Understanding and Addressing AIDS-Related Stigma: From Anthropological Theory to Clinical Practice in Haiti

Castro, Arachu; Farmer, Paul

doi:10.2105/ajph.2003.028563

Cited by 400 publications

(344 citation statements)

References 30 publications

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“…Theoretical work conceptualizes stigma as a social process, rooted in and perpetuated by social inequities (Castro and Farmer, 2005;Link and Phelan, 2001;Parker and Aggleton, 2003). Therefore, the experience and intensity of HIV-related stigma may be compounded or "layered" (Castro and Farmer, 2005;Nyblade, 2006;Reidpath and Chan, 2005) among groups already marginalized because of race/ethnicity, gender, socio-economic status, sexual orientation, or drug use. In our sample, PLHA reported higher overall internalized stigma scores if they were a racial/ethnic minority, had low levels of income or education, were not a native English speaker, were not in a committed relationship, were heterosexual, or had been diagnosed with HIV more recently.…”

Section: Discussionmentioning

confidence: 99%

Development and Psychometric Assessment of a Multidimensional Measure of Internalized HIV Stigma in a Sample of HIV-positive Adults

Sayles¹,

Hays

Sarkisian³

et al. 2008

AIDS Behav

170

153

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There is a need for a psychometrically sound measure of the stigma experienced by diverse persons living with HIV/AIDS (PLHA). The goal of this study was to develop and evaluate a multidimentional measure of internalized HIV stigma that captures stigma related to treatment and other aspects of the disease among sociodemographically diverse PLHA. We developed a 28-item measure of internalized HIV stigma composed of four scales based on previous qualitative work. Internal consistency reliability estimates in a sample of 202 PLHA was 0.93 for the overall measure, and exceeded 0.85 for three of the four stigma scales. Items discriminated well across scales, and correlations of the scales with shame, social support, and mental health supported construct validity. This measure should prove useful to investigators examining in the role of stigma in HIV treatment and health outcomes, and evaluating interventions designed to mitigate the impacts of stigma on PLHA.

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Section: Discussionmentioning

confidence: 99%

Development and Psychometric Assessment of a Multidimensional Measure of Internalized HIV Stigma in a Sample of HIV-positive Adults

Sayles¹,

Hays

Sarkisian³

et al. 2008

AIDS Behav

170

153

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“…As women are the principal providers of food and drink in the region they may be the principal recipients of discrimination based on these attitudes. The association of HIV with multiple partnerships also brings strong moral judgments against women since these challenges ideals of monogamy and chastity associated with traditional feminine roles (Castro & Farmer, 2005;White & Carr, 2005;Norman, Carr et al, 2006;Royes, 2007). Direct violence against women is also associated with susceptibility to HIV and experiences following diagnosis and this should be factored into any discussion of mental health.…”

Section: Women Tradition and Hiv-risk Factorsmentioning

confidence: 99%

Mental Health of Caribbean Women with HIV/AIDS

Baird¹,

Jones²,

Martin³

et al. 2012

PSYCH

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“…21 From this perspective, the WHO recommendation that individuals must be "assured that testing is linked to accessible and relevant treatment, care, and other services" seems to be a bold and positive step forward.…”

Section: Testing Without Treatmentmentioning

confidence: 99%

Desperately seeking targets: the ethics of routine HIV testing in low-income countries

Rennie

Behets

2004

Bull World Health Organ

106

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The human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) pandemic, and responses to it, have exposed clear political, social and economic inequities between and within nations. The most striking manifestations of this inequity is access to AIDS treatment. In affluent nations, antiretroviral treatment is becoming the standard of care for those with AIDS, while the same treatment is currently only available for a privileged few in most resource-poor countries. Patients without sufficient financial and social capital -i.e., most people with AIDS -die each day by the thousands. Recent AIDS treatment initiatives such as the UNAIDS and WHO "3 by 5" programme aim to rectify this symptom of global injustice. However, the success of these initiatives depends on the identification of people in need of treatment through a rapid and massive scale-up of HIV testing. In this paper, we briefly explore key ethical challenges raised by the acceleration of HIV testing in resource-poor countries, focusing on the 2004 policy of routine ("opt-out") HIV testing recommended by UNAIDS and WHO. We suggest that in settings marked by poverty, weak health-care and civil society infrastructures, gender inequalities, and persistent stigmatization of people with HIV/AIDS, optout HIV-testing policies may become disconnected from the human rights ideals that first motivated calls for universal access to AIDS treatment. We leave open the ethical question of whether opt-out policies should be implemented, but we recommend that whenever routine HIV-testing policies are introduced in resource-poor countries, that their effect on individuals and communities should be the subject of empirical research, human-rights monitoring and ethical scrutiny. Voir page 55 le résumé en français. En la página 56 figura un resumen en español.

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Understanding and Addressing AIDS-Related Stigma: From Anthropological Theory to Clinical Practice in Haiti

Cited by 400 publications

References 30 publications

Development and Psychometric Assessment of a Multidimensional Measure of Internalized HIV Stigma in a Sample of HIV-positive Adults

Development and Psychometric Assessment of a Multidimensional Measure of Internalized HIV Stigma in a Sample of HIV-positive Adults

Mental Health of Caribbean Women with HIV/AIDS

Desperately seeking targets: the ethics of routine HIV testing in low-income countries

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