HIV and AIDS-related stigma and discrimination: a conceptual framework and implications for action

SummaryPeople living with HIV and AIDS (PLWHAs) often face stigma and discrimination, especially in developing countries. HIV-related stigma is expressed through social ostracism, personal rejection, direct and indirect discrimination, and denial from families and friends. Consequently, it is associated with reduced adoption of preventive and care behaviours, including condom use, seeking for HIV test and care-seeking behaviour subsequent to diagnosis. Ignorance about the epidemiology of the disease on modes of transmission and prevention aggravates HIV-related stigma in Nigeria. Behaviour change communication activities through mass media have been shown to be an effective approach in improving people's knowledge about the disease. This paper monitors trends in the level of accepting attitudes towards PLWHAs in Nigeria between 2003 and 2007. It also evaluates the impact of exposure to mass media and social support on the levels of accepting attitudes towards PLWHAs. A significant and positive trend was evident between 2003 and 2007 (p<0.0001). Furthermore, exposure to mass media communications on HIV and AIDS issues and social support were significantly related to the reduced stigma and discrimination against PLWHAs (p<0.0001).

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A Conceptual Analysis of Metaphors Engendering HIV and AIDS-Related Stigma and Discrimination in Kisii County, Kenya

Language Circle: Journal of Language and Literature ◽

10.15294/lc.v14i2.22006 ◽

2020 ◽

Vol 14 (2) ◽

pp. 137-147

Author(s):

Geoffrey Mokua Maroko ◽

Gladys Nyamoita Mokua ◽

Augustus Onchari Nyakundi ◽

Meshack Ondora Onyambu

Keyword(s):

Hiv And Aids ◽

People Living With Hiv ◽

Language Management ◽

Group Discussions ◽

Support Providers ◽

Stigma And Discrimination ◽

Success Stories ◽

Related Stigma ◽

Living With Hiv

Metaphors are mapped across two conceptual domains where A is B. Metaphorical expressionsare defined by dimensions including novelty, conventionality, abstractness and concreteness. The AbaGusii of Western Kenya is a highly conservative community of Bantu speakers of Western part of Kenya. They view HIV and Aids as taboo that cannot be the subject of discussion in public. Hence, People Living with HIV (hereafter PLHIV) are stigmatized and discriminated. The purpose of this paper is to analyse the metaphorical words and concepts that engender HIV and Aids-related stigma and discrimination in Kisii County. Descriptive narratives were elicited from HIV support providers using focus group discussions and follow-up interviews. The narratives were analysed in terms of five attributes of stigma and discrimination within the conceptual metaphor theory. Results revealed some culturally ingrained metaphors that evoke stigma and discrimination. The paper advocates for language management efforts using success stories in HIV and Aids management to construct positive messages to counter the negative metaphors.

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Measuring HIV- and AIDS-Related Stigma and Discrimination in Nicaragua: Results From a Community-Based Study

AIDS Education and Prevention ◽

10.1521/aeap.2013.25.2.164 ◽

2013 ◽

Vol 25 (2) ◽

pp. 164-178 ◽

Cited By ~ 8

Author(s):

William J. Ugarte ◽

Ulf Högberg ◽

Eliette C. Valladares ◽

Birgitta Essén

Keyword(s):

Hiv And Aids ◽

Community Based ◽

Stigma And Discrimination ◽

Related Stigma

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HIV/AIDS-related stigma and discrimination: A conceptual framework and an agenda for action

10.31899/hiv2002.1010 ◽

2002 ◽

Keyword(s):

