Maternal HIV Stigma and Child Adjustment: Qualitative and Quantitative Perspectives

Kim, Sae-Jin; Robbertz, Abigail S; Goodrum, Nada M.; Armistead, Lisa; Cohen, Lindsey L.; Schulte, Marya T.; Murphy, Debra A.

doi:10.1007/s10826-021-02034-x

Cited by 4 publications

(5 citation statements)

References 43 publications

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“…Sangaramoorthy et al [ 41 ] described the weight of nondisclosure and secrecy as a constant burden for the women. Kim et al [ 50 ] noted that women experienced disclosure-related stigma with most individuals, including their own children. McDoom et al [ 23 ] and Relf et al [ 45 ] highlighted the isolation that occurred as a by-product of reluctance to disclose.…”

Section: Resultsmentioning

confidence: 99%

“…In this new construct, women came to view themselves independently from their status and stigma. Several studies observed this process in which women began redefining stigma as ignorance [ 13 , 19 , 20 , 22 , 50 ]. Through this lens, they directed the fears and hostility surrounding HIV away from themselves as individuals and onto a lack of education and the perpetuation of cultural myths.…”

Section: Resultsmentioning

confidence: 99%

“…Similarly, Kempf et al [42] and Sangaramoorthy et al [12] noted increases in anticipated and experienced stigma for women in their roles as mothers. Kim et al [50] discussed how mothers felt intensified stigma in relation to transmitting HIV, with comments centering on judgment that they might have engaged in unprotected and promiscuous sex. Sommer and Barroso International Journal for Equity in Health (2023) 22:158 However, many studies highlighted the positive impact of motherhood.…”

Section: The Paradox Of Motherhoodmentioning

confidence: 99%

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A qualitative metasynthesis of stigma in women living with HIV in the United States

Sommer,

Barroso

2023

Int J Equity Health

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Our goal was to synthesize qualitative studies on HIV-related stigma as experienced by women living with HIV (WLWH) in the U.S. Qualitative metasynthesis techniques as developed by Sandelowski et al. (Res Nurs Health 30(1):99–111, 2007) were used to integrate and update findings on stigma in WLWH in the U.S. in 43 reports of qualitative studies conducted between 2004 and 2023 with 1118 participants. Developed themes explored a collective narrative of women first surviving the intersectionality of multiple sources of stigma, discovering non-linear pathways to transcend their stigma, and finally experiencing resilience through their transcendence of stigma. While this metasynthesis revealed similarities to an earlier metasynthesis in the ubiquity and persistence of stigma, they differ primarily in women’s abilities to find agency in managing and opposing their stigma. This cognitive reframing of their stigma helped women to redefine stigma as ignorance and move towards a more positive assessment of the self. In doing so, they separated themselves from their stigma and the damaging effects of it. Findings from this metasynthesis may serve as a useful tool for the development of stigma reduction interventions specific to the needs and experiences of WLWH in the U.S.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: The Paradox Of Motherhoodmentioning

confidence: 99%

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A qualitative metasynthesis of stigma in women living with HIV in the United States

Sommer,

Barroso

2023

Int J Equity Health

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“…Stigma is associated with a variety of adverse outcomes among people living with HIV, including social isolation (3), depression (4)(5)(6)(7), and poor quality of life (8). Providers generally suggest prospective adoptive parents prepare for HIV-related stigma from both extended family members and the community (9) and there is extensive research on internalized HIV stigma at the child and family level [e.g., (10,11)]. However, there is a lack of understanding and research focused on community-level HIV stigma and the lived experiences of adoptive parents in the United States as they navigate HIV disclosure and manage stigma at the community level.…”

Section: Introductionmentioning

confidence: 99%

“Nothing is ever going to change if we don't start advocating for our child.”: Community-level disclosure and stigma management strategies among parents of internationally adopted children living with PHIV

