scholarly journals A preliminary analysis of the association between perceived stigma and HIV-related pain in South Africans living with HIV

Author(s):  
Antonia L. Wadley ◽  
Tamar Pincus ◽  
Michael Evangeli

Background: Stigma related to the human immunodeficiency virus (HIV) remains common and has been associated with severity of HIV-related symptoms. Associations between HIV stigma and HIV-related pain, one of the most common symptoms in HIV, have however not been investigated. Data from low back pain populations suggest that stigma is associated with worse pain intensity and so we hypothesised that the same would be the case in HIV.Aim: The goal of this study was to assess the association between HIV stigma and pain intensity in people living with HIV (PLWH) with chronic pain whilst controlling for depression, a well-established correlate of pain.Setting: The study took place at an HIV clinic in Johannesburg, South Africa.Methods: Mediation analysis was used to assess the effect of depression on the relationship between stigma and pain intensity in a cross-sectional cohort of 50 PLWH and chronic pain (pain most days of the week for > 3 months). All participants were assessed using the HIV/AIDS Stigma Instrument – PLWA, an 11-point numerical pain rating scale and the Beck Depression Inventory II.Results: In all, 88% (44/50) of participants reported experiencing some form of HIV stigma (HIV stigma scale score ≥ 1). Worst pain intensity and depressive symptoms individually correlated with total stigma score (Spearman’s r = 0.33, p = 0.02 for both). The mediation analysis highlighted that mediation of the relationship by depression was equivocal (b = -0.002, bootstrapped confidence interval -0.02 to 0.00).Conclusion: Whilst these preliminary data are marginal, they do suggest that associations between HIV stigma and HIV-related pain warrant further investigation. Future study should also include potential mechanisms, which may include mediation through depression.

2017 ◽  
Author(s):  
Antonia L Wadley ◽  
Tamar Pincus ◽  
Michael Evangeli

AbstractObjectiveHIV stigma remains common and has been associated with severity of HIV-related symptoms. Associations between HIV stigma and HIV-related pain, one of the most common symptoms in HIV, have not been investigated however. Data from low back pain populations suggest that stigma associates with worse pain intensity and so we hypothesised that the same would be the case in HIV. In a small pilot study we assessed the association between HIV stigma and pain intensity in PLWH with chronic pain while controlling for depression, a well-established correlate of pain.MethodsMediation analysis was used to assess the effect of depression on the relationship between stigma and pain intensity in a cross-sectional cohort of 50 PLWH and chronic pain (pain most days of the week for > 3 months) recruited in Johannesburg, South Africa. All participants were assessed using: HIV/AIDS stigma instrument – PLWA (HASI-P), 11-point numerical pain rating scale, and the Beck Depression Inventory II.Results88% (44/50) of participants reported experiencing some form of HIV stigma (HIV stigma scale score ≥ 1). Worst pain intensity and depressive symptoms individually correlated with total stigma score (Spearman’s r = 0.33, p = 0.02 for both). The mediation analysis highlighted that mediation of the relationship by depression was equivocal (b = −0.002, bootstrapped CI −0.02 to 0.00).ConclusionsWhilst these preliminary data are marginal, they do suggest that associations between HIV stigma and HIV-related pain warrant further investigation. Future study should also include potential mechanisms, which may include mediation through depression.


Author(s):  
Dharma N. Bhatta ◽  
Jennifer Hecht ◽  
Shelley N. Facente

Background: Stigma and discrimination are major challenges faced by people living with HIV (PLWH), and stigma continues to be prevalent among PLWH. We conducted a cross-sectional study of 584 men who have sex with men (MSM) living with HIV between July 2018 and December 2020, designed to better understand which demographic and behavioral characteristics of MSM living with HIV in San Francisco, California are associated with experience of stigma, so that programs and initiatives can be tailored appropriately to minimize HIV stigma’s impacts. Methods: This analysis was conducted with data from San Francisco AIDS Foundation (SFAF) encompassing services from multiple different locations in San Francisco. Data about the level of HIV-related stigma experienced were collected through a single question incorporated into programmatic data collection forms at SFAF as part of the client record stored in SFAF’s electronic health record. We performed linear regression to determine the associations between self-reported experiences of HIV stigma and other characteristics among MSM living with HIV. Results: HIV stigma was low overall among MSM living with HIV who are actively engaged in HIV care in San Francisco; however, it was significantly higher for the age groups of 13–29 years (adjusted risk difference (ARD): 0.251, 95% CI: 0.012, 0.489) and 30–49 years (ARD: 0.205, 95% CI: 0.042, 0.367) when compared to the age group of 50 years and older, as well as people who were homeless (ARD: 0.844, 95% CI: 0.120, 1.568), unstably housed (ARD: 0.326, 95% CI: 0.109, 0.543) and/or having mental health concerns (ARD: 0.309, 95% CI: 0.075, 0.544), controlling for race, injection history, and viral load. Conclusions: These findings highlight an opportunity to develop culturally, socially, and racially appropriate interventions to reduce HIV stigma among MSM living with HIV, particularly for younger men and those struggling with housing stability and/or mental health.


