An exploratory survey measuring stigma and discrimination experienced by people living with HIV/AIDS in South Africa: the People Living with HIV Stigma Index

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Abstract

Background

The continued presence of stigma and its persistence even in areas where HIV prevalence is high makes it an extraordinarily important, yet difficult, issue to eradicate. The study aimed to assess current and emerging HIV/AIDS stigma and discrimination trends in South Africa as experienced by people living with HIV/AIDS (PLHIV).

Methods

The PLHIV Stigma Index, a questionnaire that measures and detects changing trends in relation to stigma and discrimination experienced by PLHIV, was used as the survey tool. The study was conducted in 10 clinics in four provinces supported by the Foundation for Professional Development (FPD), with an interview total of 486 PLHIV. A cross-sectional design was implemented in the study, and both descriptive and inferential analysis was conducted on the data.

Results

Findings suggest that PLHIV in this population experience significant levels of stigma and discrimination that negatively impact on their health, working and family life, as well as their access to health services. Internalised stigma was prominent, with many participants blaming themselves for their status.

Conclusion

The findings can be used to develop and inform programmes and interventions to reduce stigma experienced by PLHIV. The current measures for dealing with stigma should be expanded to incorporate the issues related to health, education and discrimination experienced in the workplace, that were highlighted by the study.

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Most cited references 14

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HIV and AIDS-related stigma and discrimination: a conceptual framework and implications for action.

Richard Parker, Peter Aggleton (2003)

Internationally, there has been a recent resurgence of interest in HIV and AIDS-related stigma and discrimination, triggered at least in part by growing recognition that negative social responses to the epidemic remain pervasive even in seriously affected communities. Yet, rarely are existing notions of stigma and discrimination interrogated for their conceptual adequacy and their usefulness in leading to the design of effective programmes and interventions. Taking as its starting point, the classic formulation of stigma as a 'significantly discrediting' attribute, but moving beyond this to conceptualize stigma and stigmatization as intimately linked to the reproduction of social difference, this paper offers a new framework by which to understand HIV and AIDS-related stigma and its effects. It so doing, it highlights the manner in which stigma feeds upon, strengthens and reproduces existing inequalities of class, race, gender and sexuality. It highlights the limitations of individualistic modes of stigma alleviation and calls instead for new programmatic approaches in which the resistance of stigmatized individuals and communities is utilized as a resource for social change.

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Interventions to reduce HIV/AIDS stigma: what have we learned?

Lisanne Brown, Kate Macintyre, Lea Trujillo (2003)

This article reviews 22 studies that test a variety of interventions to decrease AIDS stigma in developed and developing countries. This article assesses published studies that met stringent evaluation criteria in order to draw lessons for future development of interventions to combat stigma. The target group, setting, type of intervention, measures, and scale of these studies varied tremendously. The majority (14) of the studies aimed to increase tolerance of persons living with HIV/AIDS (PLHA) among the general population. The remaining studies tested interventions to increase willingness to treat PLHA among health care providers or improve coping strategies for dealing with AIDS stigma among PLHA or at-risk groups. Results suggest some stigma reduction interventions appear to work, at least on a small scale and in the short term, but many gaps remain especially in relation to scale and duration of impact and in terms of gendered impact of stigma reduction interventions.

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Stigma, HIV and AIDS: an exploration and elaboration of a stigma trajectory.

N Reynolds, Diego A. Alonzo (1995)

Stigma is a social construction which dramatically affects the life experiences of the individuals infected with the human immunodeficiency virus (HIV) and their partners, family and friends. While it has been generally recognized that the nature of stigma varies across illnesses, it has usually not been considered as changing and emerging over the course of a single illness. In this paper, HIV/AIDS is analyzed in terms of a stigma trajectory. The primary purpose is to conceptualize how individuals with HIV/AIDS experience stigma and to demonstrate how these experiences are affected by changes in the biophysical dimensions of HIV/AIDS. Four phases of the HIV/AIDS stigma trajectory are depicted: (1) at risk: pre-stigma and the worried well; (2) diagnosis: confronting an altered identity; (3) latent: living between illness and health; and (4) manifest: passage to social and physical death. The essential processes through which individuals personalize the illness, dilemmas encountered in interpersonal relations, strategies that are used to avoid or minimize HIV-related stigma, and subcultural networks and ideologies that are drawn upon to construct, avow, and adapt to an HIV identity are considered across the stigma trajectory.

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Author and article information

Journal

Journal ID (nlm-ta): BMC Public Health

Journal ID (iso-abbrev): BMC Public Health

Title: BMC Public Health

Publisher: BioMed Central

ISSN (Electronic): 1471-2458

Publication date Collection: 2014

Publication date (Electronic): 27 January 2014

Volume: 14

Page: 80

Affiliations

[1 ]Psychology Department, University of South Africa, PO Box 392, 0004 Pretoria, South Africa

[2 ]International HIV/AIDS Alliance, Hove, UK

[3 ]Foundation for Professional Development (FPD), Pretoria, South Africa

[4 ]Independent Consultant, The Research Network, Sandwich, UK

Article

Publisher ID: 1471-2458-14-80

DOI: 10.1186/1471-2458-14-80

PMC ID: 3909177

PubMed ID: 24461042

SO-VID: 98193453-018a-4c70-a067-6ef37ffd3f8b

License:

This is an open access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

An exploratory survey measuring stigma and discrimination experienced by people living with HIV/AIDS in South Africa: the People Living with HIV Stigma Index

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Abstract

Background

Methods

Results

Conclusion

Related collections

Annual Reviews HIV/AIDS: Public Health and Society

Most cited references 14

HIV and AIDS-related stigma and discrimination: a conceptual framework and implications for action.

Interventions to reduce HIV/AIDS stigma: what have we learned?

Stigma, HIV and AIDS: an exploration and elaboration of a stigma trajectory.

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