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Stigma, HIV and health: a qualitative synthesis

Lori A. Chambers, Sergio Rueda, D. Nico Baker and 5 more

BMC Public Health · 2015 · Review

doi:10.1186/s12889-015-2197-0

Abstract

Background. HIV-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.

Methods. A 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.

Results. The 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.

Conclusion. This 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 material. The online version of this article (doi:10.1186/s12889-015-2197-0) contains supplementary material, which is available to authorized users.

References 137

  1. 1.

    Mann JM. Statement at an Informal Briefing on AIDS to the 42nd Session of the United Nations General Assembly. Journal of the Royal Statistical Society Series A (Statistics in Society). 1988;151(1):131-136.

    Not in our library10.2307/2982189

  2. 2.

    Goffman E. Stigma: Notes on the Management of Spoiled Identity. 1963.

    Not in our library

  3. 3.

    Alonzo AA, Reynolds NR. Stigma, HIV and AIDS: An exploration and elaboration of a stigma trajectory. Soc Sci Med. 1995;41(3):303-315.

    Not in our library10.1016/0277-9536(94)00384-6

  4. 4.

    Parker R, Aggleton P. HIV and AIDS-related stigma and discrimination: A conceptual framework and implications for action. Soc Sci Med. 2003;57(1):13-24.

    Not in our library10.1016/s0277-9536(02)00304-0

  5. 5.

    Taylor B. HIV, stigma and health: Integration of theoretical concepts and the lived experiences of individuals. J Adv Nurs. 2001;35(5):792-798.

    Not in our library10.1046/j.1365-2648.2001.01912.x

  6. 6.

    Earnshaw V, Chaudoir S. From Conceptualizing to Measuring HIV Stigma: A Review of HIV Stigma Mechanism Measures. AIDS Behav. 2009;13(6):1160-1177.

    Not in our library10.1007/s10461-009-9593-3

  7. 7.

    Holzemer WL, Uys L, Makoae L, Stewart A, Phetlhu R, Dlamini PS, et al. A conceptual model of HIV/AIDS stigma from five African countries. J Adv Nurs. 2007;58(6):541-551.

    Not in our library10.1111/j.1365-2648.2007.04244.x

  8. 8.

    Herek GM, Capitanio JP. Symbolic prejudice or fear of infection? A functional analysis of AIDS-related stigma among heterosexual adults. Basic and Applied Social Psychology. 1998;20(3):230-241.

    Not in our library10.1207/s15324834basp2003_5

  9. 9.

    Herek GM. AIDS and stigma. Am Behav Sci. 1999;42(7):1106-1116.

    Not in our library10.1177/00027649921954787

  10. 10.

    Collins E, Cain R, Bereket T, Chen YY, Cleverly S, George C, et al. Living & Serving II: 10 Years Later - The Involvement of People Living with HIV/AIDS in the Community AIDS Movement in Ontario. 2007.

    Not in our library

  11. 11.
    Combating HIV stigma in health care settings: what works? · 2009
    No notice
  12. 12.

    Sears B, Cooper C, Younai FS, Donohoe T. HIV discrimination in dental care: Results of a testing study in Los Angeles county. Loyola Los Angel Law Rev. 2012;45(3):909.

    Not in our library

  13. 13.

    Elford J, Ibrahim F, Bukutu C, Anderson J. HIV-related discrimination reported by people living with HIV in London. UK. AIDS Behav. 2008;12(2):255-264.

    Not in our library10.1007/s10461-007-9344-2

  14. 14.

    Schuster MA, Collins R, Cunningham WE, Morton SC, Zierler S, Wong M, et al. Perceived discrimination in clinical care in a nationally representative sample of HIV‐infected adults receiving health care. J Gen Intern Med. 2005;20(9):807-813.

    Not in our library10.1111/j.1525-1497.2005.05049.x

  15. 15.

    Fife BL, Wright ER. The dimensionality of stigma: A comparison of its impact on the self of persons with HIV/AIDS and cancer. J Health Soc Behav. 2000;50–67.

    Not in our library

  16. 16.

    Sandelowski M, Lambe C, Barroso J. Stigma in HIV-Positive Women. J Nurs Scholarsh. 2004;36(2):122-128.

    Not in our library10.1111/j.1547-5069.2004.04024.x

  17. 17.

    Gonzalez A, Solomon SE, Zvolensky MJ, Miller CT. The interaction of mindful-based attention and awareness and disengagement coping with HIV/AIDS-related stigma in regard to concurrent anxiety and depressive symptoms among adults with HIV/AIDS. J Health Psychol. 2009;14(3):403-413.

    Not in our library10.1177/1359105309102193

  18. 18.

    Ivanova E, Hart T, Wagner A, Aljassem K, Loutfy M. Correlates of Anxiety in Women Living with HIV of Reproductive Age. AIDS Behav. 2012:1–11. doi:10.1007/s10461-011-0133-6.

    Not in our library10.1007/s10461-011-0133-6

  19. 19.

    Wagner AC, Hart TA, Mohammed S, Ivanova E, Wong J, Loutfy MR. Correlates of HIV stigma in HIV-positive women. Arch Womens Ment Health. 2010;13(3):207-214.

    Not in our library10.1007/s00737-010-0158-2

  20. 20.

    Rueda S, Gibson K, Rourke S, Bekele T, Gardner S, Cairney J, et al. Mastery Moderates the Negative Effect of Stigma on Depressive Symptoms in People Living with HIV. AIDS Behav. 2012;16(3):690-699.

