scholarly journals Associations of internalized and anticipated HIV stigma with returning to work for persons living with HIV

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252783
Author(s):  
Joseph S. Lightner ◽  
Serena Rajabiun ◽  
Howard J. Cabral ◽  
Jessica Flaherty ◽  
Jamie Shank ◽  
...  
Keyword(s):  
The United States ◽  
Hiv Stigma ◽  
Internalized Stigma ◽  
Linear Regression Models ◽  
Cross Sectional ◽  
Employment Barriers ◽  
Persons Living With Hiv ◽  
Related Stigma ◽  
Anticipated Stigma ◽  
Living With Hiv

Introduction Employment is particularly beneficial for persons living with HIV (PLWH). However, PLWH experiencing internalized stigma or anticipating that they may experience stigma may be less likely to seek employment due to additional barriers associated with HIV. The purpose of this study was to understand the associations between internalized and anticipated stigma and employment barriers for PLWH. Methods Participants (N = 712) from 12 sites across the United States were recruited and interviewed about barriers to employment, HIV stigma, and several other factors related to health. A series of unadjusted and adjusted linear regression models were conducted using cross-sectional data. Results Adjusted models suggest that greater anticipated stigma was related to increased employment barriers (β = 0.12, p = 0.04). Mental and physical health functioning also positively predicted employment barriers (β = -0.18, p <0.001; β = -0.40, p <0.001, respectively). Discussion Employment among PLWH has beneficial impacts on HIV-related health outcomes. This study suggests that anticipated stigma may limit and individual’s willingness to seek out employment, or may cause them to leave employment. Internalized stigma may not play as large of a role in employment as anticipated stigma for PLWH. HIV-related stigma reduction interventions focused on community-level and employers are essential to improve employment opportunities for PLWH.

scholarly journals Burden of HIV-Related Stigma and Post-Partum Depression: A Cross-Sectional Study of Patients Attending Prevention of Mother-to-Child Transmission Clinic at Kenyatta National Hospital in Nairobi

2021 ◽  
Vol 11 ◽  
Author(s):  
Obadia Yator ◽  
Muthoni Mathai ◽  
Tele Albert ◽  
Manasi Kumar
Keyword(s):  
Postpartum Depression ◽  
Post Partum ◽  
Internalized Stigma ◽  
Child Transmission ◽  
National Hospital ◽  
Cross Sectional ◽  
Women Living With Hiv ◽  
Related Stigma ◽  
Living With Hiv ◽  
Mother To Child

Background: We look at how various HIV-related stigma subtypes, especially internalizing types, interact with postpartum depression (PPD) among women living with HIV. Additionally, we identify key psychosocial risk factors that influence stigma and PPD among women attending Prevention of Mother-to-Child Transmission (PMTCT) clinics.Methods: In this cross-sectional design, 123 women living with HIV were recruited. Participants ages between 18 and 50, who were at least 8 weeks postpartum seeking PMTCT services at Kenyatta National Hospital (KNH), between June and September 2014 participated in the study. HIV/AIDS Stigma Instrument—PLWHA (HASI–P) was used to assesses stigma and Postpartum depression was assessed by Edinburgh Postnatal Depression Scale (EPDS). Bivariate and multivariate regression models were used to determine the individual characteristics associated with the HIV-related stigma Scale. Post survey a few in-depth-interviews were conducted to explore individuals' stigma and depression experiences.Results: The mean age was 31.2 years (SD = 5.2). Fifty-nine (48%) women screened positive for significant depressive symptoms. Post-partum depression was a significant predictor of internalized stigma, enacted, and total stigma (P &lt; 0.05). Older age was associated with less internalized stigma. Living with a partner was associated with more internalized stigma. Having an income above 100 USD per month was protective against stigma. Having good family social support was protective against internalized stigma. A higher educational level was protective against enacted stigma. Being treated for STIs was a risk factor for both enacted and overall stigma.Conclusions: HIV-related stigma needs to be addressed through integrated mental health care programs in PMTCT. Postpartum depression requires comprehensive management to improve short- and long-term outcomes of women living with HIV.

scholarly journals Associations Between Experienced and Internalized HIV Stigma, Adversarial Growth, and Health Outcomes in a Nationwide Sample of People Aging with HIV in Germany

2020 ◽  
Author(s):  
Jochen Drewes ◽  
Phil C. Langer ◽  
Jennifer Ebert ◽  
Dieter Kleiber ◽  
Burkhard Gusy
Keyword(s):  
Health Outcomes ◽  
Indirect Effect ◽  
Cross Sectional Study ◽  
Hiv Stigma ◽  
People Living With Hiv ◽  
Internalized Stigma ◽  
Sectional Study ◽  
Cross Sectional ◽  
Adversarial Growth ◽  
Living With Hiv

