scholarly journals Determinants and effects or consequences of internal HIV-related stigma among people living with HIV in Morocco

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Amal Ben Moussa ◽  
Rosemary M. Delabre ◽  
Virginie Villes ◽  
Mohammed Elkhammas ◽  
Aziza Bennani ◽  
...  
Keyword(s):  
Negative Binomial ◽  
Care Center ◽  
Healthcare Access ◽  
People Living With Hiv ◽  
Hiv Status ◽  
African Countries ◽  
Stigma And Discrimination ◽  
Stigma Score ◽  
Related Stigma ◽  
Living With Hiv

Abstract Background HIV-related stigma and discrimination constitute a barrier to different intervention programs. Unlike external stigma, internal stigma is not well explored in in the Middle East and North African countries, while grasping this particular form of stigma is essential to limit its effects. The present study aims to measure internal stigma effects and to identify factors associated with this kind of stigma not yet documented among people living with HIV (PLHIV) in Morocco. Methods The PLHIV Stigma Index questionnaire (adapted and translated into French and Moroccan Arabic dialect “darija”) was used to collect information regarding the stigma and discrimination experienced by PLHIV across 8 cities in Morocco (September–October 2016). A randomly drawn cluster of 10 PLHIV, consisting of 5 men and 5 women, was drawn at each participating medical care center to achieve a nationally representative sample of PLHIV. Fifteen interviewers living with HIV and five supervisors were selected and trained to administer the questionnaire. An internal stigma score (range: 0–7), was calculated based on seven negative feelings/ beliefs. Negative binomial regression was used to identify characteristics associated with the internal stigma score. Results Among 626 PLHIV, internal stigma was reported by 88.2%. The median [IQR] internal stigma score was 4 [2–5]. Regarding internal stigma, 51% avoided going to the local clinic when needed and 44% chose not to attend social gatherings. Belonging to at least one key population (aIRR [95%CI] = 1.15 [1.03; 1.28]), experiencing discriminatory reactions from family following HIV status disclosure (1.28 [1.11; 1.49]), avoiding HIV services for fear of stigmatization by staff (1.16 [1.05; 1.28]) and being denied health services because of HIV status (1.16 [1.03;1.32]), are among the factors significantly associated with an increase of the internal stigma score. Conclusions Internal stigma is high among Moroccan PLHIV and significantly impacting their life decisions and their healthcare access. Multi-level interventions are needed to address internal stigma experienced by PLHIV in Morocco.

scholarly journals Prevalence and Predictors of Food Insecurity among People Living with and without HIV in the African Cohort Study

2021 ◽  
pp. 1-37
Author(s):  
Cecilia C. Onyenakie ◽  
Raphael U. Nnakwe ◽  
Nicole Dear ◽  
Allahna Esber ◽  
Emmanuel Bahemana ◽  
...  
Keyword(s):  
Food Insecurity ◽  
Elderly Care ◽  
People Living With Hiv ◽  
Hiv Status ◽  
African Countries ◽  
Cross Sectional ◽  
Robust Poisson Regression ◽  
Living With Hiv ◽  
Hiv Policies ◽  
Prevalence Ratios

Abstract Objective: We determined the prevalence and identified predictors of food insecurity in four African countries. Design: Cross-sectional analyses at study enrollment. Setting: From January 2013 to March 2020, people living with HIV (PLWH) and without HIV were enrolled at 12 clinics in Kenya, Uganda, Tanzania, and Nigeria. Participants: Participants reporting not having enough food to eat over the past 12 months or receiving <3 meals/day were defined as food insecure. Robust Poisson regression models were used to estimate unadjusted and adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) for predictors of food insecurity among all participants and separately among PLWH. Results: 1694/3496 participants (48.5%) reported food insecurity at enrollment, with no difference by HIV status. Food insecurity was more common among older participants (50+ years vs. 18-24 years aPR 1.35, 95% CI 1.15-1.59). Having 2-5 (aPR 1.14, 95% CI 1.01-1.30) or >5 dependents (aPR 1.17, 95% CI 1.02- 1.35), and residing in Kisumu West, Kenya (aPR 1.63, 95% CI 1.42-1.87) or Nigeria (aPR 1.20, 95% CI 1.01- 1.41) was associated with food insecurity. Residing in Tanzania (aPR 0.65, 95% CI 0.53-0.80) and increasing education (secondary/above education vs. none/some primary education aPR 0.73, 95% CI 0.66-0.81) was protective against food insecurity. ART-experienced PLWH were more likely to be food secure irrespective of viral load. Conclusion: Food insecurity was highly prevalent in our cohort though not significantly associated with HIV. Policies aimed at promoting education, elderly care, ART access in PLWH, and financial independence could potentially improve food security in Africa.

