Self-Esteem and HIV Infection in Morocco: Associated Factors Among People Living with HIV—Results from a Community-Based Study

Bernier, Adeline; Benmoussa, Amal; Hilali, Mohamed Kamal; Henry, E.; Otis, Joanne; Loukid, Mohamed; Préau, Marie

doi:10.1007/s10597-019-00394-9

Cited by 4 publications

(4 citation statements)

References 35 publications

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“…The bolstering of the national surveillance system [11], development of national harm reduction strategies [8], implementation of community-based education interventions and testing [12] and harm reduction advocacy and services [13], advocacy for rights for PLHIV [14] and most recently a pilot PrEP project [15] have all contributed to the national HIV response. Despite these advances, key populations in Morocco and elsewhere continue to disproportionately bear the burden of HIV and experience stigma and discrimination [16][17][18].…”

Section: Introductionmentioning

confidence: 99%

Determinants and effects or consequences of internal HIV-related stigma among people living with HIV in Morocco

Moussa¹,

Delabre²,

Villes³

et al. 2021

BMC Public Health

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Background HIV-related stigma and discrimination constitute a barrier to different intervention programs. Unlike external stigma, internal stigma is not well explored in in the Middle East and North African countries, while grasping this particular form of stigma is essential to limit its effects. The present study aims to measure internal stigma effects and to identify factors associated with this kind of stigma not yet documented among people living with HIV (PLHIV) in Morocco. Methods The PLHIV Stigma Index questionnaire (adapted and translated into French and Moroccan Arabic dialect “darija”) was used to collect information regarding the stigma and discrimination experienced by PLHIV across 8 cities in Morocco (September–October 2016). A randomly drawn cluster of 10 PLHIV, consisting of 5 men and 5 women, was drawn at each participating medical care center to achieve a nationally representative sample of PLHIV. Fifteen interviewers living with HIV and five supervisors were selected and trained to administer the questionnaire. An internal stigma score (range: 0–7), was calculated based on seven negative feelings/ beliefs. Negative binomial regression was used to identify characteristics associated with the internal stigma score. Results Among 626 PLHIV, internal stigma was reported by 88.2%. The median [IQR] internal stigma score was 4 [2–5]. Regarding internal stigma, 51% avoided going to the local clinic when needed and 44% chose not to attend social gatherings. Belonging to at least one key population (aIRR [95%CI] = 1.15 [1.03; 1.28]), experiencing discriminatory reactions from family following HIV status disclosure (1.28 [1.11; 1.49]), avoiding HIV services for fear of stigmatization by staff (1.16 [1.05; 1.28]) and being denied health services because of HIV status (1.16 [1.03;1.32]), are among the factors significantly associated with an increase of the internal stigma score. Conclusions Internal stigma is high among Moroccan PLHIV and significantly impacting their life decisions and their healthcare access. Multi-level interventions are needed to address internal stigma experienced by PLHIV in Morocco.

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Section: Introductionmentioning

confidence: 99%

Determinants and effects or consequences of internal HIV-related stigma among people living with HIV in Morocco

Moussa¹,

Delabre²,

Villes³

et al. 2021

BMC Public Health

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“…O fator com mais forte foi a sensação de solidão. Um diagnóstico de HIV pode ter um impacto profundo nos aspectos psicossociais da vida de alguém, e pode perturbar ou romper relações sociais, seja como preconceito ou como uma opção para evitar o enfrentamento do estigma 12 .…”

Section: Masculinounclassified

“…Costa et al ressaltam que receber o diagnóstico para o HIV/AIDS não consiste em aceitar pacifi camente a doença 29,30 . Trata-se de um processo que será construído sobre um enfrentamento de valores culturais arraigados a partir da construção que o paciente e o mundo a sua volta fazem acerca da doença 12,29,30 .…”

Section: Masculinounclassified

Levantamento epidemiológico bucal, auto estima e qualidade de vida de pacientes portadores do vírus HIV/AIDS: Estudo transversal exploratório

Garbín

Teruel

Gatto

et al. 2021

SDH

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Objetivo: Objetivou-se avaliar nos pacientes portadores de HIV/AIDS a condição de saúde bucal, a autoestima, a qualidade de vida e verificar as possíveis associações entre elas. Metodologia: Trata-se de um estudo transversal, realizado no Serviço de Atendimento Especializado ligado a Faculdade de medicina. Para a coleta de dados foi realizado o exame bucal, o que foram utilizados os índices CPO-D e IHOS, preconizados pela Organização Mundial de Saúde e por meio da Escala de Autoestima de Rosenberg. A análise de dados foi aplicada o coeficiente de Correlação por Postos de Spearman, Teste G com correção de Williams e teste do Qui-Quadrado, no Programa SPSS 22.0. Resultados: Participaram da pesquisa 146 pacientes portadores de HIV, sendo a maioria do gênero masculino (61,64%), com idade média 44 anos e nível de escolaridade básico/fundamental, (50%). Em relação à saúde bucal o CPOD médio foi de 14,31 e o IHOS foi regular em 38,36% da amostra. A maior parte dos pacientes não apresentava sintomas de depressão (60,28%) e 52,06% apresentou uma autoestima positiva. A baixa autoestima apresentou correlação negativa com os domínios atividade sexual (p=0,005), satisfação com a vida (p=0,040) e conscientização sobre o HIV (p=0,026). Conclusão: Os resultados sugerem que a condição de saúde bucal foi considerada regular e a autoestima foi classificada como positiva, mas algumas variáveis interferiram negativamente nos domínios de qualidade de vida.

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“…24 Other evidence points to the risk of internalising HIV/AIDS-related stigma when self-esteem is low, which could have negative downstream implications for health and wellbeing. 25,26…”

Section: Self-esteem and Internalised Hiv/aids-related Stigmamentioning

confidence: 99%

Self-esteem and antiretroviral therapy adherence among young people living with HIV: An exploratory serial mediation analysis

2021

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Capitalising further on the benefits of antiretroviral therapy (ART) for individual treatment requires an improved understanding of the psychological processes that may affect optimal ART adherence among people living with HIV. We examined internalised HIV/AIDS-related stigma and body appreciation as mediators of the association between self-esteem and ART adherence among young people living with HIV (YPLHIV). A sample of 76 YPLHIV (Mage = 19.36, s.d.age = 2.56; male 56.58%) residing in an HIV hyperendemic region of South Africa completed self-report measures of self-esteem, internalised HIV/AIDS-related stigma, body appreciation, and ART adherence. Path-analytic mediation modelling was performed to test for direct and indirect effects linking self-esteem with ART adherence. Results of serial mediation analyses indicated that self-esteem and ART adherence were indirectly associated through a two-step path of internalised HIV/AIDS-related stigma and then body appreciation, as well as a one-step path through internalised HIV/AIDS-related stigma. The results provide preliminary support for internalised HIV/AIDS-related stigma and body appreciation as mechanisms underlying the association between self-esteem and ART adherence. Implications of the findings for promoting ART adherence among YPLHIV are discussed.

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Self-Esteem and HIV Infection in Morocco: Associated Factors Among People Living with HIV—Results from a Community-Based Study

Cited by 4 publications

References 35 publications

Determinants and effects or consequences of internal HIV-related stigma among people living with HIV in Morocco

Determinants and effects or consequences of internal HIV-related stigma among people living with HIV in Morocco

Levantamento epidemiológico bucal, auto estima e qualidade de vida de pacientes portadores do vírus HIV/AIDS: Estudo transversal exploratório

Self-esteem and antiretroviral therapy adherence among young people living with HIV: An exploratory serial mediation analysis

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