The Relationship Between Stigma and Health-Related Quality of Life in People Living with HIV Who Have Full Access to Antiretroviral Treatment: An Assessment of Earnshaw and Chaudoir’s HIV Stigma Framework Using Empirical Data

Reinius, Maria; Wiklander, Maria; Wettergren, Lena; Svedhem, Veronica

doi:10.1007/s10461-018-2041-5

Cited by 36 publications

(45 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The authors were unable to identify previous research on the relationship between anticipatory HIV-related stigma and HRQoL from sub-Saharan Africa. However, among PLWH in Sweden, anticipatory stigma, measured by concerns about public attitudes, was significantly associated with poor physical HRQoL [30]. In this same study, though, concern regarding disclosure of one's HIV status, another component of anticipatory HIVrelated stigma, was not significantly associated with worse HRQoL [30].…”

Section: Discussionmentioning

confidence: 46%

“…However, among PLWH in Sweden, anticipatory stigma, measured by concerns about public attitudes, was significantly associated with poor physical HRQoL [30]. In this same study, though, concern regarding disclosure of one's HIV status, another component of anticipatory HIVrelated stigma, was not significantly associated with worse HRQoL [30]. Among PLWH in the United States, disclosure concerns were significantly associated with poor HRQoL among men and women [20].…”

Section: Discussionmentioning

confidence: 48%

“…Among PLWH in Spain, enacted stigma was significantly associated with worse HRQoL [34]. However, no significant relationship between enacted stigma and HRQoL was found when examined among PLWH in Sweden [30]. Neither study examined the relationship between enacted stigma and HRQoL separately by gender.…”

Section: Discussionmentioning

confidence: 92%

See 2 more Smart Citations

Gender, HIV-Related Stigma, and Health-Related Quality of Life Among Adults Enrolling in HIV Care in Tanzania

et al. 2019

View full text Add to dashboard Cite

HIV-related stigma has been associated with worse health-related quality of life (HRQoL) among people living with HIV (PLWH). Little is known about how different types of HIV-related stigma (i.e., anticipatory, internalized, or enacted HIVrelated stigma) influence HRQoL and whether these relationships differ by gender. The sample included 912 PLWH aged 18 years or older enrolling in HIV care at four health facilities in Tanzania. HRQoL was assessed with the life satisfaction and overall function subscales of the HIV/AIDS-Targeted Quality of Life (HAT-QoL) instrument. Sex-stratified multivariable logistic regression modeled the association of anticipatory, internalized, and enacted HIV-related stigma on poor HRQoL. Across all participants, the mean life satisfaction score was 63.4 (IQR: 43.8, 81.3) and the mean overall function score was 72.0 (IQR: 58.3, 91.7). Mean HRQoL scores were significantly higher for women compared to men for overall function (5.1 points higher) and life satisfaction (4.3 points higher). Fourteen percent of respondents reported recent enacted HIV-related stigma and 13% reported recent medium or high levels of internalized stigma. In multivariable models, high internalized and high anticipatory stigma were significantly associated with higher odds of poor life satisfaction and poor overall function in both men and women. Psychosocial interventions to prevent or reduce the impact of internalized and anticipatory stigma may improve HRQoL among persons in HIV care. Future research should longitudinally examine mechanisms between HIV-related stigma, poor HRQoL, and HIV care outcomes.

show abstract

Section: Discussionmentioning

confidence: 46%

Section: Discussionmentioning

confidence: 48%

See 1 more Smart Citation

Gender, HIV-Related Stigma, and Health-Related Quality of Life Among Adults Enrolling in HIV Care in Tanzania

et al. 2019

View full text Add to dashboard Cite

show abstract

“…HPSS was designed based on a stigma framework with three domains (internal, anticipated, and experienced stigma) and on three attributes abstracted from PrEP stigma literature (shame, character judgments, social support), yet our factor analysis revealed a unidimensional scale. The three dimension stigma framework has been validated for HIV stigma for people living with HIV [ 49 , 50 ] and for substance abuse stigma for people who have substance abuse histories [ 51 ]. There are several notable differences between this study and past research.…”

