Impact of Asha Intervention on Stigma Among Rural Indian Women With AIDS

Nyamathi, Adeline; Ekstrand, Maria; Salem, Benissa E.; Sinha, Sanjeev; Ganguly, Kalyan K.; Leake, Barbara

doi:10.1177/0193945913482050

Cited by 31 publications

(51 citation statements)

References 27 publications

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“…Las intervenciones en estigma sentido han estado orientadas a ofrecer a los participantes información respecto a la salud, el liderazgo, estrategias de afrontamiento y derechos (Nyamathi et al, 2013); además de educación respecto al estigma, entrenamiento en relajación, entrenamiento en afrontamiento, juego de roles, resolución de problemas (Rao et al, 2012).…”

Section: Discussionunclassified

Vivir con VIH: experiencias de estigma sentido en personas con VIH

Guevara-Sotelo

Hernández

2017

Psicogente

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ResumenObjetivo: Reconocer los significados colectivos y subjetivos que un grupo de personas con VIH tiene respecto a vivir con la enfermedad.Método: Cualitativo explicativo con diseño narrativo. Los datos fueron recolectados a través de tres grupos de discusión conformados por 16 personas con VIH, hombres y mujeres entre los 22 y los 49 años de edad, que viven en la ciudad de Cali.Resultados: Los significados de los participantes giran en torno al vivir el VIH, en relación con el estigma sentido, el estigma real, el estigma percibido y el autoestigma. La experiencia del estigma se relaciona directamente con la percepción que los participantes tienen de sí mismos y la construcción de su autoimagen y autoconcepto se transforma dependiendo de la forma en que se asume la enfermedad; finalmente, las estrategias de afrontamiento que se utilizan se basan en el cuidado de la imagen, en evitar el malestar emocional y sentirse apoyados por alguna persona cercana a ellos.Conclusiones: Los hallazgos de la presente investigación permiten evidenciar que el VIH es producto de diversas situaciones en cadena, en donde las representaciones sociales construidas alrededor de la enfermedad constituyen un factor central en el afrontamiento y en la forma de vivirlo colectivamente, realizar una intervención desde temáticas como la memoria colectiva, la identidad colectiva y la reconstrucción de la identidad podría permitir resignificar y potencializar la imagen que las personas con VIH tienen de sí mismas y del grupo social al que pertenecen. Palabras Claves:Estigma sentido, VIH, Autoimagen, Identidad colectiva Abstract Objective: This paper aims to recognize what a group of people with HIV have regarding living with this disease and based on collective and subjective meanings. Method:The data collected corresponds to three discussion groups of 16 people with HIV, men and women from Cali, between 22 and 49 years sampled, through a Qualitative explanatory and following a narrative design Results: As a result, everything related to collective meanings of the participants revolve around living with this disease (HIV), as follows: Felt stigma, real stigma, perceived stigma and self-stigma; in addition, the experience of stigma is directly related to the participants perception of themselves and the construction of their self-image and self-concept, transformed depending on how do these individuals assume the disease; finally, coping strategies used are based on caring for the image, avoiding emotional distress and feeling supported by someone close to them. Conclusion:This research findings make possible to show that HIV is the result of various situations associated, where social representations built around the disease are a central factor in coping with and how to live with it collectively. Themes such as collective memory, collective identity and the reconstruction of identity could make possible to reframe and enhance the image that people with HIV have of themselves and the social group to which they belong to as well.

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Section: Discussionunclassified

Vivir con VIH: experiencias de estigma sentido en personas con VIH

Guevara-Sotelo

Hernández

2017

Psicogente

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“…However secrecy often results in non-attendance for ARDT, attempts to disguise symptoms, social isolation and women travelling large distances on unreliable public transport to access care in remote centres with hopes of anonymity [18,29]. Regular absences for treatment also take women away from the work of caring for the family and incur travel costs, both of which may further limit resources available to purchase medication and nutrition [26].…”

Section: Women In India Living An Hiv: the Pieces Of A Stigma Riddledmentioning

confidence: 99%

“…The resources WLH can access to deal with daily stigma directly affect their mental health [29]. Diagnosed with a disease that is anecdotally understood to be immoral and fatal, fearing stigma, and lacking both the education and support to make informed choices about disclosing their HIV sero-status, WLH in India report anxiety, depression and suicidal ideation [1,18,26].…”

