Experiences of Social Stigma and Implications for Healthcare Among a Diverse Population of HIV Positive Adults

Published in: Journal of Urban Health, v. 84, No. 6, Nov. 2007, p. 814-828

Posted on RAND.org on January 01, 2007

by Jennifer N. Sayles, Gery W. Ryan, Junell S. Silver, Catherine A. Sarkisian, William Cunningham

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Stigma profoundly affects the lives of people with HIV/AIDS. Fear of being identified as having HIV or AIDS may discourage a person from getting tested, from accessing medical services and medications, and from disclosing their HIV status to family and friends. In the present study, the authors use focus groups to identify the most salient domains of stigma and the coping strategies that may be common to a group of diverse, low-income women and men living with HIV in Los Angeles, CA (n=48). The authors also explore the impact of stigma on health and healthcare among HIV positive persons in our sample. Results indicate that the most salient domains of stigma include: blame and stereotypes of HIV, fear of contagion, disclosure of a stigmatized role, and renegotiating social contracts. The authors use the analysis to develop a framework where stigma is viewed as a social process composed of the struggle for both internal change (self-acceptance) and reintegration into the community. They discuss implications of HIV-related stigma for the mental and physical health of HIV-positive women and men and suggestions for possible interventions to address stigma in the healthcare setting.

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