Social Scientists Study the Stigma of HIV

People living with HIV may experience felt stigma, also known as self stigmatization, resulting from fear of discrimination. Such feelings may include embarrassment, shame, or isolation. The degree of stigma experienced by an individual may be influenced by cultural attitudes toward HIV infection. Felt stigma is a serious problem that can hinder HIV education and prevention efforts. In some cases an HIV infected individual may avoid medical care out of fear that others will find out. The AIDS initiative movement (AIM) Kenya, is a support group for people living with HIV. Based at the school of medicine, Moi University, AIM Kenya was launched in 2002 by the Academic Model for Prevention and Treatment of HIV/AIDS (AMPATH). An investigation by social scientists from the Department of Mental Health and Behavioural Sciences, Moi University School of Medicine, USA, the Sociology Department at Indiana University Bloomington, and Indiana University Purdue University at Indianapolis, used interviews with AIM members to examine differences in personal perceptions between Kenyans with HIV who live in an urban setting and those who live in a rural setting, and whether or not those perceptions change over time. The complete study is published in the journal African Health Sciences.

All study participants were members of AIM support groups based at two HIV clinics, one in Eldoret, an urban administrative centre in the Uasin Gishu district of Kenya, and the other, the Mosoriot Rural Training and Health Centre in the Nandi District of Kenya. The majority of respondents at both sites were female, and rural respondents were generally older. Participants were interviewed twice during a one-year period. To assess the degree of felt stigma, participants were asked for their responses on a scale of one to five regarding seven different statements. These included: 1) I hang with the wrong crowd, 2) I should be ashamed, 3) it is my own fault, 4) I have been irresponsible, 5) I lack self control, 6) I should be avoided, and, 7) I have poor morals.

Results indicated that differences in both gender and location influenced the degree of felt stigma. Felt stigma decreased from the first interview to the second in urban participants. Responses from rural participants, however, did not change significantly over time. The authors concluded that social structure and context had an influence on the degree of felt stigma. In the rural location, the Nandi are known to be resistant to change and conservative regarding sexuality. The urban location, Eldoret, includes people from many cultures and a variety of social circles. A large number of people living with HIV can be found in urban regions like Eldoret, so that having HIV may be more accepted there than in a rural setting. Gender may also play a role. Female participants showed significant disagreement with statements 1, 3, 4, and 5. In Kenya it is not unusual for men to have multiple sex partners. Therefore, society may hold men, rather than women, responsible for the spread of HIV. Overall, people interviewed at the Mosoriot location were much more likely to experience felt stigma than those in the urban location, and those feelings did not decrease significantly with time.

The AIM support groups in both locations have grown since this 2002 study. The authors suggest future research to include a larger number of people living with HIV, in order to further examine the influences of gender and location on felt stigma. The authors also suggest a study to examine the influence of membership in a group like AIM on the degree of felt stigma. Felt stigma among people living with HIV is an important issue. Self stigmatization can intensify feelings of stress associated with HIV infection, and affect mental and physical health, and overall quality of life. As groups like AIM expand their efforts to provide holistic care for people living with HIV, a comprehensive understanding of the factors that influence perceptions and attitudes toward HIV infection will be critical.

Source

Yebei, V., Fortenbery, J., Ayuku, D. Felt stigma among people living with HIV/AIDS in rural and urban Kenya
African Health Sciences