How stigmatizing is Stigma in the life of people living with HIV: A study on HIV positive individuals from Chennai, South India

Abstract

The nature and intensity of AIDS stigma are shaped by the social construction of the epidemic in different locales. Stigma therefore needs to be discussed in its cultural context. This clinic-based study aims at understanding stigma among 203 HIV positive individuals from Chennai, South India. The study throws light on the impact of stigma on the quality of life among these individuals. It also discusses the gender implications of stigma. This study brings out the findings that actual stigma experienced among those infected with HIV is much less (26%) as compared to the fear of being stigmatized or perceived stigma (97%). Internalizing of stigma was found to have a highly significant negative correlation with quality of life in the psychological domain and a significant negative correlation in the environmental domain. However individuals who did experience actual stigma seemed more determined to live and experience an above moderate quality of life. The implication of this study encourages HIV infected individuals to rise above stigma, avoid internalizing their stigmatized feelings and work toward a better quality of life. Health providers need to address these issues in their care for HIV infected individuals.

A systematic review of HIV/AIDS-related stigma and discrimination in India: Current understanding and future needs

“…Managing information of one's own HIV status or of a close family member is thus important as a strategy to escape from enacted stigma and its social costs (Pallikadavath et al, 2005;Steward et al, 2008). High disclosure-related concerns are supported by quantitative studies of stigma (Subramanian, Gupte, Dorairaj, Periannan & Mathai, 2009;Thomas, Rehman, Suryanarayanan, Josephine, Dilip, Dorairaj et al, 2005) with at least one study reporting significantly higher disclosure concerns among positive women (91%) than men (82%) (Subramanian et al, 2009). …”

“…By comparison, perceived or felt stigma is reported much higher. For example, more than 94% of men and women reported perceived stigma in two separate studies by Thomas et al (2005) and Subramanian et al (2009). Quality of life of those experiencing enacted stigma was found to be good in overall terms.…”

“…Between 5 and 30 per cent of HIV positive Indian respondents in Paxton's study of PLHA in Asia reported discrimination (enacted stigma): 30% experienced discrimination by health workers, 20% were refused treatment by a health worker because of HIV status, and 15% were forced to pay additional charges for medical services on account of HIV status. Similarly, in Chennai, Thomas et al (2005) reported enacted stigma among 30% of women and 20% of men, while Subramanian et al (2009) reported it among 33% of PLHA with significantly more HIVpositive women reporting perceived stigma (41%) than positive men (28%). In a Bangalore sample, 71% of positive people did not report any instance of discrimination (Steward et al, 2008).…”

“…Health care settings are reported to be the most significant contexts for stigma and discrimination in India (Bharat et al, 2001;Thomas et al, 2005;Mahendra et al, 2007;Pisal, Sutar, Sastry, Kapadia-Kundu, Joshi, Leslie et al, 2007;Elamon, 2005;Paxton et al, 2005). Across staff levels attitudes towards positive patients are unfavourable and the basis for their discriminatory acts.…”

“…All three forms of stigma are reported in the Indian context. Descriptive studies (Bharat et al 2001;Pallikadavath et al, 2005;Thomas et al, 2005) report personal experiences of men and women who are isolated in their homes, forced to use separate utensils, not allowed to cook, or refused treatment by health staff. See Box 3.…”