Macro-level implicit HIV prejudice and the health of community residents with HIV.

Abstract

Objectives This study examined how community levels of implicit HIV prejudice are associated with the psychological and physical well-being of people with HIV living in those same communities. It also examined whether community motivation to control prejudice and/or explicit HIV prejudice moderates the relationship of implicit prejudice and well-being. Methods Participants were 206 people with HIV living in 42 different communities in New England who completed measures that assessed psychological distress, thriving, and physical well-being. Telephone surveys of 347 residents of these same communities (selected via random digit dialing) were used to assess community explicit HIV prejudice and motivation to control HIV prejudice. These community residents then completed an on-line measure of implicit prejudice toward people with HIV, the Implicit Association Test (IAT, Greenwald et al., 1998). Results Multilevel analyses showed that higher community implicit HIV prejudice was associated with greater psychological distress among residents with HIV living in that community. The physical well-being of participants with HIV was negatively related to community implicit HIV prejudice in communities in which residents were unmotivated to control HIV prejudice or had high levels of explicit HIV prejudice. Conclusions These findings indicate that implicit prejudice of residents of real-world communities may create an environment that may impair the well-being of stigmatized people. Implicit prejudice can therefore be considered an element of macro-level or structural stigma. The discussion considered the possible role of implicit HIV prejudice on a community’s social capital as one pathway by which it compromises the well-being of residents with HIV.

Smaller Hippocampal Volume among Black and Latinx Youth Living in High-Stigma Contexts

“…Aggregated social norms have been used in previous research to measure contextual features of stigma and prejudice across a range of groups, including Blacks, 42 immigrants, 43 sexual minorities, 44 and people with psychopathology, 45 and HIV/AIDS. 46,47 This work has shown that community-level prejudicial attitudes are associated with self-stigma, 45 disclosure concerns, 46 psychological distress, 48 poor self-rated health, 49 and even shortened lifespans, 42 among the stigmatized.…”

Experienced HIV-Related Stigma in Health Care and Community Settings: Mediated Associations With Psychosocial and Health Outcomes

“…Thus, experienced stigma in the community can increase levels of psychological distress (i.e., anxiety and depression) among PLWH. 24 In the current study, we expect that the specific health effects of experienced stigma differ depending on the source or context (i.e., healthcare providers and staff versus the community).…”

Normative vs personal attitudes toward persons with HIV, and the mediating role of perceived HIV stigma in rural Uganda

“…In general, these adverse effects are expected to operate whether the stigmatized condition is visible (eg, race/ethnicity) or concealable (eg, asymptomatic HIV) [ 23 , 24 ]. Several studies have also examined the health and behavioral impacts of social norms [ 25 - 31 ], but few studies in the literature on HIV stigma have directly connected the two constructs [ 29 , 32 , 33 ]. In a well-designed US study of persons with concealable stigmatized identities such as mental illness and family health problems, Quinn and Chaudoir [ 17 ] examined how both anticipated stigma and social norms (described in their article as “cultural stigma”) were associated with psychological distress.…”