Abstract HIV-related stigmatization and adversarial growth are known to influence health outcomes in people living with HIV. But not much is known how these psychosocial factors are related to each other and how they interact to influence health outcomes. We tested whether the effect of experienced and internalized stigma on mental health and self-rated health is mediated by adversarial growth, and whether each of these factors is uniquely associated with health outcomes. In our sample of 839 people aging with HIV in Germany based on a cross-sectional study design we did not find an indirect effect of experienced HIV stigma on health outcomes and a very small indirect effect of internalized HIV stigma. All variables were significant predictors of health outcomes in multiple regression analyses.

scholarly journals Association Between Maternal HIV Stigma Among South Indian Mothers Living with HIV and the CD4 Count of Children Living with HIV

2021 ◽  
Author(s):  
Valerie PhamDo ◽  
Adeline M. Nyamathi ◽  
Maria L. Ekstrand ◽  
Sanjeev Sinha ◽  
Kartik Yadav ◽  
...  
Keyword(s):  
Cd4 Count ◽  
Hiv Stigma ◽  
Cross Sectional ◽  
South Indian ◽  
Unit Increase ◽  
Mother And Child ◽  
Related Stigma ◽  
Maternal Hiv ◽  
Living With Hiv ◽  
Sectional Analysis

AbstractHIV stigma takes a multidimensional toll on a mother’s ability to care for herself and subsequently may impact her ability to care for her child, particularly when mother and child are seroconcordant. A cross-sectional analysis was conducted to examine the association between maternal HIV stigma and child CD4 count in rural India. We assessed 108 mother–child dyads and found that a one-unit increase in community stigma fear decreased child CD4 count by 352 cells (95% CI = − 603, − 102), highlighting the need to develop a better understanding of the consequences of HIV-related stigma on the compounded burden of care in households where mother and child both live with HIV.

scholarly journals A study on the impact of HIV related stigma on adherence to anti-retroviral treatment among people living with HIV/AIDS in central Kerala, India

2020 ◽  
Vol 7 (4) ◽  
pp. 1498
Author(s):  
Priyanka Rajmohan ◽  
Joe Thomas ◽  
Jubina Bency Anthoora Thodi ◽  
Unnikrishnan Uttumadathil Gopinathan
Keyword(s):  
Structured Interview ◽  
Cross Sectional Study ◽  
People Living With Hiv ◽  
Internalized Stigma ◽  
Double Burden ◽  
Cross Sectional ◽  
Related Stigma ◽  
Living With Hiv ◽  
The Impact ◽  
Hiv Aids

Background: In India, an estimated 20,88,638 people are living with HIV/AIDS (prevalence 0.27%). The people living with HIV/AIDS (PLHA) are facing double burden of physical and psychosocial impact of infection. This study is conducted to determine prevalence of HIV related stigma among PLHA and to find the association between stigma and adherence to Anti-Retroviral Therapy (ART) among HIV patients in central Kerala.Methods: A cross-sectional study was done from July to December 2018 among 105 adult HIV positive patients who have enrolled in Thrissur Network of People living with HIV/AIDS (TNP PLUS). After obtaining informed consent, the participants were interviewed using a structured interview schedule consisting of questions on socio-demographic details, stigma and ART adherence.Results: The prevalence of high stigma was found to be 21% and moderate stigma 61%.Out of 105 study subjects,68 (64.8%) were found to have a high adherence to ART (≥95%) and 37 (35.2%) were found to have a low adherence (<95%). Patients who had a moderate/high internalized stigma tend to have a low adherence to ART as compared to patients who had low stigma (OR=3.4 (1.2-12.8) p=0.04). On analyzing the association between the different forms of stigma and adherence to ART, isolation by family members, abandoned by friends and verbal stigma were significantly associated with low ART adherence.Conclusions: HIV related internalized stigma was pervasive among the study subjects. These patients also experience other forms of enacted stigma. The presence of internalized stigma was found to be significantly associated with low adherence to ART.

scholarly journals HIV-Related Stigma among African Immigrants Living with HIV/AIDS in USA

2010 ◽  
Vol 15 (3) ◽  
pp. 61-74 ◽  
Author(s):  
Emmanuel F. Koku
Keyword(s):  
African Immigrants ◽  
The Body ◽  
Hiv Stigma ◽  
Persons Living With Hiv ◽  
The Us ◽  
Prevention And Treatment ◽  
Related Stigma ◽  
Study Participants ◽  
Living With Hiv ◽  
Depth Interviews

