HIV-Related Internalized Stigma and Patient Health Engagement Model in an Italian Cohort of People Living With HIV

The care engagement of people living with HIV (PLWH) measured with the patient health engagement (PHE) model and its association with HIV-related internalized stigma are not well established. Indeed, currently there are no data yet about the engagement of PLWH measured with the PHE model. This study aimed to evaluate the effects of HIV-related internalized stigma on care engagement and mental health and to fill the lack of data on PHE model applied to PLWH. We found that the internalized stigma score was significantly higher for PLWH ( n=82) in worse care engagement phase and both higher internalized stigma scores and worse engagement were associated to major depression symptoms. In conclusion, our findings describe for the first time the engagement in care of PLWH measured with PHE and highlight the importance of PLWH support to find strategies to cope stigma-related stress and optimize their care engagement.

Estigma internalizado en personas con trastorno mental, residentes de hogar protegido con rehabilitación de base comunitaria (primer semestre de 2019)

El estigma hace referencia a las actitudes y creencias que conducen a las personas a rechazar, evitar y temer a aquellos a quienes perciben como diferentes; por su parte, el estigma internalizado hace referencia a aquel que es orientado hacia sí mismo En este sentido, el objetivo de la presente investigación es determinar el nivel de estigma internalizado en personas con trastorno mental (tm), residentes de un hogar protegido con rehabilitación de base comunitaria, durante el primer semestre de 2019. Para la metodología, se realizó un estudio observacional y descriptivo, de enfoque cuantitativo; además, se utilizaron dos instrumentos: una encuesta de caracterización sociodemográfica de la persona con alteración mental y la aplicación de la escala de autoestigma de la enfermedad Internalized Stigma of Mental Illness Scale (ismi) (Tanabe et ál., 2016). Los resultados obtenidos arrojan que las cuatro mediciones permiten verificar que hay un 62,5 % de percepción de estigma y discriminación. A su vez, puntúa la resistencia al estigma en un 70 %, pues se muestra que puede existir una adaptación social en el dispositivo de rehabilitación de base comunitaria que es capaz de contrarrestar el estigma social y evitar que sea internalizarlo en los integrantes de la comunidad. Se concluye que es evidente que existe una alta percepción de alienación, estigma y discriminación, no solo en el ámbito social, que es en el que más se ve este rechazo así como en el mismo aislamiento del paciente, sino a nivel familiar y laboral. Gracias a las practicas comunitarias, la comunidad ha construido mecanismos basados en procesos de pensamiento crítico y entendimiento, que permiten afrontar el estigma social y no lo internalizan.

The Role of Minority Stress and Social Resources in the Healthcare Utilization of Aging LGBT Adults

Research suggests that minority stress can influence the healthcare utilization of aging LGBT adults, and that social resources can buffer the effect of stress on healthcare utilization. Using data from Aging with Pride: National Health, Aging, and Sexuality/Gender Study (N = 2,560), multiple logistic regression assessed the associations between minority stress (i.e., internalized stigma and LGBT identity disclosure) and healthcare utilization (i.e., health screenings, emergency room use, routine checkups, and regular provider). We also examined the moderating effect of social resources, including social network size, social support, and LGBT community belonging, in these associations. Internalized stigma was negatively associated with having a routine checkup in the previous year (OR = 0.82, p = .038). Disclosure was positively associated with having a health screening within the past 3 years (OR = 1.52, p = .000) and having a regular provider (OR = 1.33, p = .021). Further, we found that social support moderated the association between disclosure and health screenings (OR = 1.52, p < .001); thus, having higher levels of social support and disclosure in tandem increased the likelihood of getting a health screening in the last three years. Health and human service professionals should provide information about internalized stigma and LGBT identity disclosure to educate their clients about the ways in which these minority stressors can impact their healthcare experiences. Providers should assess the social support of their aging LGBT clients and inform them about the added benefit that social support can have in their healthcare experiences.

Internalization of stigma among parents of children with autism spectrum disorder in Nigeria: a mixed method study

Background Autism Spectrum disorder (ASD) has uniquely stigmatizing aspects because children with ASD have no physical markers of their condition. Parents are usually blamed and judgment from others is often internalized (felt stigma). Aim This study was conducted to determine knowledge about ASD, negative experiences (enacted stigma), internalization of stigma (felt or self stigma) and its correlates among parents of children with ASD in Lagos, Nigeria. Methods This was a cross-sectional study of 230 parents in Lagos, Nigeria employing mixed-method data collection methods. Quantitative data were collected using a structured interviewer-administered questionnaire and analyzed with Epi- Info™ version 7.0 statistical package. Data were summarized with proportions, mean and standard deviation. Chi square and Spearman’s correlation tests were done, and the level of significance was pre-determined at 5% (p < 0.05). In-depth interviews were also conducted among six parents to further explore the topic. The interviews were analyzed narratively. Results The proportion of mothers and fathers were 175 (76.1%) and 55 (23.9%) respectively. The mean age of respondents was 42 ± 8.5 years. Overall knowledge of ASD was very poor as only 3(1.3%) had good knowledge. Overall, 122(53%) usually had negative experience of parenting a child with ASD (enacted stigma), mothers (17.1%) more than fathers (9.1%). Majority 192(83.5%) internalized stigma. There was a low–moderate correlation between ‘enacted’ stigma and ‘internalized’ stigma (ρ- 0.400, p < 0.001). From in-depth interviews, many parents revealed that their child’s condition had negative effects on the family. Many also recounted negative experience of stigma. Conclusion Overall, parents of children with ASD had poor knowledge of the condition. Majority internalized stigma and this increases with negative treatment from others. Parents should be properly educated about ASD. Community-based education to increase awareness about ASD in addition to encouraging people to show empathy and reduce stigmatizing behaviour towards parents of children with ASD are recommended.