Stigma in the HIV/AIDS epidemic: a review of the literature and recommendations for the way forward

Mahajan, Anish P.; Sayles, Jennifer N.; Patel, Vishal; Remien, Robert H.; Sawires, Sharif; Ortiz, Daniel J.; Szekeres, Greg; Coates, Thomas J.

doi:10.1097/01.aids.0000327438.13291.62

Cited by 1,053 publications

(915 citation statements)

References 69 publications

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“…Several reviewers highlighted the need for improved measurement (e.g. Obermeyer et al, 2011;Smith et al, 2008), and several authors proposed models to guide research on disclosure (Bairan et al, 2007;Bird & Voisin, 2011;Chaudoir & Fisher, 2010;Chaudoir et al, 2011;Mayfield Arnold et al, 2008;Serovich et al, 2008) and stigma (Bos et al, 2013;Earnshaw & Chaudoir, 2009;Mahajan et al, 2008). However, although most research has focused on the broader process of increasing one's disclosure levels from none or few confidants to the entire social network, the existing theoretical models interpreted all empirical evidence in terms of causes and consequences of single disclosure events.…”

Section: Introductionmentioning

confidence: 99%

Advancing methodology in the study of HIV status disclosure: The importance of considering disclosure target and intent

Dima

Stutterheim

Lyimo

et al. 2014

Social Science & Medicine

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Advancing methodology in the study of HIV status disclosure: The importance of considering disclosure target and intent Dima, A.L.; Stutterheim, S.E.; Lyimo, R.; de Bruin, M. General rightsIt is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), other than for strictly personal, individual use, unless the work is under an open content license (like Creative Commons). Disclaimer/Complaints regulationsIf you believe that digital publication of certain material infringes any of your rights or (privacy) interests, please let the Library know, stating your reasons. In case of a legitimate complaint, the Library will make the material inaccessible and/or remove it from the website. Please Ask the Library: http://uba.uva.nl/en/contact, or a letter to: Library of the University of Amsterdam, Secretariat, Singel 425, 1012 WP Amsterdam, The Netherlands. You will be contacted as soon as possible. Acknowledgements:The authors appreciatively acknowledge the financial assistance from RVVZ from the Netherlands, the participation of PLWH in our target group, and the cooperation of the management in the ART clinics where we conducted the study. Abstract:Disclosure of HIV status has been the focus of three decades of research, which have revealed its complex relations to many behaviors involved in HIV prevention and treatment, and exposed its central role in managing the HIV epidemic. The causes and consequences of disclosure acts have recently been the subject of several theoretical models. Although it is acknowledged that individual disclosure events are part of a broader process of disclosing one's HIV status to an increasing number of people, this process has received less theoretical attention. In quantitative studies of disclosure, researchers have often implicitly assumed that disclosure is a single unidimensional process appropriately measured via the total number of one's disclosure acts. However, there is also evidence that disclosure may have different causes and consequences depending on the types of actors involved (e.g. family members, friends) and on the presence or absence of the discloser's intention, suggesting that the unidimensionality assumption may not hold. We quantitatively examined the dimensionality of voluntary and involuntary disclosure to different categories of actors, using data collected via structured interviews in the spring of 2010 from 158 people living with HIV in Kilimanjaro, Tanzania. For voluntary disclosure, nonparametric item response analyses identified two multi-category clusters, family and community, and two single-category dimensions, partner and children. Involuntary disclosure consisted of several single-or twocategory dimensions. Correlation analyses between the resulting disclosure dimensions and stigma and social support revealed distinct relationships for each disclosure dimension. Our results suggest that treating disclosure as a unidimensional construct is a simplification of disclosure...

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Section: Introductionmentioning

confidence: 99%

Advancing methodology in the study of HIV status disclosure: The importance of considering disclosure target and intent

Dima

Stutterheim

Lyimo

et al. 2014

Social Science & Medicine

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“…15 There is growing awareness and debate on the role of stigma and discrimination in HIV prevention, testing, and medical care. [16][17][18] Most of these studies have focused on stigma among people who are living with HIV/AIDS. A few studies have examined how HIV stigma may impede HIV prevention activities and HIV testing and counseling.…”

Section: Introductionmentioning

confidence: 99%

The Relationship between Drug User Stigma and Depression among Inner-City Drug Users in Baltimore, MD

et al. 2012

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There is growing awareness of the role of stigma and discrimination in HIV prevention, testing, and medical care. Yet, few studies have examined the stigma associated with using illicit drugs. In the present study, we examined the relationship between social network characteristics, drug user stigma, and depression. Study participants were comprised of 340 individuals who reported cocaine, crack, and/or heroin use in the prior 6 months and were involved in an HIV prevention study. They were recruited through street outreach, referrals, and word of mouth in inner-city Baltimore, MD, USA. The stigma scale was comprised of eight items, such as "how much do you feel ashamed of using drugs?" Depression was assessed with the Center for Epidemiological Studies Depression Scale, using cutoffs of 16 and 20 or greater. In the bivariate analyses, gender, homelessness in the past 6 months, drug user stigma, larger size of drug network, and current use of heroin, cocaine, and crack were all significantly associated with high levels of depression, whereas in the multivariate analyses, only drug user stigma remained significantly associated with depression. The results of this study suggest that drug treatment providers and other professionals who provide services to drug users should consider developing trainings to address drug user stigma. These programs should focus on the attitudes and behaviors of health and service providers toward drug users, among drug users themselves, and among family members and others who provide social support to drug users.

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“…Substantial evidence from different parts of the world highlights HIV/AIDS-related stigma as a barrier in HIV prevention work and in mitigating its impact (Mahajan, Sayles, Patel, Remien, Sawires, Ortiz et al, 2008). The National AIDS Control Program of India also recognises AIDS stigma as a significant barrier to HIV prevention efforts.…”

Section: Introductionmentioning

confidence: 99%

“…6). A vast body of social science literature exists on stigma assessment (Mahajan et al, 2008) and on its role in hampering uptake of voluntary…”

Section: Introductionmentioning

confidence: 99%

A systematic review of HIV/AIDS-related stigma and discrimination in India: Current understanding and future needs

Bharat

2011

SAHARA-J: Journal of Social Aspects of HIV/AIDS

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Stigma in the HIV/AIDS epidemic: a review of the literature and recommendations for the way forward

Cited by 1,053 publications

References 69 publications

Advancing methodology in the study of HIV status disclosure: The importance of considering disclosure target and intent

Advancing methodology in the study of HIV status disclosure: The importance of considering disclosure target and intent

The Relationship between Drug User Stigma and Depression among Inner-City Drug Users in Baltimore, MD

A systematic review of HIV/AIDS-related stigma and discrimination in India: Current understanding and future needs

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