HIV-related stigma: implications for symptoms of anxiety and depression among Malawian women

Kamen, Charles; Arganbright, Jill M.; Kienitz, Eliza; Weller, Melissa; Khaylis, Anna; Shenkman, Tammy; Smith, Sarah; Koopman, Cheryl; Gore‐Felton, Cheryl

doi:10.2989/16085906.2015.1016987

Cited by 49 publications

(43 citation statements)

References 27 publications

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“…[2425262728293031] Our study, however, interestingly found that stigmatization or discrimination toward HIV/AIDs carriers was low. HCPs’ attitudes were characterized by empathy and compassion.…”

Section: Discussionmentioning

confidence: 61%

Knowledge and attitudes toward HIV, hepatitis B virus, and hepatitis C virus infection among health-care workers in Malawi

Mtengezo

Lee

Ngoma

et al. 2016

Asia-Pacific Journal of Oncology Nursing

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Objective:The highest prevalence of HIV infection occurs in Sub-Saharan Africa and hepatitis B virus (HBV), and hepatitis C virus (HCV) prevalence are the second highest in Sub-Saharan Africa including Malawi. Health-care workers (HCWs) play an important role in the prevention of, response to, and management of these infectious diseases. There is, however, no published research about the level of knowledge and attitudes toward HIV, HBV, and HCV infection among Malawian HCWs. The purpose of this study was to explore and determine the knowledge of and attitudes toward HIV, HBV, and HCV among a targeted population of Malawian HCWs.Methods:A cross-sectional community-based participatory research with 194 HCWs was completed employing health survey method. The project was a collaborative effort between nursing faculties in the USA and Malawian. A one-way analysis of variance (ANOVA) with the Bonferroni adjustment for multiple comparisons was used to assess the differences in knowledge and attitude among three subgroups of HCWs.Results:Of 194 of Malawian HCWs surveyed, 41% were support staff, 37% were nursing students, and 22% were health-care professionals. Both health-care professionals and support staff had high knowledge scores related to HIV/AIDS, and their attitudes were mainly positive. However, a series of one-way ANOVAs revealed significant differences in knowledge and attitude toward HIV/AIDs, HBV, and HCV among HCWs (P < 0.01). The majority had less knowledge about HBV and HCV and more negative attitudes toward hepatitis.Conclusions:This study highlights the ongoing need for reducing negative attitudes toward HIV, HBV, and HCV; and providing health education among HCWs, especially focusing on HBV and HCV prevention. The findings of the research project can be used to develop interventions addressing low HBV- and HCV-related knowledge and attitudes.

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Section: Discussionmentioning

confidence: 61%

Knowledge and attitudes toward HIV, hepatitis B virus, and hepatitis C virus infection among health-care workers in Malawi

Mtengezo

Lee

Ngoma

et al. 2016

Asia-Pacific Journal of Oncology Nursing

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“…HIV-related stigma continues to be a problem in the US (Ojikutu, Nnaji, Sithole-Berk, Bogart, & Gona, 2014; Shacham, Rosenburg, Onen, Donovan, & Overton, 2015) and has been shown to be associated with anxiety and depression (Kamen et al, 2015; Shacham et al, 2015). People living with HIV also exhibit levels of HIV-related stigma (Mannheimer et al, 2014), which may be related to affect, behavior and well-being among people living with HIV (Earnshaw, Smith, Chaudoir, Amico, & Copenhaver, 2013).…”

Section: Introductionmentioning

confidence: 99%

Psychological reactance and HIV-related stigma among women living with HIV

et al. 2016

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Psychological reactance is defined as the drive to reestablish autonomy after it has been threatened or constrained. People living with HIV may have high levels of psychological reactance due to the restrictions that they may perceive as a result of living with HIV. People living with HIV may also exhibit levels of HIV-related stigma. The relationship between psychological reactance and HIV-related stigma is complex yet understudied. Therefore, the main aim of this study was to examine the association between psychological reactance and HIV-related stigma among women living with HIV. Data were obtained from one time-point (a cross-sectional assessment) of a longitudinal HIV disclosure study. Psychological reactance was measured using the 18-item Questionnaire for the Measurement of Psychological Reactance (QMPR). HIV-related stigma was measured using the HIV Stigma Scale, which has four domains: personalized, disclosure concerns, negative self-image, and concerns with public attitudes. Principal component analysis was used to derive components of psychological reactance. Linear regression models were used to determine the association between overall psychological reactance and its components, and stigma and its four domains, and depressive and anxiety symptoms. The associations between stigma and mental health were also examined. Three components of psychological reactance were derived: Opposition, Irritability, and Independence. Overall psychological reactance and irritability were associated with all forms of stigma. Opposition was linked to overall and negative self-image stigma. Overall psychological reactance, opposition and irritability were positively associated with anxiety symptoms while opposition was also associated with CES-D depressive symptoms. There were also positive associations between all forms of stigma, and depressive and anxiety symptoms. Health care providers and counselors for women living with HIV addressing feelings of irritability and opposition towards others may reduce HIV-related stigma. Future research should examine the link between psychological reactance, mental health and HIV-related stigma among other populations living with HIV.

