Stigmatizing attitudes of the community towards people living with HIV/AIDS

This research involved an exploratory study in which a questionnaire was used to investigate the personal stigma and perceived community stigma regarding HIV/AIDS in a South African community. Student fieldworkers interviewed a convenient sample of 901 respondents from different races, gender and age groups, and found that respondents tended towards stigmatizing persons with HIV/AIDS. Yet, this degree of stigmatization was significantly less severe than the degree of stigmatization that respondents attributed to the community at large. Altogether 17% of the respondents had high stigmatizing attitudes, while 42% perceived the stigmatization by others in the community to be high. Race group, personal knowledge of someone with HIV, area of residence, gender and age group impacted on the respondents' personal tendency to stigmatize those with HIV/AIDS. The article discusses the difference between the level of personal stigma attached by the respondents and that perceived by them to be attached by the community. Attention is also paid to the possible implications of stigmatizing behaviour patterns and interventions on a community level. Copyright © 2006 John Wiley & Sons, Ltd.     

Effects of HIV/AIDS Information on Attitudes Toward AIDS: A Cross-Ethnic Comparison of College Students

College students (N = 274) from five ethnic groups were administered an AIDS information questionnaire and the Attitudes Toward AIDS Scale (ATAS; Goh, in press) to determine the effects of AIDS information on attitudes toward AIDS. A series of chi-squares and multivariate analyses of variance indicated significant differences among ethnic groups on the usage of HIV/AIDS information, the self-reported degree of knowledge about HIV/AIDS, measured knowledge about HIV/AIDS, and HIV/AIDS-related attitudes. Besides ethnicity, access to HIV/AIDS information and self-reported degree of knowledge about AIDS had significant effects on a person's measured knowledge of and attitudes toward HIV/AIDS.     

The Role of the Black Church in HIV Prevention: Exploring Barriers and Best Practices

Black people have the highest rate of HIV/AIDS infection in the USA, and they are less likely to access quality physical and mental healthcare. To address these disparities as outlined in the National HIV/AIDS Strategy, there is a need for culturally congruent, innovative approaches to HIV/AIDS prevention. The first multi‐denominational national study of Black faith leaders was conducted utilizing focus groups that were held in 11 US cities. The 265 participants were faith leaders who reported involvement in such prevention practices as sponsoring HIV/AIDS workshops, integrating HIV/AIDS messaging in the worship service, hosting HIV/AIDS screenings, distributing written materials about HIV/AIDS through the bulletin or flyers, pastoral counselling, advocating for policies that provide quality healthcare to the community and disseminating HIV/AIDS prevention messages through new media such as the Church website. These findings, including attention to barriers to engagement, provide insight into innovative practices that can be integrated into faith‐based HIV/AIDS prevention programming. Copyright © 2016 John Wiley & Sons, Ltd.     

The Multilevel Relationships of HIV‐Related Stigma to Child and Caregiver Mental Health among HIV‐Affected Households in South Africa

HIV/AIDS‐related (HAR) stigma is still a prevalent problem in Sub‐Saharan Africa, and has been found to be related to mental health of HIV‐positive individuals. However, no studies in the Sub‐Saharan African context have yet examined the relationship between HAR stigma and mental health among HIV‐negative, HIV‐affected adults and families; nor have any studies in this context yet examined stigma as an ecological construct predicting mental health outcomes through supra‐individual (setting level) and individual levels of influence. Multilevel modeling was used to examine multilevel, ecological relationships between HAR stigma and mental health among child and caregiver pairs from a systematic, community‐representative sample of 508 HIV‐affected households nested within 24 communities in KwaZulu‐Natal, South Africa. Two distinct dimensions of HAR stigma were measured: individual stigmatizing attitudes, and perceptions of community normative stigma. Findings suggest that individual‐level HAR stigma significantly predicts individual mental health (depression and anxiety) among HIV‐affected adults; and that community‐level HAR stigma significantly predicts both individual‐level mental health outcomes (anxiety) among HIV‐affected adults, and mental health outcomes (PTSD and externalizing behavior scores) among HIV‐affected children. Differentiated patterns of relationships were found using the two different stigma measures. These findings of unique relationships identified when utilizing two conceptually distinct stigma measures, at two levels of analysis (individual and community) suggest that HAR stigma in this context should be conceptualized as a multilevel, multidimensional construct. These findings have important implications both for mental health interventions and for interventions to reduce HAR stigma in this context.     

