“You Comfort Yourself and Believe in Yourself”: Exploring Lived Experiences of Stigma in HIV-Positive Kenyan Women

Abstract

HIV-related stigma has a negative effect on women's health and can hinder interventions aimed at eradicating HIV. In Kenya, women withstand the worst of HIV-related stigma, because they are the most affected. In this longitudinal qualitative study, we explored experiences of stigma among 54 HIV-positive Kenyan women. Using Goffman's stigma definition and Foucault's social construction of stigma to analyze women's narratives, two main themes emerged: (1) women's experience of socially constructed HIV-related stigma and (2) women's resistance of socially constructed HIV-related stigma. Even though women are creative in resisting HIV-related stigma, psychological impact of stigma can hinder HIV prevention, care, treatment, and support. Interventions that empower women are critical in reducing HIV-related stigma.

“Trust Me, It’s Different”: Experiences of Peer Case Management of Women Living with HIV in Ontario, Canada

“…After meeting with a peer and opening up dialogue about HIV, this woman felt a sense of relief. Similar responses have been documented in research throughout the world, whereby positive disclosure beliefs are associated with lower perceived stigma, higher self-esteem, and fewer depressive symptoms (Kako & Dubrosky, 2013;Patel et al, 2012).…”

“…HIV-stigma and fear of disclosure continue to create barriers for WLWH to access HIV-specifi c support (Kako & Dubrosky, 2013;Sandelowski, Lambe, & Barroso, 2004) and can result in avoidance of critical health services (Turan, Miller, Bukusi, Sande, & Cohen, 2008). Disclosure to friends, family, and health-care providers has been associated with marginalization, isolation, and social exclusion (Loutfy et al 2012;Vanable, Carey, Blair, & Littlewood, 2006 This sentiment echoes Peterson (2010) where WLWH expressed concerned with the burden they may place on their families through disclosure, both to provide support and to cope with stigma.…”

“…From a meso-level, through peer support, women equip themselves with knowledge and confi dence to navigate care landscapes in their region, streamlining the process to accessing services and receiving support. Through disclosure and sharing with another woman living with HIV, women gain confi dence and self-esteem to challenge notions about HIV stereotypes and HIV-related stigma (Kako & Dubrosky, 2013;Patel et al, 2012). Peer case management can strengthen and mobilize communities of WLWH across Ontario to challenge sexism, racism, and HIV-related stigma and to shift how support is provided to WLWH at a macro-level.…”

“…Stereotypes associated with HIV have remained unchanged over time and internalization of these stereotypes results in women being blamed for HIV transmission and feeling stigmatized (Kako & Dubrosky, 2013;Lekas, Siegel, & Schrimshaw, 2006;Loutfy et al, 2012). HIV-related stigma seeps into other areas of women's lives including parenting (Greene et al, 2015;Sandelowski & Barroso, 2003) and when accessing shelter and housing supports (Greene et al, 2010).…”

Understanding ART Adherence

“…As such, they are confronted with perceived HIV-related stigma at much higher rates than men (Magadi, 201;Mwaura, 2008). The available literature on stigma among HIV-positive individuals demonstrates higher rates of stigma among HIV-positive individuals when compared to the larger community and variability in the gendered prevalence of such stigma (Kako & Dubrosky, 2013;Kalichman, et al, 2005;Simbayi et al, 2007). Simbayi and colleagues (2007) demonstrated that men experienced higher rates of reported stigma compared to women.…”