported on the lived experiences of mental health of women as a result of HIV stigma. These studies have highlighted a range of feelings, including anger, hopelessness, thoughts of death, and guilt and fear [21][22][23]. Although such expressions may map onto biomedical concepts of common mental health disorders, such as depression or anxiety, the descriptions of mental health experiences in these studies help us understand what women actually feel and the support that they need after experiencing HIV-related stigma and discrimination, without giving them the additional label of "mentally ill".…”