Individual attitudes and perceived social norms: Reports on HIV/AIDS‐related stigma among service providers in China

This study examined HIV/AIDS‐related stigma among Chinese service providers by comparing their personal attitudes toward people living with HIV/AIDS with their perception of social norms related to people living with HIV/AIDS. We randomly selected three provincial hospitals, four city/prefecture hospitals, 10 county hospitals, 18 township health clinics, and 54 village clinics from Yunnan, China. Doctors and nurses were randomly sampled proportionally to the doctor–nurse ratio of each hospital or clinic. Lab technicians were over‐sampled in order to include an adequate representation in the analysis. A total of 1,101 service providers participated in a voluntary, anonymous survey where demographic characteristics, individual attitude and perceived social norms toward people living with HIV/AIDS, discrimination intent at work, general prejudicial attitude and knowledge on HIV/AIDS were measured. A majority of the sample demonstrated a similarity between their personal views and what they thought most people in society believe. Multiple logistic regressions revealed that participants who were younger or reported personal contact with people living with HIV/AIDS were significantly more likely to report personal attitudes toward the population that were more liberal than their perceived social norms. Holding a more liberal personal attitude toward people living with HIV/AIDS than perceived social norms was significantly and negatively related to the level of discrimination intent at work, perceived discrimination at interpersonal level and the level of general prejudicial attitude toward people living with HIV/AIDS. Results underscored the importance of understanding social norms and personal attitudes in studying HIV‐related stigma and called for the incorporation of existing human capital into future HIV stigma reduction programs.     

HIV/AIDS and immigrant Cape Verdean women: Contextualized perspectives of Cape Verdean community advocates

This research explored Cape Verdean community advocates’ understandings of the structural and social realities that contribute to the increased HIV/AIDS risk of Northeastern U.S.-based immigrant Cape Verdean women. A community perspective informed the analysis of the multi-layered contextual barriers that these advocates identified as limiting the effectiveness of individual-level HIV/AIDS prevention and intervention models. Qualitative content analysis of interviews with nine community advocates revealed several thematic clusters including challenges to (1) perceived institutional and community realities; (2) traditional gender relations; and, (3) traditional ways of thinking. These findings challenge universalist cognitive-behavioral change models of HIV/AIDS prevention and intervention and are critically discussed to better understand the complex realities faced by Cape Verdean immigrant women. A liberatory community psychology perspective framed the research process and contributed to reconceptualizing HIV/AIDS risk as a community problem that requires interventions not simply at the individual and relational levels, but also at the structural level.     

基于未感染者与感染者双重视角的艾滋病污名

艾滋病污名由公众污名和自我污名两部分构成。前者指公众所持有的对艾滋病和艾滋病感染者的偏见、刻板印象和歧视; 后者指艾滋病感染者感知到的来自公众的偏见、刻板印象和歧视, 并由此产生的负面自我认知。测量主要从未感染者和感染者两个层面展开。艾滋病的公众污名与自我污名广泛存在于个人、家庭、医疗、媒体等诸多领域, 阻碍艾滋病的有效防治并损害社会平等。减少艾滋病污名的干预既需要消除公众的偏见、刻板印象和歧视, 改善社会环境; 也需要感染者自我的心理健康和治疗意愿, 提升生活质量。未来应该从未感染者和感染者的双重视角出发, 对其相互作用机制、测量工具、干预措施及连带污名等进行深入研究。     

A Preliminary Examination of Sexual Orientation as a Social Vulnerability for Experiencing HIV/AIDS-related Stigma

This investigation is a preliminary examination of sexual orientation as a social vulnerability for experiencing HIV/AIDS-related stigma, specifically concerns about disclosure and public attitudes. Participants were 36 heterosexual men and 82 gay men with HIV/AIDS. Consistent with prediction, a heterosexual sexual orientation was significantly associated with HIV/AIDS disclosure concerns. This effect was evident after controlling for various demographic variables, CD4 T-cell count, time since HIV diagnosis, self-esteem, and coping styles. Also, as predicted, similar levels of enacted stigma were evident regardless of sexual orientation. Further work is needed to understand the process of HIV/AIDS disclosure for heterosexual men with this illness and to differentiate the experience of HIV/AIDS-related stigma among gay and straight men with HIV/AIDS.     