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

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.

scholarly journals Stigmatization and Discrimination toward People Living with HIV/AIDS in a Coastal City of South India

2015 ◽  
Vol 16 (3) ◽  
pp. 226-232 ◽  
Author(s):  
Nithin Kumar ◽  
Bhaskaran Unnikrishnan ◽  
Rekha Thapar ◽  
Prasanna Mithra ◽  
Vaman Kulkarni ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
People Living With Hiv ◽  
Chi Square ◽  
Cross Sectional ◽  
Stigma And Discrimination ◽  
Related Stigma ◽  
Chi Square Test ◽  
And Gender ◽  
Living With Hiv ◽  
Hiv Aids

Background: The HIV/AIDS scenario all over the world is complicated by the stigmatic and discriminative attitudes toward the HIV-infected individuals. Methodology: In this facility-based, cross-sectional study, 104 HIV-positive patients were assessed regarding their personal experience with HIV-related stigma and discrimination using a Revised HIV Stigma Scale. The association between stigma and factors such as socioeconomic status and gender was tested using chi-square test, and P < .05 was considered statistically significant. Results: A large proportion (41.3%) of the participants were in the age-group of 26 to 35 years. Confidentiality of the HIV positivity status was maintained only in 14.4% of the participants. Compared to females (48.2%), more than half (51.5%) of the male participants had experienced HIV/AIDS-related personalized stigma ( P > .05). Conclusion: HIV-related stigma and discrimination are the major social determinants driving the epidemic, despite the advances in medical treatment and increases in the awareness about the disease.

scholarly journals Experiences and Impact of Stigma and Discrimination among People on Antiretroviral Therapy in Dar es Salaam: A Qualitative Perspective

2016 ◽  
Vol 2016 ◽  
pp. 1-11 ◽  
Author(s):  
Maisara Mhode ◽  
Tumaini Nyamhanga
Keyword(s):  
Antiretroviral Therapy ◽  
Negative Impact ◽  
Phenomenological Approach ◽  
People Living With Hiv ◽  
Stigma And Discrimination ◽  
Care Workers ◽  
Related Stigma ◽  
Positive Treatment ◽  
Living With Hiv ◽  
The Impact

Background. The impact of stigma on adherence to antiretroviral therapy (ART) has been less studied in Tanzania. Recent studies indicate that people on ART still experience stigma. Qualitative information on the subject matter is especially insufficient.Objective. This paper reports on the dimensions of stigma and discrimination and their impact on adherence to ART as experienced by people living with HIV (PLHIV).Design. A phenomenological approach was used to gather information on the lived experiences of stigma and discrimination. The sample size was determined according to the saturation principle.Results. Respondents experienced different forms of HIV-related stigma such as verbal, social, and perceived stigma. Various forms of discrimination were experienced, including relational discrimination, mistreatment by health care workers, blame and rejection by spouses, and workplace discrimination. HIV-related stigma and discrimination compromised ART adherence by reinforcing concealment of HIV status and undermining social suppport.Conclusion. After nearly a decade of increasing the provision of ART in Tanzania, PLHIV still experience stigma and discrimination; these experiences still appear to have a negative impact on treatment adherence. Efforts to reduce stigma and discrimination remain relevant in the ART period and should be given more impetus in order to maximize positive treatment outcomes.