Section: Women In India Living An Hiv: the Pieces Of A Stigma Riddledmentioning

confidence: 99%

“…Most married, monogamous WLH report that their internalised stigma is associated with feeling that they have failed their families by needing to receive care, rather than providing care to the family as social roles teach that a woman should [1,6,14,26,31]. To minimise the risk to their children, nursing mothers reported implementing avoidant coping strategies, eschewing maternal acts such as breastfeeding or touching their infants, strategies which further reinforce feelings of maternal failure [29]. Women also reported fearing that their children would be ostracised and would have reduced opportunities for education and a better future [9,26].…”

Section: Women In India Living An Hiv: the Pieces Of A Stigma Riddledmentioning

confidence: 99%

“…A multi-faceted care program will respond not only to daily tangible and biomedical needs of WLH, but also to provide social and psychological support, and/or promote change in social constructions of exclusion and poverty. While not using the terminology of intersectionality, or a biopsychosocial complex, the principles of this approach are demonstrated in base-line research and an Asha-Life village intervention reported by Nyamathi et al [26,29,33]. In the most recently reported focus group study [26], a group of 16 South Indian, rural WLH met regularly with ASHA (Accredited Social Health Activists), trained local advocates and were provided with; transport to trusted medical therapy; tangible support in the form of high protein food, cooking oil and money; vocational training; and, education regarding management of their condition.…”

Section: Stigmatised Women: Looking Up Through An Intersectional Biopmentioning

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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Evidence and gap map report: Social and Behavior Change Communication (SBCC) interventions for strengthening HIV prevention and research among adolescent girls and young women (AGYW) in low‐ and middle‐income countries (LMICs)

Bose¹,

Hundal²,

Singh

et al. 2023

Campbell Systematic Reviews

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Background Adolescent girls and young women (AGYW), aged 15–24 years, are disproportionately affected by HIV and other sexual and reproductive health (SRH) risks due to varying social, cultural, and economic factors that affect their choices and shape their knowledge, understanding, and practices with regard to their health. Socio‐Behavioral Change Communication (SBCC) interventions targeted at strengthening the capabilities of individuals and their networks have supported the demand and uptake of prevention services and participation in biomedical research. However, despite growing global recognition of the domain, high‐quality evidence on the effectiveness of SBCC remains scattered. This evidence and gap map (EGM) report characterizes the evidence base on SBCC interventions for strengthening HIV Prevention and Research among AGYW in low‐ and middle‐income countries (LMICs), identifying evidence gaps and outlining the scope of future research and program design. Objectives The objectives of the proposed EGM are to: (a) identify and map existing EGMs in the use of diverse SBCC strategies to strengthen the adoption of HIV prevention measures and participation in research among AGYW in LMICs and (b) identify areas where more interventions and evidence are needed to inform the design of future SBCC strategies and programs for AGYW engagement in HIV prevention and research. Methods This EGM is based on a comprehensive search of systematic reviews and impact evaluations corresponding to a range of interventions and outcomes—aimed at engaging AGYW in HIV prevention and research ‐ that were published in LMICs from January 2000 to April 2021. Based on guidance for producing a Campbell Collaboration EGM, the intervention and outcome framework was designed in consultation with a group of experts. These interventions were categorized across four broad intervention themes: mass‐media, community‐based, interpersonal, and Information Communication and Technology (ICT)/Digital Media‐based interventions. They were further sub‐categorized into 15 intervention categories. Included studies looked at 23 unique behavioral and health outcomes such as knowledge attitude and skills, relationship dynamics, household dynamics, health care services, and health outcomes and research engagement. The EGM is presented as a matrix in which the rows are intervention categories/sub‐categories, and the columns are outcome domains/subdomains. Each cell is mapped to an intervention targeted at outcomes. Additional filters like region, country, study design, age group, funding agency, influencers, population group, publication status, study confidence, setting, and year of publication have been added. Selection Criteria To be eligible, studies must have tested the effectiveness of SBCC interventions at engaging AGYW in LMICs in HIV prevention and research. The study sample must have consisted of AGYW between the ages of 15–24, as defined by UNAIDS. Both experimental (random assignment) and quasi‐experimental studies that included a compariso...

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Impact of Asha Intervention on Stigma Among Rural Indian Women With AIDS

Cited by 31 publications

References 27 publications

Vivir con VIH: experiencias de estigma sentido en personas con VIH

Vivir con VIH: experiencias de estigma sentido en personas con VIH

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

Evidence and gap map report: Social and Behavior Change Communication (SBCC) interventions for strengthening HIV prevention and research among adolescent girls and young women (AGYW) in low‐ and middle‐income countries (LMICs)

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