Volunteer Participation in Context: Motivations and Political Efficacy Within Three AIDS Organizations

Employed quantitative and qualitative data in a contextual examination of participation in three San Francisco-area HIV/AIDS organizations: an urban, gay community-based social change setting; an urban, broadly focused information/referral setting; and a suburban individual support setting. The settings attracted different kinds of volunteers and engaged them differently with the setting, each other, and community. In quantitative analyses external political efficacy (belief in the responsiveness of sociopolitical systems to change efforts) significantly distinguished settings, but was best predicted by setting-moderated relationships to scaled motivations. Qualitative data more clearly illuminated volunteers' motivations for participation, as well as complex, embedded relationships between setting, motivations, attitudes about sociopolitical participation, and personal and community experience and identification. Together the findings underscore three unique but related stories for the three AIDS organizations, and the value of contextual approaches to participation and empowerment.     

Disengagement and Engagement Coping with HIV/AIDS Stigma and Psychological Well-Being of People with HIV/AIDS

The stigma associated with HIV/AIDS poses a psychological challenge to people living with HIV/AIDS. We hypothesized that that the consequences of stigma-related stressors on psychological well-being would depend on how people cope with the stress of HIV/AIDS stigma. Two hundred participants with HIV/AIDS completed a self-report measure of enacted stigma and felt stigma, a measure of how they coped with HIV/AIDS stigma, and measures of depression and anxiety, and self-esteem. In general, increases in felt stigma (concerns with public attitudes, negative self-image, and disclosure concerns) coupled with how participants reported coping with stigma (by disengaging from or engaging with the stigma stressor) predicted self-reported depression, anxiety, and self-esteem. Increases in felt stigma were associated with increases in anxiety and depression among participants who reported relatively high levels of disengagement coping compared to participants who reported relatively low levels of disengagement coping. Increases in felt stigma were associated with decreased self-esteem, but this association was attenuated among participants who reported relatively high levels of engagement control coping. The data also suggested a trend that increases in enacted stigma predicted increases in anxiety, but not depression, among participants who reported using more disengagement coping. Mental health professionals working with people who are HIV positive should consider how their clients cope with HIV/AIDS stigma and consider tailoring current therapies to address the relationship between stigma, coping, and psychological well-being.     

Tobacco, Drug, and HIV Preventive Media Interventions

Media-based health promotion interventions can reach large segments of the population and lower barriers to participation in programs. By collaborating with media specialists, we can develop interventions that might be broader, more publicized, and ultimately more likely to change behaviors and attitudes within the community. The present paper describes a series of media interventions involving smoking cessation, drug abuse prevention, stress reduction, weight control, and HIV/AIDS prevention. The process by which I became involved in these interventions is discussed, and the implications of developing these types of large-scale behavioral interventions are discussed.     

An Investigation of the Determinants of Stigmatization and Prejudice Toward People Living With HIV/AIDS

The components and determinants of HIV/AIDS stigma and prejudice were investigated in an online‐questionnaire study. The results show that the components of the attitude toward people with HIV/AIDS consist of social distance, demands for political measures, negative stereotypes, and attribution of responsibility to people living with HIV/AIDS. Besides antigay attitudes and false beliefs about ways of infection, the HIV/AIDS attitude is connected to and depends on social dominance orientation (SDO) and right‐wing authoritarianism (RWA). Structural equation modeling indicated that antigay attitudes and false beliefs function as mediator variables for SDO and RWA. Implications of the results are discussed.     

Empowering Latino Church Leaders to Deal with the HIV-AIDS Crisis: A Strengths-Oriented Service Model

Ideology and attitudes of Latino church leaders in the United States toward HIV/AIDS are explored. A qualitative approach utilized with emergent categories including: a desire within the Latino church for greater acceptance of HIV/AIDS sufferers, the supposed contaminating influence of HIV/AIDS individuals over other church members, and the feelings of helplessness many church members experience in relation to the HIV/AIDS crisis. Understanding ideological resistance that prevents engagement is here identified and a strategy of empowerment of church leaders is recommended to overcome it including: adopting a strengths-oriented service model that focuses on resources religious denominations already have, as opposed to a financially driven, medically oriented service model that highlights what churches often do not have; church leaders educating health care agencies on how to use religious beliefs to motivate church members to work on behalf of HIV/AIDS patients; the power of doctrinal ideology in affecting church and civil society’s response to HIV/AIDS.     

