The experience and management of HIV stigma among HIV-negative adults in heterosexual serodiscordant relationships in New York City

Abstract

Despite treatment advances that have improved the health and life expectancy of HIV-positive people and contribute to the prevention of HIV transmission, HIV stigma is still frequently experienced by HIV-infected individuals and those close to them. This study investigated the types of HIV-related stigma experienced by HIV-negative adults in serodiscordant heterosexual relationships when their partner's HIV-positive status was revealed to family and friends and their strategies to manage such stigma. In-depth interviews were conducted in New York City with 56 men and 44 women who were HIV negative and had been in a relationship for at least six months with an HIV-positive partner of the opposite sex. Those who had disclosed the HIV status of their partner to family or friends experienced four main types of stigmatizing behaviours: distancing (avoidance of the participant or his/her partner for fear of infection), depreciation of the partner (being told their partner is not worthy of them), violation of privacy (people spreading the information that the partner is HIV positive), or accusations (being told that it was wrong to be in a relationship with HIV-positive people or to try to conceive with them). Participants described four main ways of managing actual or anticipated stigma: secrecy (not disclosing the HIV status of their partner to anyone), avoidance (breaking ties with people who held stigmatizing views), seeking support from their partner or the HIV-positive community (e.g., HIV-related organizations or their partner's family or friends), or education (informing family or friends about HIV treatment and prevention). Findings show that HIV-related "courtesy" stigma is frequently experienced by HIV-negative people in serodiscordant relationships but often can be managed. Offering support to individuals in serodiscordant relationships can improve the quality of life of HIV-positive people and their HIV-negative partners and potentially reduce HIV stigma.

Couple identity and well-being in Chinese HIV serodiscordant couples: resilience under the risk of stigma

“…To our knowledge, this is the first study examining the interaction between couples' we-ness and stigma experience in HIV serodiscordant couples. Our findings are consistent with the experience of PLWHA and seronegative spouses reported in previous qualitative studies (Rispel, Cloete, & Metcalf, 2015;Siegel et al, 2018). For instance, a concern of bringing stigma to spouses led to enormous distress and even suicidal attempts in PLWHA who were injection drug users (Salter et al, 2010).…”

“…Thus, PLWHA is particularly distressful about bringing disgrace to the couple, and the seronegative spouses feel devalued because "we have HIV", even if they are not infected. Previous qualitative studies showed that such process brought additional shame, guilt and isolation to discordant couples, exacerbating the negative consequences of stigma (Li et al, 2008;Siegel et al, 2018). We-ness entailed in couple identity may further facilitate the transmission of distress within the couple (Larson & Almeida, 1999).…”

“…Previous evidence has indicated that stigmatization of HIV has brought enormous pressure to PLWHA (Liamputtong, 2013). Seronegative spouses of PLWHA suffered from courtesy stigma (Goffman, 1963) including avoidance and accusation (Ho & Mak, 2013;Siegel, Meunier, & Lekas, 2018) because the public tended to treat the stigmatized individuals and people related to them "as one" (Goffman, 1963). Both PLWHA and spouses reported consequences of stigma in their psychological and physical well-being (e.g., depression, poor physical health; Charles et al, 2012;Earnshaw, Smith, Chaudoir, Amico, & Copenhaver, 2013;Wight, 2000;.…”

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“…Aquellos que revelaron el estado serológico informaron de actitudes estigmatizantes como distanciamiento, desprecio, violación de la privacidad y acusaciones por parte de su pareja y de su círculo social más cercano. Ante esto, se mostraron diferentes formas de gestionar la enfermedad dentro de la pareja, tales como la ruptura, la búsqueda de apoyo social externo y la educación a familiares y amigos sobre la enfermedad (Siegel et al, 2018).…”

Estigma e preconceito com casais sorodiferentes para o HIV

“…1) pré-análise; 2) exploração do material e 3) o tratamento dos resultados e interpretação 12,13 . 16 .…”