Author(s):  
Hema Malini

Community-level stigma and discrimination towards people living with HIV is found all over the world, with people forced to leave their home, change their daily activities such as shopping, socializing or schooling, face rejection and verbal and physical abuse. The objective of the study was to assess the HIV/AIDS stigma among the general public. Quantitative approach  and descriptive research design was adopted for the  present study. The study was conducted in Vallancherry a selected rural village of Kattankulathur . The sample size for the present study was 300. Three point rating scale  was used to assess the HIV/STIGMA and discrimination.The present study findings revealed that among 300 samples none of them reported severe stigma ,50 (16.7%)  participants reported moderate stigma and 250 (83.3%)  participants reported  low stigma. Stigma blocks access to HIV testing and treatment services, making onwards transmission more likely. The removal of barriers to these services is key to end the global HIV epidemic.Key Words : HIV, AIDS, Stigma, Discrimination, Rejection


Author(s):  
James Prah ◽  
Anna Hayfron-Benjamin ◽  
Mohammed Abdulai ◽  
Obed Lasim ◽  
Yvonne Nartey ◽  
...  

Background: Stigma against people living with HIV (PLHIV) among health workers remains a barrier to the provision of needed care to HIV patients worldwide. We sought to investigate predictors of HIV stigma among health workers in Cape Coast, Ghana. Methods: This was a cross sectional study conducted in three hospitals from November 2016 to February 2017. The study made use of a pre-existing self-administered questionnaire. Multiple regression analysis and Pearson’s coefficient tests were performed to determine the relationship between the dependent variable, stigmatized attitudes of health workers and some independent variables, and to determine which of the independent variables predict stigma amongst health care workers. Results: A total of 331 health workers of different categories participated. Respondents’ personal opinions on HIV, fears/worries of getting infected and category of staff {F(3,327)= 23.934 p<0.00 }, R2 = 0.180) significantly predicted their stigmatizing behaviour. Compared to other health workers, nurses had higher scores for stigmatizing behaviour. Conclusions: the study found evidence of discriminatory and stigmatizing behaviour towards PLHIV by health workers. Stigma reduction programmes aimed at health workers should be strengthened at all health facilities that provide care to PLHIV.


2020 ◽  
Author(s):  
Jochen Drewes ◽  
Phil C. Langer ◽  
Jennifer Ebert ◽  
Dieter Kleiber ◽  
Burkhard Gusy

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.


Author(s):  
Néstor Njejimana ◽  
Lucía Gómez-Tatay ◽  
José Miguel Hernández-Andreu

HIV/AIDS stigma is a global issue and a serious problem in African countries. Although prevalence remains high in this region, no detailed study has yet been carried out to determine and characterize this problem in Burundi. Using a qualitative analysis based on an extensive series of 114 interviews, we describe the main characteristics of HIV stigma in the country. The results of our study indicate that the problem of HIV/AIDS stigma is widespread in Burundian society, as all participants in the research reported having experienced some kind of HIV stigma. The seven dimensions of stigma identified in people living with HIV/AIDS (PLWHA) in Burundi are physical violence, verbal violence, marginalization, discrimination, self-stigma, fear and insecurity, and healthcare provider stigma. These dimensions of stigma can be experienced through different manifestations, which have been characterized in this study, revealing that the problem of stigma in PLWHA is still an important issue in Burundi.


Author(s):  
Azreen Abdullah ◽  
Adibah Hanim Ismail ◽  
Ching Siew Mooi

Introduction:HIV stigma refers to negative beliefs, feelings and attitudes towards people living with HIV (PLWH), groups associated with PLWH and other key populations at higher risk of HIV infection, such as people who inject drugs, sex workers, men who have sex with men and transgender people. Despite the advancement made in the knowledge and treatment of HIV, PLWH continues to be stigmatized.Objective: To determine the level of HIV stigma and its predictors among people living with HIV/AIDS in a tertiary hospital in Malaysia.Methods: A cross sectional study was conducted among HIV/AIDS patients aged 18 and above at infectious disease clinic in Hospital Sungai Buloh, Gombak, Malaysia. HIV stigma was assessed using Berger’s HIV stigma scale, which is available in Bahasa Malaysia and English.A self-administered questionnaire was used to determine their demographic and clinical characteristics. Multiple linear regression analysis was used to identify the predictors.Results: 526 subjects participated in this study. The mean age of the study population was 33.5± 8.4 years. The majority of the participants were male (90.9%) and contracted HIV through sexual activities (87.8%). The mean score of HIV stigma was 104.7 ± 19.5. Based on multiple linear regression analysis, patients who were unemployed (B = -8.00, 95% confidence interval (CI) = -12.12,-3.88, p = < 0.001) and being on antiretroviral treatment (B = 4.95, 95% (CI) = 0.30, 9.60, p = < 0.037) had higher level of HIV stigma.Conclusions: The level of HIV stigma was high (mean score =104.7 ± 19.5). HIV/AIDS patients who are unemployed and on antiretroviral agents were at risks of having higher level of HIV stigma. Future study is needed urgently to implement intervention that can minimize the stigmatization among patients with HIV/AIDS.International Journal of Human and Health Sciences Vol. 04 No. 01 January’20 Page : 26-35


