Internalized stigma and HIV status disclosure among HIV-positive black men who have sex with men

Overstreet, Nicole; Earnshaw, Valerie A.; Kalichman, Seth C.; Quinn, Diane M.

doi:10.1080/09540121.2012.720362

Cited by 104 publications

(68 citation statements)

References 24 publications

(24 reference statements)

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“…Nondisclosure of one's positive HIV status has been associated with internalized stigma-negative feelings towards oneself because of HIV positive status. Stigma makes some PLHIV remain silent, alienate themselves, and opt not to enroll in health care services, or hide their antiretroviral drugs (ARVs) from others even when they are faced with life threatening health conditions [11]. In a recent study in rural Nigeria, researchers found a strong association between levels of stigma and adherence to ART.…”

Section: Introductionmentioning

confidence: 97%

The Value of Support Group Participation in Influencing Adherence to Antiretroviral Treatment among People Living with Human Immunodeficiency Virus (HIV)

Tumwikirize¹,

Torpey²,

Adedokun³

et al. 2015

WJA

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Advances in antiretroviral therapy for both Human Immunodeficiency Virus (HIV) treatment and prevention have increased interest in adherence to HIV treatment. This is because the individual patient and public health benefits of antiretroviral treatment (ART) greatly depend on the extent to which people living with HIV (PLHIV) adhere to the prescribed daily dosing regimens. Studies have shown that nonadherence to ART increases drug resistance, morbidity and person-to-person HIV transmission. Public health experts are trying different innovations to enhance ART adherence, including promoting support groups of PLHIV. The purpose of this study was to determine the value of support group participation in enhancing ART adherence. The study used a cross-sectional design to compare ART adherence among PLHIV who participate in support group activities and those who do not. Respondents were adults who were initiated on ART between January 1, 2010 and December 31, 2012. Multistage probability sampling was used to select study sites and respondents. Data was collected using a self-administered questionnaire from 1676 respondents between February and May 2014. Data was analyzed using STATA. Univariate analysis was carried out to generate descriptive statistics, while Chi-square tests were used to examine if there was an association between participation in support group activities and antiretroviral treatment adherence. ART adherence was self-reported by 745/788 (95%) and 814/888 (92%) respondents who had ever and had never participated in support group activities respectively. Among respondents who reported nonadherence to ART, 74/117 (8%) had never participated in support group activities compared to just 43/117 (5%) who participated in support group activities. These findings suggest that PLHIV who participate in support group activities are more likely to adhere to ART * Corresponding author. S. Tumwikirize et al. 190than those who do not participate. This implies that there is value in participating in support groups by PLHIV in terms of ART adherence.

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Section: Introductionmentioning

confidence: 97%

The Value of Support Group Participation in Influencing Adherence to Antiretroviral Treatment among People Living with Human Immunodeficiency Virus (HIV)

Tumwikirize¹,

Torpey²,

Adedokun³

et al. 2015

WJA

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“…Shame about one’s HIV status can make HIV status disclosure difficult (Chaudoir, Fisher, & Simoni, 2011) and can influence decisions to seek out social support (Chesney, 1999). Internalized stigma is also associated with less frequent disclosure of HIV status to sexual partners (Overstreet, Earnshaw, Kalichman, & Quinn, 2013), increasing risk of HIV transmission. There are also established relationships between stigma and poor HIV outcomes.…”

Section: Introductionmentioning

confidence: 99%

“It's Almost Like a Crab-in-a-Barrel Situation”: Stigma, Social Support, and Engagement in Care Among Black Men Living With HIV

Quinn¹,

Dickson‐Gómez²,

Broaddus³

et al. 2018

AIDS Education and Prevention

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Social support is associated with improved health outcomes for people living with HIV (PLWH), including initiation and engagement in HIV care and antiretroviral therapy (ART) adherence. Yet, stigma may negatively affect the availability and utilization of social support networks, especially among African American PLWH, subsequently impacting HIV care and health outcomes. This qualitative study examines the relationship between stigma and social support relationships among African American PLWH. We conducted 23 interviews with Black men living with HIV who reported being out of care or non-adherent to ART. Thematic content analysis revealed three primary themes including variation in social support, experiences of stigma and discrimination, and coping mechanisms used to deal with stigma. Findings reveal that although social support may be protective for some men, many African American PLWH face challenges in harnessing and sustaining needed social support, partly due to stigma surrounding HIV and homosexuality.

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“…Second, PLWH who have experienced HIV self-stigma may be less likely to disclose their HIV status to sex partners (Chaudoir, Fisher, & Simoni, 2011). Several studies demonstrate that HIV self-stigma is associated with a decreased likelihood of disclosure of HIV status to sex partners (Kingori et al, 2012; Overstreet, Earnshaw, Kalichman, & Quinn, 2012; Simbayi et al, 2006). Some, but not all, studies further find an association between status disclosure and unprotected sex (Crepaz & Marks, 2002).…”

Section: Introductionmentioning

confidence: 99%

HIV stigma and unprotected sex among PLWH in KwaZulu-Natal, South Africa: a longitudinal exploration of mediating mechanisms

et al. 2014

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Social and structural factors including HIV stigma are theorized to drive global disparities in HIV prevalence. This study tests whether HIV self-stigma, or experiences of stigma at the individual level, is associated with engagement in unprotected sex among PLWH in KwaZulu-Natal, South Africa, where 37.4% of adults are living with HIV compared with 0.8% worldwide. It further explores whether depressive symptoms, HIV status disclosure to sex partners, and/or condom use attitudes mediate potential associations between HIV self-stigma and unprotected sex. Participants, including 924 PLWH, were recruited from primary care clinics and completed baseline, 6-, 12-, and 18- month survey assessments between 2008 and 2011. Hierarchical linear modeling analyses were used to examine longitudinal within-subjects associations between HIV self-stigma, mediators, and unprotected sex with both HIV-negative/unknown and HIV-positive partners. Results demonstrate that HIV self-stigma was prospectively associated with greater likelihood of unprotected sex with HIV-negative/unknown partners. None of the variables explored significantly mediated this association. HIV self-stigma was also prospectively associated with greater likelihood of unprotected sex with HIV-positive partners via the mediators of greater depressive symptoms and more negative condom use attitudes. The current study suggests that HIV self-stigma undermines HIV secondary prevention and care efforts among PLWH in KwaZulu-Natal. It is therefore critical to address HIV stigma at the social/structural level to reduce HIV self-stigma at the individual level and ultimately curb global disparities in HIV prevalence. In the absence of widespread social/structural change, interventions that treat depressive symptoms and encourage more positive condom use attitudes despite the existence of HIV stigma may buffer associations between HIV self-stigma and unprotected sex with HIV-positive partners among PLWH in KwaZulu-Natal.

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Internalized stigma and HIV status disclosure among HIV-positive black men who have sex with men

Cited by 104 publications

References 24 publications

The Value of Support Group Participation in Influencing Adherence to Antiretroviral Treatment among People Living with Human Immunodeficiency Virus (HIV)

The Value of Support Group Participation in Influencing Adherence to Antiretroviral Treatment among People Living with Human Immunodeficiency Virus (HIV)

“It's Almost Like a Crab-in-a-Barrel Situation”: Stigma, Social Support, and Engagement in Care Among Black Men Living With HIV

HIV stigma and unprotected sex among PLWH in KwaZulu-Natal, South Africa: a longitudinal exploration of mediating mechanisms

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