Conceptual Framework ◽

Stigma And Discrimination ◽

Aids Epidemic ◽

Current Thinking ◽

Poor Understanding ◽

Related Stigma ◽

The Way ◽

Three Phases ◽

Hiv Aids

In 1987, Jonathan Mann, then director of the WHO Global Programme on AIDS, identified three phases of the HIV/AIDS epidemic: the epidemic of HIV, the epidemic of AIDS, and the epidemic of stigma, discrimination, and denial. Despite international efforts to tackle HIV/AIDS since then, stigma and discrimination (S&D) remain among the most poorly understood aspects of the epidemic. This poor understanding is due in part to the complexity and diversity of S&D, but also to limitations in current thinking within the field and the inadequacy of available theoretical and methodological tools. This paper proposes a new conceptual framework to help inform thinking about the processes of S&D, about the way these processes relate to HIV/AIDS, and about potential interventions to address S&D and minimize their impact. The paper analyzes the sources of S&D, the ways in which HIV/AIDS-related S&D manifests itself, and the contexts in which HIV/AIDS-related S&D take place; highlights the limitations of current thinking and argues that S&D need to be understood as social rather than individual processes; and identifies an agenda for research and intervention.

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Stigma and discrimination - An integrative perspective. Spatial disparities and their impact on the introduction of an antiretroviral therapy scheme for HIV and AIDS treatment in Botswana

Erdkunde ◽

10.3112/erdkunde.2010.01.03 ◽

2010 ◽

Vol 64 (1) ◽

pp. 33-45 ◽

Cited By ~ 2

Author(s):

Klaus Geiselhart

Keyword(s):

Antiretroviral Therapy ◽

Hiv And Aids ◽

Spatial Disparities ◽

Stigma And Discrimination

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The role of unintended pregnancy in internalized stigma among women living with HIV in Kenya

BMC Women s Health ◽

10.1186/s12905-021-01224-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Sara Chace Dwyer ◽

Aparna Jain ◽

Wilson Liambila ◽

Charlotte E. Warren

Keyword(s):

Unintended Pregnancy ◽

Hiv Treatment ◽

Outcome Variable ◽

Internalized Stigma ◽

Health Seeking ◽

Logistic Regression Models ◽

Stigma And Discrimination ◽

Women Living With Hiv ◽

Related Stigma ◽

Living With Hiv

Abstract Background Kenya has successfully expanded HIV treatment, but HIV-related stigma and discrimination, and unintended pregnancy remain issues for many Kenyan women living with HIV. While HIV-related stigma can influence the health seeking behaviors of those living with HIV, less is known about how reproductive health outcomes influence internalized stigma among women living with HIV. Methods Baseline data only were used in this analysis and came from an implementation science study conducted in Kenya from 2015 to 2017. The analytic sample was limited to 1116 women who are living with HIV, between 18 to 44 years old, and have ever experienced a pregnancy. The outcome variable was constructed from 7 internalized stigma statements and agreement with at least 3 statements was categorized as medium/high levels of internalized stigma. Unintended pregnancy, categorized as unintended if the last pregnancy was mistimed or unwanted, was the key independent variable. Univariate and multivariate logistic regression models were used to assess the association between unintended pregnancy and internalized stigma. Associations between internalized stigma and HIV-related discrimination and violence/abuse were also explored. Results About 48% agreed with at least one internalized stigma statement and 19% agreed with at least three. Over half of women reported that their last pregnancy was unintended (59%). Within the year preceding the survey, 52% reported experiencing discrimination and 41% reported experiencing violence or abuse due to their HIV status. Women whose last pregnancy was unintended were 1.6 times (95% CI 1.2–2.3) more likely to have medium/high levels of internalized stigma compared to those whose pregnancy was wanted at the time, adjusting for respondents’ characteristics, experiences of discrimination, and experiences of violence and abuse. Women who experienced HIV-related discrimination in the past 12 months were 1.8 times (95% CI 1.3–2.6) more likely to have medium/high levels of internalized stigma compared to those who experienced no discrimination. Conclusions Results suggest that unintended pregnancy is associated with internalized stigma. Integrated HIV and FP programs in Kenya should continue to address stigma and discrimination while increasing access to comprehensive voluntary family planning services for women living with HIV.

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