Recent advances in the fight against HIV have increased the life expectancy of those infected. Despite these, a number of barriers such as stigma continue to affect HIV prevention and treatment. Although the body of work on HIV stigma is growing, there is a paucity of literature on the experiences of specific sub-groups such as African immigrants living with HIV. Drawing on in-depth interviews with a sample of these immigrants in the US, this study examines their experiences of HIV-related stigma, its impact on their lives, and the means of coping and resistance they adopted. Like other persons living with HIV, study participants experienced interpersonal, internalized and institutional stigma. However, their experiences of, and responses to stigmatization are shaped largely by cultural/religious assumptions and perceptions about HIV learnt from their countries of origin and western media's construction of HIV. The study concludes with broader implications for further conceptualization of stigma.

scholarly journals Recent US Centers for Disease Control and Prevention Activities to Reduce HIV Stigma

2019 ◽  
Vol 18 ◽  
pp. 232595821882354 ◽  
Author(s):  
Linda Beer ◽  
Donna Hubbard McCree ◽  
William L. Jeffries ◽  
Ansley Lemons ◽  
Catlainn Sionean
Keyword(s):  
Disease Control ◽  
Hiv Transmission ◽  
Population Level ◽  
The United States ◽  
Hiv Stigma ◽  
Persons Living With Hiv ◽  
Control And Prevention ◽  
Centers For Disease Control ◽  
Social Marketing Campaigns ◽  
Living With Hiv

HIV stigma affects many persons living with HIV in the United States, and reducing stigma is central to the US Centers for Disease Control and Prevention’s (CDC) mission to promote health and prevent HIV transmission. To this end, CDC funds and implements programmatic activities, research, communication campaigns, and monitoring through data collection and public health surveillance. Centers for Disease Control and Prevention-funded programs have developed promising interventions and educational materials for reducing HIV stigma. Research conducted by CDC staff and their collaborators have made important contributions to the scientific literature on stigma, which have informed current CDC programmatic efforts, including public education activities and social marketing campaigns. By monitoring HIV stigma in multiple populations, CDC can evaluate the population-level effectiveness of stigma-reduction efforts and identify key populations in need of support and intervention. This article describes these and other recent CDC efforts to address HIV stigma, and discusses new strategies with the potential to further reduce stigma.

scholarly journals Functional Limitations and Disability in Persons Living with HIV in South Africa and United States: Similarities and Differences

2019 ◽  
Vol 18 ◽  
pp. 232595821985055 ◽  
Author(s):  
David Kietrys ◽  
Hellen Myezwa ◽  
Mary Lou Galantino ◽  
James Scott Parrott ◽  
Tracy Davis ◽  
...  
Keyword(s):  
United States ◽  
South Africa ◽  
Muscle Pain ◽  
Secondary Analysis ◽  
The United States ◽  
World Health ◽  
Hiv Diagnosis ◽  
Cross Sectional ◽  
Persons Living With Hiv ◽  
Living With Hiv

Persons living with HIV (PLHIV) may experience disability. We compared disability among PLHIV in the United States and South Africa and investigated associations with health and demographic characteristics. Secondary analysis of cross-sectional data using medical records and questionnaires including the World Health Organization Disability Assessment Schedule (WHO-DAS) 2.0 12-item version (range: 0-36, with higher scores indicative of more severe disability). Between-country differences for the presence of disability were assessed with logistic regression and differences in severity using multiple regression. Eighty-six percent of US participants reported disability, compared to 51.3% in South Africa. The mean WHO-DAS score was higher in the United States (12.09 ± 6.96) compared to South Africa (8.3 ± 6.27). Participants with muscle pain, depression, or more years since HIV diagnosis were more likely to report disability. Being female or depressed was associated with more severity. Being adherent to anti-retroviral therapy (ART) and employed were associated with less severity. Because muscle pain and depression were predictive factors for disability, treatment of those problems may help mitigate disability in PLHIV.

scholarly journals Assessment of HIV-related stigma and determinants among people living with HIV/AIDS in Abeokuta, Nigeria: A cross-sectional study

2019 ◽  
Vol 7 ◽  
pp. 205031211986910
Author(s):  
Olaide Olutoyin Oke ◽  
Adeolu Oladayo Akinboro ◽  
Fatai Olatunde Olanrewaju ◽  
Olatunbosun Ayokunle Oke ◽  
Ayanfe Samuel Omololu
Keyword(s):  
Hiv Stigma ◽  
People Living With Hiv ◽  
Perceived Stigma ◽  
Cross Sectional ◽  
Stigma Score ◽  
Low Education ◽  
Related Stigma ◽  
Enacted Stigma ◽  
Living With Hiv ◽  
Hiv Aids