Section: Discussionmentioning

confidence: 99%

Validation of the HIV Pre-exposure Prophylaxis Stigma Scale: Performance of Likert and Semantic Differential Scale Versions

et al. 2020

View full text Add to dashboard Cite

Stigma regarding HIV pre-exposure prophylaxis (PrEP) is commonly implicated as a factor limiting the scale-up of this highly effective HIV prevention modality. To quantify and characterize PrEP stigma, we developed and validated a brief HIV PrEP Stigma Scale (HPSS) among a group of 279 men who have sex with men (MSM). Scale development was informed by a theoretical model to enhance content validity. We assessed two scale versions, Semantic Differential and Likert, randomizing the order in which scales were presented to participants. Both scales demonstrated high internal consistency. The Likert scale had substantially better construct validity and was selected as the preferred option. Scale scores demonstrated construct validity through association with constructs of interest: healthcare distrust, HIV knowledge, perceived proportion of friends/partners on PrEP, perceived community evaluation of PrEP, and perceived effectiveness of PrEP. The scale accounted for 25% of the total variance in reported willingness to be on PrEP, indicating the substantial role PrEP stigma may have on decisions to initiate PrEP. Given increased efforts to roll-out PrEP, having a valid tool to determine the level and types of PrEP stigma in individuals, groups, and communities can help direct implementation plans, identify goals for stigma reduction, and monitor progress over time.

show abstract

“…Ample research has addressed the clinical and health system challenges of the HIV and TB co-epidemic [7,8], butas Daftary (2012) rightfully pointed out -"the social aspects remain relatively unexplored" [9], especially the potential stigma associated with HIV and TB in a setting confronted with this dual epidemic. Evidencebased knowledge on the double stigma generated by the interlinked nature of both epidemics is urgently needed as both HIV and TB stigma have been individually extensively associated with non-disclosure [10][11][12], delayed health care [13][14][15][16], and ultimately worse (physical and psychological) health outcomes [10,14,[17][18][19][20][21].…”

Section: Introductionmentioning

confidence: 99%

Unpacking the dynamics of double stigma: how the HIV-TB co-epidemic alters TB stigma and its management among healthcare workers

et al. 2020

View full text Add to dashboard Cite

Background: HIV and tuberculosis (TB) are intricably interlinked in South Africa. The social aspects of this coepidemic remain relatively unexplored. More specifically, no research has quantitatively explored the double stigma associated with HIV and TB in this context, and more specifically the impact of the co-epidemic on [1] the stigmatisation of TB and [2] the TB stigma mangement strategy of covering (i.e. the use of TB as a cover for having HIV). The current study aims to address this research gap by disentangling the complex mechanisms related to HIV-TB stigma. Methods: Using Structural Equation Modelling (SEM), data of 882 health care workers (HCWs) in the Free State province, South Africa, are analysed to investigate the link between the stigmatization of HIV and TB and the stigma management by those affected. The current study focuses on health care workers (HCWs), as both TB and HIV have a severe impact on this professional group. Results: The results demonstrate that the perceived link between the epidemics is significantly associated with double HIV-TB stigmatization. Furthermore, the link between the illnesses and the double stigma are driving the stigmatization of TB. Finally, the link between HIV and TB as well as the stigmatization of both diseases by colleagues are associated with an increased use of covering as a stigma management strategy. Conclusions: This is the first quantitative study disentagling the mediating role of double stigma in the context of the co-epidemic as well as the impact of the co-epidemic on the social connotations of TB. The results stress the need for an integrated approach in the fight against HIV and TB recognizing the intertwined nature of the coepidemic, not only in medical-clinical terms, but also in its social consequences.

show abstract

The Relationship Between Stigma and Health-Related Quality of Life in People Living with HIV Who Have Full Access to Antiretroviral Treatment: An Assessment of Earnshaw and Chaudoir’s HIV Stigma Framework Using Empirical Data

Cited by 36 publications

References 35 publications

Gender, HIV-Related Stigma, and Health-Related Quality of Life Among Adults Enrolling in HIV Care in Tanzania

Gender, HIV-Related Stigma, and Health-Related Quality of Life Among Adults Enrolling in HIV Care in Tanzania

Validation of the HIV Pre-exposure Prophylaxis Stigma Scale: Performance of Likert and Semantic Differential Scale Versions

Unpacking the dynamics of double stigma: how the HIV-TB co-epidemic alters TB stigma and its management among healthcare workers

Contact Info

Product

Resources

About