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“…Third, women’s stigma related to HIV and PND cut across all of their identities mentioned above (31,32). Most prior work focuses on HIV-related stigma specifically and finds that women reporting greater stigma related to HIV in Malawi are significantly more likely to report depression (32). This indicates that in addition to women having an unexpected HIV diagnosis, HIV may contribute to PND through stigma.…”

Section: Discussionmentioning

confidence: 99%

“…Moving forward, literature suggesting that HIV and depression care should be combined in treatment and that providers should attend to the emotional and psychological needs of women need to be transferred to the perinatal population and expand beyond ART counseling (28,32). Additionally, examples exist that address PND at the community level using pre-existing primary care structures and training lay health workers in counseling (36–38).…”

Section: Discussionmentioning

confidence: 99%

“Pain in my heart”: Understanding perinatal depression among women living with HIV in Malawi

LeMasters

Dussault

Barrington

et al. 2020

Preprint

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20 21 Background: Perinatal depression (PND) can interfere with HIV care engagement and outcomes. 22 We examined experiences of PND among women living with HIV (WLWH) in Malawi. 23 24 Methods: We screened 73 WLWH presenting for perinatal care in Lilongwe, Malawi using the 25 Edinburgh Postnatal Depression Scale (EPDS). We conducted interviews with 24 women 26 experiencing PND and analyzed data using inductive and deductive coding and narrative 27 analysis. 28 29 Results: Women experienced a double burden of physical and mental illness, expressed as pain 30 in one's heart. Receiving an HIV diagnosis unexpectedly during antenatal care was a key 31 contributor to developing PND. This development was influenced by stigmatization and social 32 support. 33 34 Conclusions: These findings highlight the need to recognize the mental health implications of 35 routine screening for HIV and to routinely screen and treat PND among WLWH. Culturally 36 appropriate mental health interventions are needed in settings with a high HIV burden. 37 38 Introduction 39The scale-up of antiretroviral therapy to all pregnant and breastfeeding women living 40 with HIV, known as Option B+, has the potential to dramatically improve maternal health and 41 end mother-to-child HIV transmission (MTCT) (1). In Malawi, all pregnant women diagnosed 42 with HIV in antenatal care (ANC) begin lifelong antiretroviral therapy (ART) under Option B+ 43 (2). However, women who initiate ART during pregnancy under Option B+ are one-fifth as 44 likely to return to HIV care after their initial visit compared to non-pregnant women initiating 45 ART in Malawi (3). Maternal mental health is likely an important factor in undermining the 46 delivery of Option B+ by affecting initiation of and retention in HIV care, with implications for 47 ongoing risk of MTCT and negative effects on women's quality of life and psychological well-48 being (4). 49Globally, adults living with HIV are at an increased risk of depression, with the 50 association being stronger among patients who are newly diagnosed and women (5). A 51 systematic review conducted in high-, middle-, and low-income countries found that pregnant 52 and postpartum women living with HIV are at particularly high risk for perinatal depression 53 (PND) due to multiple bio-psychosocial risk factors (4). These risk factors include increased 54 stress, HIV-related stigma, a lack of social support, concerns about disclosing their HIV status, 55 and concerns about their infant's health and HIV status (4). 56Through Option B+, more women are becoming aware of their HIV status and initiating 57 ART during the perinatal period. Simultaneously, many are experiencing PND. PND is known to 58 affect 13.1% of women in low and middle-income countries, with as many as 19.2% of women 59 having a depressive episode within the first three months postpartum (6,7). Among women living 60 with HIV in Sub-Saharan Africa, a meta-analysis found a pooled prevalence for PND of 42.5% 61 for prenatal women and 30.7% for postpartum women, indic...

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HIV-related stigma: implications for symptoms of anxiety and depression among Malawian women

Cited by 49 publications

References 27 publications

Knowledge and attitudes toward HIV, hepatitis B virus, and hepatitis C virus infection among health-care workers in Malawi

Knowledge and attitudes toward HIV, hepatitis B virus, and hepatitis C virus infection among health-care workers in Malawi

Psychological reactance and HIV-related stigma among women living with HIV

“Pain in my heart”: Understanding perinatal depression among women living with HIV in Malawi

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