The impact of living with HIV: differences in experiences of stigma for heterosexual and homosexual people living with HIV in Australia

Sexual Health ◽  
2013 ◽  
Vol 10 (4) ◽  
pp. 316 ◽  
Author(s):  
Loren Brener ◽  
Hannah Wilson ◽  
Sean Slavin ◽  
John de Wit
Keyword(s):  
Hiv Treatment ◽  
Hiv Stigma ◽  
Heterosexual Transmission ◽  
People Living With Hiv ◽  
Hiv Status ◽  
Health And Wellbeing ◽  
Gay Community ◽  
Related Stigma ◽  
Living With Hiv ◽  
The Impact

Background HIV in Australia has been closely aligned with the gay community and continues to disproportionately affect members of this community. Although heterosexual transmission remains low, recently there has been an increase in new HIV diagnoses attributable to heterosexual sex. This highlights the need to address the health and social consequences for heterosexual people living with HIV (PLHIV). This subanalysis of a larger study compared the experiences of stigma, health and wellbeing of a sample of gay and heterosexual PLHIV. Methods: Data were drawn from a study of experiences of stigma among PLHIV in Australia. All 49 participants who reported being heterosexual were included, as were 49 participants randomly selected from the 611 gay participants. The samples were compared on perceived HIV stigma, HIV treatment-related stigma, perceived negative reactions of others, HIV status disclosure, and health and wellbeing measures. Results: The findings illustrate that heterosexual PLHIV have more negative experiences in terms of both general HIV stigma and treatment-related stigma than gay PLHIV. The heterosexual PLHIV also perceived greater negative reactions in relation to their HIV status by different people in their social environment and were less likely to access treatment than the gay PLHIV. There were no differences between the two groups in any of the health and wellbeing measures. Conclusions: This study shows that in the Australian context, heterosexual PLHIV may feel more stigmatised than gay PLHIV. In view of lower HIV treatment uptake in heterosexual PLHIV, addressing HIV-related stigma could contribute to increasing access to HIV treatment.

scholarly journals Stigma and discrimination: barriers to the utilisation of a nutritional program in HIV care services in the Tigray region, Ethiopia.

2020 ◽  
Author(s):  
Fisaha Tesfay ◽  
Sara Javanparast ◽  
Lillian Mwanri ◽  
Anna Ziersch
Keyword(s):  
Family Members ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Hiv Status ◽  
Hiv Services ◽  
Tigray Region ◽  
Stigma And Discrimination ◽  
Hiv Status Disclosure ◽  
Living With Hiv ◽  
Status Disclosure

Abstract Background: In Ethiopia, stigmatising attitudes towards people living with HIV have reduced over time due to improved HIV knowledge and the expansion of services. However, HIV stigma and discrimination remain a key challenge and have negative impacts on access to and utilisation of HIV services including nutritional programs. A small number of studies have examined the experience of stigma related to nutritional programs, but this is limited. This study explored HIV status disclosure and experience of stigma related to a nutritional program in HIV care settings in Ethiopia and impacts on nutritional program utilisation. Methods: As part of a larger study, qualitative in-depth interviews were conducted with 20 adults living with HIV, 15 caregivers of children living with HIV and 13 program staff working in the nutritional program in three hospitals in the Tigray region of Ethiopia. Framework thematic analysis using NVivo was employed to analyse the data. Results: The study found varying levels of positive HIV status disclosure, depending on who the target of disclosure was. Disclosing to family members was reported to be less problematic by most participants. Despite reported benefits of the nutritional program in terms of improving weight and overall health status, adults and caregivers of children living with HIV revealed experiences of stigma and discrimination that were amplified by enrolment to the nutritional program. This was due to: a) transporting, consuming and disposing of the nutritional support itself, which is associated with HIV in the broader community; b) required increased frequency of visits to HIV services for those enrolled in the nutritional program and associated. Conclusion: There was evidence of concerns about HIV-related stigma and discrimination among individuals enrolled in this program and their family members, which in turn negatively affected the utilisation of the nutritional program. Stigma and discrimination are a source of health inequity and undermine access to the nutritional program. Nutritional programs in HIV care should include strategies to take these concerns into account by mainstreaming stigma prevention and mitigation activities. Further research should be done to identify innovative ways of facilitating social inclusion to mitigate stigma and improve utilisation.

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