HIV-related stigma and psychological distress: The harmful effects of specific stigma manifestations in various social settings

Department of Work and Social Psychology, Maastricht University, 6200 MD Maastricht, The Netherlands.
AIDS (London, England) (Impact Factor: 5.55). 10/2009; 23(17):2353-7. DOI: 10.1097/QAD.0b013e3283320dce
Source: PubMed


Recent research has shown that experiences of stigmatization have an adverse impact on the psychological well being of people living with HIV/AIDS (PLWHA). Most studies investigating this relationship employ an aggregate measure of stigma. Although this approach provides useful information about the psychological implications of HIV-related stigma in general, it neglects to acknowledge the possibility that some manifestations in specific settings may be psychologically more detrimental than others. The present study examines which specific stigma experiences are most strongly related to psychological distress across a number of social settings.
A cross-sectional survey was administered to 667 PLWHA in the Netherlands. We examined participants' experiences of 11 manifestations of HIV-related stigma in six social settings. Linear regression analyses were conducted to determine which setting-specific manifestations best predict psychological distress after controlling for marital status, education and health status.
Three manifestations in family settings, namely receiving advice to conceal one's status, being avoided and being treated with exaggerated kindness, and one manifestation in healthcare settings, namely awkward social interaction, best predicted psychological distress in PLWHA.
Manifestations of HIV-related stigma vary according to setting. Certain manifestations in specific social settings impact the psychological well being of PLWHA more than others. In this study, certain experiences of stigmatization with PLWHA's families and in healthcare settings were more strongly related to psychological distress than experiences occurring in other social settings. These findings suggest that stigma reduction interventions focusing on these influential settings may benefit the psychological well being of PLWHA.

1 Follower
25 Reads
  • Source
    • "We chose HIV patients as a control group because first, as is the case in schizophrenia, persons with HIV often experience significant marginalization linked with stigma, discrimination, social isolation and alienation (Elliott et al., 2009; Stutterheim, 2009). Risk for HIV is also associated with a history of childhood trauma and HIV is itself a traumatic experience for many (Aaron et al., 2013; Plattner and Meiring, 2006). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Research has suggested that many with schizophrenia experience decrements in synthetic metacognition, or the abilities to form integrated representations of oneself and others and then utilize that knowledge to respond to problems. Although such deficits have been linked with functional impairments even after controlling for symptoms and neurocognition, it is unclear to what extent these deficits can distinguish persons with schizophrenia from others experiencing significant life adversity but without psychosis. To explore this issue we conducted logistic regression analysis to determine whether assessment of metacognition could distinguish between 166 participants with schizophrenia and 51 adults with HIV after controlling for social cognition and education. Metacognition was assessed with the Metacognitive Assessment Scale Abbreviated (MAS-A), and social cognition with the Bell Lysaker Emotion Recognition Test. We observed that the MAS-A total score was able to correctly classify 93.4% of the schizophrenia group, with higher levels of metacognition resulting in increased likelihood of accurate categorization. Additional exploratory analyses showed specific domains of metacognition measured by the MAS-A were equally able to predict membership in the schizophrenia group. Results support the assertion that deficits in the abilities to synthesize thoughts about oneself and others into larger representations are a unique feature of schizophrenia.
    Journal of Psychiatric Research 04/2014; 55(1). DOI:10.1016/j.jpsychires.2014.04.011 · 3.96 Impact Factor
  • Source
    • "Most interviewees reported on the lack of support provided by family and friends after discovering their own HIV infection. Potential psychological damage resulting from a nonsupportive family environment, manifested especially in the form of avoidance, is also highlighted by previous findings (Stutterheim 2009). However, avoidance by family could be explained partly by the fact that they had already grown very much apart from their families because of previous family conflicts, often related to their homosexuality and partly by the stigma associated with being HIV-infected or even knowing someone who is infected: It is harder for them to have an acquaintance with HIV than for me acquiescing that I am infected with HIV … I knew a gay guy from the countryside who was… in a tantrum saying that he does not want to be even close to me because the virus might jump from my skin to his (Edomer 38). "
    [Show abstract] [Hide abstract]
    ABSTRACT: This qualitative study highlights the social dynamics affecting people living with HIV (PLH) in Hungary and in the Central-Eastern European region. The study focused on the special needs and concerns of men living with HIV/AIDS as well as changes in their social relationships and institutional support provision, coping strategies and patterns of social functioning, especially in the context of social stigmatization. Consistent with international qualitative research findings in the field of HIV/AIDS prevention, the present study contributes to a fuller understanding of relationship between sexual behavior, HIV/AIDS related risks and risk perceptions as well as homosexuality-and HIV/AIDS stigma-related social exclusion in a previously under-researched socio-cultural setting. The findings of our study point to several barriers to effective HIV prevention, which should be overcome to improve the present situation by lessening the adverse effects of HIV/AIDS-and homosexuality-related stigma within the gay community, the general population and especially among service providers. One of the main barriers is the lack of public health programs specifically targeting MSM in Hungary, where the predominant mode of HIV transmission remains sex between men.
    Sexuality Research and Social Policy Journal of NSRC 03/2013; 10(1):24-34. DOI:10.1007/s13178-012-0102-5
  • Source
    • "Numerous studies have shown that stigma has detrimental consequences for the psychological well-being of stigmatized individuals (Meyer, 2003; Stutterheim et al., 2009). Self-stigma can result from an awareness of public stigma, as people with stigmatized conditions are keenly aware of the social devaluation connected with their condition. "
    [Show abstract] [Hide abstract]
    ABSTRACT: It has been 50 years since the publication of Goffman’s influential work Stigma: Notes on the Management of Spoiled Identity. This special issue celebrates Goffman’s contribution with 14 articles reflecting the current state of the art in stigma research. In this article, we provide a theoretical overview of the stigma concept and offer a useful taxonomy of four types of stigma (public stigma, self-stigma, stigma by association, and structural stigma). We utilize this taxonomy to organize an overview of the articles included in this special issue. Finally, we outline new developments and challenges in stigma research for the coming decades.
    Basic and Applied Social Psychology 02/2013; 35(1):1-9. DOI:10.1080/01973533.2012.746147 · 1.09 Impact Factor
Show more