Bingaman

Hamilton

Houpt

et al. 2023

Front. Public Health

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BackgroundThe number of internationally adopted children living with perinatally-acquired HIV (IACP) in the U.S. is increasing, yet little is known about their families' experiences navigating HIV disclosure within a community context. This paper examines the lived experiences of adoptive parents as they navigate HIV disclosure and manage stigma toward their adopted children within their broader communities.MethodsA purposive sample of parents of IACP was recruited at two pediatric infectious disease clinics and via closed Facebook groups. Parents completed two semi-structured interviews approximately one year apart. Interview questions included strategies parents used to reduce the impact of community level stigma that their child is likely to encounter as they mature. Interviews were analyzed using Sort and Sift, Think and Shift analytic approach. All parents (n = 24) identified as white and most (n = 17) had interracial families, with children adopted from 11 different countries (range: age at adoption 1-15 years; range: age at first interview 2-19 years).ResultsAnalyses revealed that parents serve as advocates for their child by both supporting more public HIV disclosure at times, but also applying indirect strategies such as working to improve outdated sex education material. Knowledge of HIV disclosure laws empowered parents to make informed decisions about who, if anyone, in the community needed to know their child's HIV status.ConclusionFamilies with IACP would benefit from HIV disclosure support/training and community-based HIV stigma reduction interventions.

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“…in their longitudinal study of stigma experienced by pregnant women living with HIV found that anticipated stigma was associated with alcohol abuse, depression, decreased HIV knowledge and non-disclosure of HIV status [ 21 ]. For mothers living with HIV, their fear that HIV would compromise how they are perceived by family and others often delays disclosure of their status to their children or other close family members [ 22 ].…”

Section: Introductionmentioning

confidence: 99%

“If I don’t take my treatment, I will die and who will take care of my child?”: An investigation into an inclusive community-led approach to addressing the barriers to HIV treatment adherence by postpartum women living with HIV

Pepper

2023

PLoS ONE

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Introduction Initiatives to support adherence to HIV treatment in South Africa are often centred on service delivery thereby avoiding key challenges to adherence: stigma and poverty. In contrast, this study aims to demonstrate the strength of an inclusive research and programme approach to improving the lives of people living with HIV and simultaneously ARV adherence. Methods Participatory Action Research combined with a visual participatory method (Photovoice) was used by postpartum women to share their experience of taking ARVs. The research was analysed from an interpretative and critical paradigm where both the women and a non-governmental organisation collaborated in the data collection, analysis and interpretation of the findings. Together, they then disseminated the findings and used a community-led approach to create a programme addressing these barriers effectively. Findings Two main barriers to ARV adherence emerged: the anticipated stigma associated with issues of disclosure and poverty epitomized by alcohol abuse, gender-based violence and hunger. The women and the NGO staff successfully presented their findings at conferences and collaborated to develop a programme of support for all women living with HIV in the area. The programme addresses each of the issues raised by the co-researchers and is run via a community-led process where the participants lead on design, implementation, and monitoring and ultimately will revise the programme as needed. Discussion The inclusive approach of this study enabled these postpartum women to portray the intersectional nature of both HIV stigma and poverty that affects their lives. By working with the local NGO to develop a programme based on these insights, they were able to tailor specific interventions to the issues women living with HIV face in their area. In doing so, they aim to improve the lives of people living with HIV by demonstrating a more sustainable way to impact ARV adherence. Conclusion Currently, health service insistence on measuring ARV adherence does not address the core barriers to taking ARVs and misses the opportunity to focus on the long term health and well-being of people living with HIV. In contrast, locally targeted participatory research and programme development based on inclusivity, collaboration and ownership do address the fundamental challenges of people living with HIV. In doing so, it can have a greater impact on their long term well-being.

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Maternal HIV Stigma and Child Adjustment: Qualitative and Quantitative Perspectives

Cited by 4 publications

References 43 publications

A qualitative metasynthesis of stigma in women living with HIV in the United States

A qualitative metasynthesis of stigma in women living with HIV in the United States

“Nothing is ever going to change if we don't start advocating for our child.”: Community-level disclosure and stigma management strategies among parents of internationally adopted children living with PHIV

“If I don’t take my treatment, I will die and who will take care of my child?”: An investigation into an inclusive community-led approach to addressing the barriers to HIV treatment adherence by postpartum women living with HIV

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