Introduction: HIV/AIDS-related stigma remains an essential barrier to the formulated care delivery and improved quality of life of people living with HIV/AIDS in sub-Saharan Africa. Only a few studies have evaluated stigma and its determinants as concerns people living with HIV/AIDS in Nigeria. Methods: A cross-sectional design study recruited 386 people living with HIV/AIDS attending the government clinic, Federal Medical Centre, Abeokuta, Nigeria, for the assessment of stigma using Berger’s HIV stigma scale and United States Agency International Development-recommended indicators and questions on HIV-related stigma among people living with HIV/AIDS. Data were analyzed using SPSS 21. Results: Of the 386 people living with HIV/AIDS, 322 (83.4%) were females and 64 (16.6%) were males, and 96.9% had disclosed their HIV status. Overall, mean perceived stigma score was moderately high at 95.74 (standard deviation = ±16.04). Majority (77.2%) of the participants experienced moderately perceived stigma. Among the subscales, disclosure concerns contributed the most to stigma score at 68.9%. Enacted stigma in the last 12 months was documented in 35.8% (138). There was no association observed between age, gender, marital status and HIV-related stigma. However, low education was associated with higher negative self-image perception (31.83 ± 5.81 vs 29.76 ± 5.74, p < 0.001). Furthermore, higher perceived stigma score was associated with abandonment by spouses (p < 0.001), isolation from household members (p < 0.001) and social exclusion (p < 0.001). We demonstrated a correlation between the domains of enacted stigma and Berger HIV stigma scales except for the loss of resources. Conclusion: Perceived HIV-related stigma is moderately high among people living with HIV/AIDS. Low education, disclosure concerns, spousal or household abandonment and social exclusion are the significant contributors. HIV-related stigma preventive interventions at different levels of care are advocated.

scholarly journals Telepsychiatry adoption across hospitals in the United States: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhong Li ◽  
Sayward E. Harrison ◽  
Xiaoming Li ◽  
Peiyin Hung
Keyword(s):  
Continuity Of Care ◽  
Psychiatric Care ◽  
The United States ◽  
Psychiatric Services ◽  
Linear Regression Models ◽  
Cross Sectional ◽  
Promising Alternative ◽  
American Hospital ◽  
American Hospital Association ◽  
Inpatient Psychiatric Care

Abstract Background Access to psychiatric care is critical for patients discharged from hospital psychiatric units to ensure continuity of care. When face-to-face follow-up is unavailable or undesirable, telepsychiatry becomes a promising alternative. This study aimed to investigate hospital- and county-level characteristics associated with telepsychiatry adoption. Methods Cross-sectional national data of 3475 acute care hospitals were derived from the 2017 American Hospital Association Annual Survey. Generalized linear regression models were used to identify characteristics associated with telepsychiatry adoption. Results About one-sixth (548 [15.8%]) of hospitals reported having telepsychiatry with a wide variation across states. Rural noncore hospitals were less likely to adopt telepsychiatry (8.3%) than hospitals in rural micropolitan (13.6%) and urban counties (19.4%). Hospitals with both outpatient and inpatient psychiatric care services (marginal difference [95% CI]: 16.0% [12.1% to 19.9%]) and hospitals only with outpatient psychiatric services (6.5% [3.7% to 9.4%]) were more likely to have telepsychiatry than hospitals with neither psychiatric services. Federal hospitals (48.9% [32.5 to 65.3%]), system-affiliated hospitals (3.9% [1.2% to 6.6%]), hospitals with larger bed size (Quartile IV vs. I: 6.2% [0.7% to 11.6%]), and hospitals with greater ratio of Medicaid inpatient days to total inpatient days (Quartile IV vs. I: 4.9% [0.3% to 9.4%]) were more likely to have telepsychiatry than their counterparts. Private non-profit hospitals (− 6.9% [− 11.7% to − 2.0%]) and hospitals in counties designated as whole mental health professional shortage areas (− 6.6% [− 12.7% to − 0.5%]) were less likely to have telepsychiatry. Conclusions Prior to the Covid-19 pandemic, telepsychiatry adoption in US hospitals was low with substantial variations by urban and rural status and by state in 2017. This raises concerns about access to psychiatric services and continuity of care for patients discharged from hospitals.

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

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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