Association between stigma, depression and quality of life of people living with HIV/AIDS (PLHA) in South India – a community based cross sectional study

Charles, Bimal; Jeyaseelan, Lakshmanan; Pandian, Arvind Kumar; Sam, Asirvatham Edwin; Mani, Thenmozhi; Jayaseelan, Visalakshi

doi:10.1186/1471-2458-12-463

Cited by 176 publications

(206 citation statements)

References 43 publications

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“…Such an approach seeks to understand the PLH psychological experience, and identifies the need to educate both the uninfected (wider society and heath care professionals) to be more tolerant, and the infected to understand their illness, access medical care and develop coping strategies [1,4,9,13,18]. Parker and Aggleton's criticism of this approach is that it ignores Goffman's insight that stigma is a public cultural belief, a social construction of degraded identity where power is wielded to exclude individuals on the basis of undesirable difference [16].…”

Section: Recognising An Hiv Stigma Continummentioning

confidence: 99%

“…With access to effective antiretroviral drug treatment, HIV infection can now be experienced as a survivable chronic illness, allowing long-term health management to focus on maintaining quality of life and infection containment [1,2]. Given the effectiveness and availability of treatment, it might be assumed that the stigma experienced by the 2.1 million Indian people living with HIV (PLH) would be reducing as they receive: testing and treatment; education about disease management, virus transmission and life strategies; and social support no longer constrained by fear of a deadly infection [1,3].…”

Section: Introductionmentioning

confidence: 99%

“…The major factor limiting regular use of ARDT by women living with HIV (WLH) is stigma [1,3]. In order to probe for reasons as to the differences in the experience of being HIV-positive for Indian women and men, a number of studies utilised sex disaggregated quantitative data [1,14,15]. The potential risk of this approach is that some groups of women or men with particular social risk factors may not be identified if analysis of the data assumes a binary male: female biological sex paradigm and conflates it with social constructions of gender (different groups of, and social conventions about, diverse women and men).…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Given the effectiveness and availability of treatment, it might be assumed that the stigma experienced by the 2.1 million Indian people living with HIV (PLH) would be reducing as they receive: testing and treatment; education about disease management, virus transmission and life strategies; and social support no longer constrained by fear of a deadly infection [1,3]. And yet, stigma has not only survived the advent of antiretroviral drug treatment in India, but remains pervasive, affecting life patterns and disrupting biomedical interventions [1,3]. While stigma is experienced by all PLH, cultural beliefs and unequal power relations make Indian women particularly vulnerable [4].…”

Section: Introductionmentioning

confidence: 99%

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Women Living with HIV in India: Looking up from a Place of Stigma, Identifying Nexus Sites for Change

Short¹,

Vissandjée²

2017

Divers Equal Health Care

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Current knowledge• For people living with HIV infection in India, stigma is a pervasive reality and the greatest barrier to accessing treatment, quality of life and survival.• However, women and men experience stigma differently. Despite typically contracting the disease through marital sexual relations, married monogamous women are also subject to stigma resulting from moral blame.• Stigma affects women both in public spheres of social relationships and in private through psychological stresses. These spheres are typically considered in isolation not as interrelating. Novel information• In order to go beyond consideration of discrete public and private arenas of stigma, this paper applies Engel's biopsychosocial model on chronic disease experience as promoting an understanding of the effects of illness on women across their biomedical, social and psychological life arenas. Use of Engel's approach resists binary separation of private and public experiences of HIV related stigma and encourages care responses to address a whole-of-life continuum.• By gaining information from particular groups of HIV-positive women about the whole-of-life situations where they experience stigma related constraint, inter-relationships between stigma sites can be mapped and specific root causes of marginalisation identified.• In the complex context of establishing programs of care for women living with HIV, arranging qualitative information on lived experiences in such a way as to identify interacting barriers to care, can assist in tailoring multifaceted HIV-care programs that address the particular needs of specific groups of women. Such customised programs would embody dual objectives: 1) to respond to the women's own identified and prioritised needs across biomedical, social and psychological arenas in a coordinated manner, and 2) to work to reduce stigma as a barrier to care. ABSTRACTFor women living with HIV infection in India, stigma is a pervasive reality and the greatest barrier to accessing treatment, quality of life and survival. Defining stigma according to Goffman as a socially conceived abnormality, this paper then draws on Engel's biopsychosocial model for chronic disease to show the pervasive nature of stigma as a continuum affecting all dimensions of life for married, monogamous Indian women with positive HIV sero-status. Two distinct perspectives were identified in the literature: 1) Public: social and relational stigma, or 2) Private: internalised psychological stigma. Only four of the twenty published works reviewed noted interrelationships between these public and private spheres. Only one of those employed an ethnographic methodology to understand stigma from the perspective of the women themselves.While concepts associated with stigma among women living with HIV are diversely employed in research, by considering them as a whole through an intersectional biopsychosocial lens, this paper attempts to provide a basis for implementing integrated and tailored responses. Once the manifestations and interconnected caus...

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Section: Recognising An Hiv Stigma Continummentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Women Living with HIV in India: Looking up from a Place of Stigma, Identifying Nexus Sites for Change

Short¹,

Vissandjée²

2017

Divers Equal Health Care

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Toxic Stress and Quality of Life in Early School‐Aged Ugandan Children With and Without Perinatal Human Immunodeficiency Virus Infection

Ezeamama

Zalwango

Tuke

et al. 2020

New Directions for Child and Adolescent Development

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Caregiver's and child's self‐reported quality of life (QOL) was defined using standardized questionnaires in a sample (N = 277) of 6–10 years old HIV‐infected, HIV‐exposed uninfected, and HIV‐unexposed uninfected children from Uganda. Psychosocial stress (acute stress and cumulative lifetime adversity) and physiologic stress (dysregulations across 13 biomarkers), perinatal HIV status, and their interaction were related to child QOL via general linear models. Lower child‐ and caregiver‐reported psychosocial stress were dose‐dependently associated with higher QOL (acute stress: mean difference coefficient b = 8.1–14.8, effect size [ES] = 0.46–0.83). Lower allostasis was dose‐dependently associated with higher QOL (b = 6.1–9.7, ES = 0.34–0.54). Given low caregiver acute stress, QOL for HIV‐infected was similar to HIV‐uninfected children; however, given high caregiver acute stress, a QOL disadvantage (b = −7.8, 95% CI: −12.8, −2.8; ES = −0.73) was evident for HIV‐infected versus uninfected children. Testing of caregiver stress reduction interventions is warranted to increase wellbeing in dependent children.

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Other Socially Constructed Vulnerabilities: Focus on People Living with HIV/AIDS and Internal Migrants

Chitra

2017

Health Inequities in India

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Association between stigma, depression and quality of life of people living with HIV/AIDS (PLHA) in South India – a community based cross sectional study

Cited by 176 publications

References 43 publications

Women Living with HIV in India: Looking up from a Place of Stigma, Identifying Nexus Sites for Change

Women Living with HIV in India: Looking up from a Place of Stigma, Identifying Nexus Sites for Change

Toxic Stress and Quality of Life in Early School‐Aged Ugandan Children With and Without Perinatal Human Immunodeficiency Virus Infection

Other Socially Constructed Vulnerabilities: Focus on People Living with HIV/AIDS and Internal Migrants

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