    Not in our library10.1007/s10461-010-9878-6

  21. 21.

    Lee SL, Kochman A, Sikkema KJ. Internalized stigma among people living with HIV-AIDS. AIDS Behav. 2002;6(4):309-319.

    Not in our library10.1023/a:1021144511957

  22. 22.

    Peltzer K, Ramlagan S. Perceived stigma among patients receiving antiretroviral therapy: a prospective study in KwaZulu-Natal. South Africa. AIDS Care. 2011;23(1):60-68.

    Not in our library10.1080/09540121.2010.498864

  23. 23.

    Capron DW, Gonzalez A, Parent J, Zvolensky MJ, Schmidt NB. Suicidality and Anxiety Sensitivity in Adults with HIV. AIDS Patient Care STDS. 2012;26(5):298-303.

    Not in our library10.1089/apc.2011.0429

  24. 24.

    Carrico AW. Elevated suicide rate among HIV-positive persons despite benefits of antiretroviral therapy: implications for a stress and coping model of suicide. Am J Psychiatry. 2010;167(2):117-119.

    Not in our library10.1176/appi.ajp.2009.09111565

  25. 25.

    Vance D. Self-rated emotional health in adults with and without HIV. Psychol Rep. 2006;98(1):106-108.

    Not in our library10.2466/pr0.98.1.106-108

  26. 26.

    Varni SE, Miller CT, McCuin T, Solomon S. Disengagement and engagement coping with HIV/AIDS stigma and psychological well-being of people with HIV/AIDS. J Soc Clin Psychol. 2012;31(2):123-150.

    Not in our library10.1521/jscp.2012.31.2.123

  27. 27.

    Greeff M, Uys LR, Wantland D, Makoae L, Chirwa M, Dlamini P, et al. Perceived HIV stigma and life satisfaction among persons living with HIV infection in five African countries: A longitudinal study. Int J Nurs Stud. 2010;47(4):475-486.

    Not in our library10.1016/j.ijnurstu.2009.09.008

  28. 28.

    Vyavaharkar M, Moneyham L, Murdaugh C, Tavakoli A. Factors associated with quality of life among rural women with HIV disease. AIDS Behav. 2012;16(2):295-303.

    Not in our library10.1007/s10461-011-9917-y

  29. 29.

    Holzemer WL, Human S, Arudo J, Rosa ME, Hamilton MJ, Corless I, et al. Exploring HIV stigma and quality of life for persons living with HIV infection. J Assoc Nurses AIDS Care. 2009;20(3):161-168.

    Not in our library10.1016/j.jana.2009.02.002

  30. 30.

    Dlamini PS, Wantland D, Makoae LN, Chirwa M, Kohi TW, Greeff M, et al. HIV stigma and missed medications in HIV-positive people in five African countries. AIDS Patient Care STDS. 2009;23(5):377-387.

    Not in our library10.1089/apc.2008.0164

  31. 31.

    Kinsler JJ, Wong MD, Sayles JN, Davis C, Cunningham WE. The effect of perceived stigma from a health care provider on access to care among a low-income HIV-positive population. AIDS Patient Care STDS. 2007;21(8):584-592.

    Not in our library10.1089/apc.2006.0202

  32. 32.

    Golin C, Isasi F, Bontempi JB, Eng E. Secret pills: HIV-positive patients' experiences taking antiretroviral therapy in North Carolina. AIDS Educ Prev. 2002;14(4):318-329.

    Not in our library10.1521/aeap.14.5.318.23870

  33. 33.

    Rao D, Feldman BJ, Fredericksen RJ, Crane PK, Simoni JM, Kitahata MM, et al. A structural equation model of HIV-related stigma, depressive symptoms, and medication adherence. AIDS Behavior. 2012;16(3):711-716.

    Not in our library10.1007/s10461-011-9915-0

  34. 34.

    Mann JM, Tarantola D, editors. AIDS in the world II. Oxford, UK: Oxford University Press; 1996.

    Not in our library

  35. 35.

    Brickley DB. AIDS stigma and women: Impact on prevention and treatment interventions in Vietnam in the era of antiretroviral therapy. 2007.

    Not in our library

  36. 36.

    Valdiserri RO. HIV/AIDS stigma: an impediment to public health. Am J Public Health. 2002;92(3):341-342.

    Not in our library10.2105/ajph.92.3.341

  37. 37.

    Kingori C, Reece M, Obeng S, Murray M, Shacham E, Dodge B, et al. Impact of internalized stigma on HIV prevention behaviors among HIV-infected individuals seeking HIV care in Kenya. AIDS Patient Care STDS. 2012;26(12):761-768.

    Not in our library10.1089/apc.2012.0258

  38. 38.

    Vanable PA, Carey MP, Blair DC, Littlewood RA. Impact of HIV-related stigma on health behaviors and psychological adjustment among HIV-positive men and women. AIDS Behav. 2006;10(5):473-482.

    Not in our library10.1007/s10461-006-9099-1

  39. 39.

    Brown L, Macintyre K, Trujillo L. Interventions to reduce HIV/AIDS stigma: what have we learned? AIDS Educ Prev. 2003;15(1):49-69.

    Not in our library10.1521/aeap.15.1.49.23844

  40. 40.

    Crawford AM. Stigma associated with AIDS: A meta-analysis. Journal of Applied Social Psychology. 1996;26(5):398-416.

    Not in our library10.1111/j.1559-1816.1996.tb01856.x

All 137 references

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