Responsibility judgments and responses to people living with AIDS in China: testing an attributional perspective

With one in five individuals in the world living in China, there is an urgent need for HIV prevention and understanding HIV/AIDS stigma in China. This study applies an attributional analysis to Chinese students' responses to AIDS, examining effects of attributions of causal controllability for HIV infection on reactions to people living with HIV/AIDS. Students (n = 309) read one of two scenarios describing an AIDS patient and manipulating controllability of AIDS onset. Controllability of AIDS onset contributed to responsibility judgments, less positive affect, and lower desires to personally interact with the patient. Responsibility judgments predicted interaction wishes directly and indirectly through positive affect. Results provide support for Weiner's interpersonal attributional model. Implications for responses to AIDS in China are discussed.     

艾滋病羞辱和歧视的概念及研究工具发展状况

艾滋病相关羞辱和歧视量表的研制是对其进行评价和采取有效干预措施的先决条件。阐述了艾滋病相关羞辱和歧视的定义和分类,重点介绍和分析了目前应用较广泛的艾滋病羞辱和歧视量表,并指出这些量表主要由发达国家研制,缺少适合中国文化背景的量表;对艾滋病高危人群所经历的双重羞辱和歧视,全世界还没有相应的测量工具。研制和修订适合中国文化背景的艾滋病羞辱和歧视量表是该研究领域亟待解决的难题     

Reducing AIDS-related stigma in developing countries: the importance of theory- and evidence-based interventions

In many developing countries persons living with HIV and AIDS experience strong stigma and discrimination, and AIDS-related stigma has an enormous negative impact on their social relationships, access to resources, and psychological well being. Moreover, AIDS-related stigma hampers HIV-related health promotion, including voluntary HIV counselling and testing. In this article, we will argue that programs to reduce AIDS-related stigma are most likely to be effective if these programs are based upon thorough needs assessments, theory- and evidence-based intervention strategies and collaborative planning. A protocol for health promotion programs design is outlined. Furthermore, psychosocial correlates of AIDS-related stigma in developing countries, social-psychological theories that might be useful in designing intervention strategies to reduce stigmatisation and successful elements of previous interventions aimed at stigma reduction are discussed. It is concluded that psychological theory does provide guidelines for the development of stigma-reducing intervention programs, but that such programs can only be effective when based upon context-specific needs assessment and collaborative planning.     

Stigma and Psychological Distress in People With HIV/AIDS

Using a community sample of 197 people living with HIV/AIDS, we examined how awareness of societal stigma (felt stigma) and negative feelings toward oneself as a member of a stigmatized group (self-stigma) are related to psychological well-being. Both felt stigma and self-stigma were significantly correlated with symptoms of depression and anxiety, but controlling for felt stigma reduced self-stigma's association with depressive symptoms to nonsignificance. Global self-esteem and social avoidance fully mediated the associations between self-stigma and distress but only partially mediated the associations between felt stigma and distress. Felt stigma mediated the relationship between distress and HIV-related changes in physical appearance.     

Measuring HIV stigma: existing knowledge and gaps

The growing recognition of the reduction of HIV stigma as central to effective programs across the HIV/AIDS prevention to care and treatment continuum is leading to an increasing number of programs focused on stigma reduction. Correctly evaluating the impact of these programs depends on having a good set of measures that effectively capture and distinguish the complexities of HIV stigma. This paper reviews the existing literature on HIV stigma measurement and identifies key gaps that remain. There is a need for measures at the general population level that are unambiguous about the cause of the stigmatizing behavior, that capture enacted stigma (discrimination), and that can distinguish compound (layered) stigma. In addition, studies are needed in a wider variety of contexts and on a larger scale that include a comprehensive set of measures to capture the complexity of HIV-related stigma and ensure appropriate evaluation of stigma-reduction programs.     

Community-Based Collaboration in Support of Older Persons

This study describes the processes for community-based collaboration in support of the older person living in the world of HIV/AIDS in South Africa. Secondary data from study from 333 older persons (> 60 years) and 28 leaders of community agencies of and for health and wellbeing were thematically analyzed. Findings suggest that older persons are resources in community partnership for ameliorating the impact of HIV and AIDS. This would be the case even as the older people may be living with HIV or AIDS.