Stigma, HIV and health: a qualitative synthesis

Abstract

BackgroundHIV-related stigma continues to negatively impact the health and well-being of people living with HIV, with deleterious effects on their care, treatment and quality of life. A growing body of qualitative research has documented the relationship between HIV-related stigma and health. This review aims to synthesize qualitative evidence that explored the intersections of stigma and health for people with HIV.MethodsA thematic summary was conducted that was guided by the qualitative metasummary technique developed by Sandelowski and Barraso. Literature searches yielded 8,622 references of which 55 qualitative studies were identified that illustrated HIV-related stigma in the context of health.ResultsThe metasummary classified qualitative findings into three overarching categories: conceptualizing stigma which identified key dimensions of HIV-related stigma; experiencing stigma which highlighted experiences of stigma in the health context, and managing stigma which described ways in which stigma is avoided or addressed. To better illustrate these connections, the qualitative literature was summarized into the following themes: stigma within health care settings, the role of stigma in caring for one’s health, and strategies to address HIV-related stigma in the health context. A number of health care practices were identified – some rooted in institutional practices, others shaped by personal perceptions held by practitioners – that could be stigmatizing or discriminatory towards people with HIV. There existed interconnections between enacted stigma and felt stigma that influenced health care utilization, treatment adherence, and overall health and well-being of people with HIV. Intersectional stigma also emerged as instrumental in the stigma experiences of people living with HIV. A number of strategies to address stigma were identified including social support, education, self-efficacy, resilience activities, and advocacy.ConclusionThis review of the qualitative evidence indicates that HIV-related stigma within health contexts is a broad social phenomenon that manifests within multiple social spheres, including health care environments. Findings from this review indicate that future stigma research should consider the social structures and societal practices – within and outside of health care environments – that perpetuate and reinforce stigma and discrimination towards people with HIV.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-2197-0) contains supplementary material, which is available to authorized users.

Patients Are Socially Excluded When Their Pain Has No Medical Explanation

“…Although we know that these fears are characteristic of people's stigmatizing behaviors towards others with infectious diseases 6 , little is known about their influence in the context of stigma related to unexplained pain.…”

“…Social exclusion is one of the core features of stigmatizing behavior, is related to lower psychological wellbeing, 38 and has been identified in many health conditions, such as mental health illnesses, 9 chronic infectious diseases, 6 and eating and weight disorders. 42 Using a vignette paradigm with videos of low back pain patients performing back straining activities, the present study had three aims.…”

Work-related stigma and disclosure: A daily challenge for people living with HIV

“…The prevalence of anxiety and depression among PLWH is higher than that of the general population [4]. HIV-related stigma can have a negative impact on health aspects and the wellbeing of PLWH [43]. It is recommended to further examine the role of stigma on health and wellbeing at work in order to provide appropriate counseling.…”

Perceived stigma of HIV patients receiving task-shifted primary care service and its relation to satisfaction with health service

“…Nowadays HIV-related stigma is conceptualized as a social process which may be resisted and challenged via social action such as through assistance from families, communities and health care services [6,7,25]. This concept allows for analysis of the possible influences and actions which may relate to HIV-stigmata.…”