2021 ◽  
Vol 9 (T6) ◽  
pp. 153-158
Author(s):  
Siti Ulfah Rifa'atul Fitri ◽  
Kusman Ibrahim ◽  
Siti Sandra Liani ◽  
Laili Rahayuwati ◽  
Yusshy Kurnia Herliani

Background: Diagnosis and treatment of HIV infection may impact the individual's life, including the physical aspect such as the length of HIV diagnosed, WHO stage, the ART, and the psychological aspect such as the level of stress. People living with HIV/AIDS (PLWHA) have an increased need for energy but they have symptoms of lack of nutrition intake. Therefore, PLWHA has a risk of low nutrition status. The aims of this study were to examine the relationship between nutritional status and health characteristics among HIV/AIDS patients. Methods: A cross-sectional analytical design was conducted among people living with HIV/AIDS (PLWHA) in outpatients’ hospital. A purposive sampling method was used and the sample size was 78 respondents. Data were collected using questionnaire of were the socio-demographic, health characteristic, and nutritional status. The cross-tabulation calculations used chi-square were presented to identify the relationship between nutritional status and health characteristics. Results: The majority of respondents had good health characteristics include the length of HIV diagnosis more than 6 months (79.5%), clinical WHO stage I (61.5%), no stress level (94.9%), and the first choice of ART (83.3%). The nutritional status reported that the majority of the respondents had normal BMI (61.5%), MUAC not at risk (>23,5 cm) (71.8%), and a moderate level of energy intake (37.2%). There were no significant associations between the nutritional status and health characteristics (p > 0.05). Conclusion: The good condition of health characteristics among PLWHA in this study impacted the level the nutritional status.


2021 ◽  
Vol 4 (1) ◽  
pp. 23
Author(s):  
Novianti Lailiah ◽  
Nursalam Nursalam ◽  
Ninuk Dian Kurniawati

Introduction: Adherence in ARV therapy is an important mechanism in preventing drug resistance. The level of adherence is influenced by several factors, one of which is the information skills factor. This study aims to analyze the relationship between information skills and ARV adherence in People Living With HIV/AIDS (PLWHA).Method: This was a cross-sectional approach with a sample size of 100 respondents who were selected through simple random sampling technique. The inclusion criteria for respondents were PLWHA who were undergoing ARV therapy, cooperative, aged 20-60 years. The instrument used was information skills questionnaire and Medical Adherence Rating Scale (MARS). The data were analyzed using descriptive analysis and logistic regression test with p value ≤ 0.05.Results: Information skills were  associated with ARV adherence (p = 0.01). Information skills consisting of knowledge about HIV/AIDS and ARV therapy can increase ARV adherence in PLWHA with indicators taking drugs regularly and have medical control on schedule.Conclusions: The information skills factor has an effect on ARV adherence. Increasing information skills can be done through educational activities or peer-group support aimed at gaining insight into disease and treatment, especially for newly diagnosed PLWHA.


Author(s):  
Brett Van Coppenhagen ◽  
Helene S. Duvenage

Background: Compared to the general population, there is an increased prevalence of depression in people living with HIV and AIDS (PLWHA). The combination of these two common illnesses has profound consequences on the patient and on the healthcare system.Objective: This study determined the prevalence of depressive symptomatology in PLWHA attending the Kalafong Hospital ARV Clinic. The study also established if the patients received definitive treatment for unipolar depression.Methods: A cross-sectional, descriptive study was carried out on 622 adult patients, aged 18 years or older. A brief rating scale for depression, the Centre for Epidemiological Study Depression Scale (CES-D) was administered to participants. The CES-D is a 20-item self-rating scale that assesses current levels of depression as per DSM-IV criteria. The traditional score of 16 and above was used to define a case of depression.Results: The prevalence of depression according to CES-D scale was 53.8%. The study found that none of the 622 patients ever received definitive treatment for depression. A lower CD4 count is associated with more depressive symptomatology, most significantly in patients with a CD4 count of 50 or less.Conclusions: Depressive symptomatology was highly prevalent in the study patients. Despite the high prevalence, none of the study sample patients were treated for clinical depression. The findings reflect the importance of evaluating for depression in PLWHA, especially in high-risk groups such as patients presenting for their initiation visit or patients with a CD4 count of 50 or less. Depression remains under-recognised and under-treated in PLWHA.


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