Experience of Stigma by Women Infected with HIV by Their Husbands: A Qualitative Study (original) (raw)
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Qualitative study of HIV related stigma and discrimination: What women say in Iran
Electronic Physician
Introduction: HIV-related stigma is a major social problem of people living with HIV. Stigma against these people, especially women, interferes with the prevention, diagnosis and treatment of HIV. This study examined the experiences of HIV infected women who were stigmatized, as well as the strategies used to tackle the issue. Methods: Twenty-five women living with HIV were examined using in-depth, semi-structured interviews. The data obtained was analyzed using content analysis method in MAXQDA10. Results: The finding of this study was classified into four themes: fear, shame, rejection by family or friends and feelings of frustration. The participant strategies adopted to the perceived stigma and discrimination included isolation, nondisclosure, and loss of follow-up. Conclusions: HIV in women has different social interposition. It is necessary to intervene, so as to alleviate the effect of stigma on HIV infected women, in order that they gain the ability to accomplish wellness, increase life span and improve quality of life. Nurses, midwives and other professionals need to be involved to ensure public policy in providing supportive environments, and decrease stigma.
Stigma against people living with HIV (PLWH) seriously affects their quality of life. Moreover it can lead them to hide their HIV status from others, which in turn endangers public health. Many studies dealing with HIV-related stigma focus on the consequences of this phenomenon and pay less attention to the social conditions which affect different types of HIV-related stigma (anticipated, internalized and enacted stigma [ES]). Therefore, in this study, we tried to achieve more understanding about effective causal conditions of various types of experienced stigma. First of all, data were collected from 19 PLWH, using semi-structured interviews from those who had visited the Counseling Center for Behavioral Diseases in Mashhad. Secondly, the data were analyzed by applying a mixture of two methods: thematic analysis and qualitative comparative analysis (Boolean Algebra). The analysis of the data reveals that a combination of informing family members about HIV status, lack of family support, and medical support lead to anticipated stigma; a combination of religious beliefs and poor self-esteem results in internalized stigma and a combination of lack of family support, mistreatment by community, poor self-esteem, poverty and no religious beliefs lead to ES.
HIV/AIDS-related stigma can affect the diagnosis, treatment and the prevalence of HIV. Health providers’ stigmacan be fatal in this regard. In this study,we have tried to explore the perceptions of health providers’ stigma against HIV/AIDS among HIV-affected women. Here we applied a phenomenography approach. Samples were selected purposively from the behavioural disorders clinic and HIV positive club of Iranian Research Centre for HIV/AIDS (HPC). In-depth interviews were conducted for at least one hour with 14 healthcare providers (HCP), 14 women living with HIV and 7 family members. Data collections and analysis were conducted at the same time using a seven-step Sjöström process. Women experienced health providers’ stigma in two contexts: i- Professional Level (ethics, relations and duties); ii- Institutional Level (support, education/research, monitoring and services). Wefound lack of communication skills and professional ethics. To remove stigma, we need to evaluate, modify and design various organisational programs with its relevant applications .
HIV Stigma among People Living with HIV in Southeast Iran
Journal of Kerman University of Medical Sciences, 2021
Background: This study aimed to measure internal and external HIV stigma and their associated factors among people living with HIV in the southeast of Iran. Methods: Using convenience sampling and a standard questionnaire, we recruited 104 HIVpositive patients (40% women) in 2018-2019 from two public clinics in Kerman, Iran. The internal stigma scale ranged from 0-22 and the external stigma scale ranged from 0-11 in which a higher score indicates higher stigma. Results: The mean internal stigma score was 10.7 (SD: 5.2), and that of the external stigma score was 3.1 (SD: 2.9). In multivariable regression analysis, women (Adjusted (Adj). ᵦ=-3.3; p=0.08), and married people (Adj. ᵦ=-5.5; p=<0.001) experienced less internal stigma. In contrast, those who were a member of support group of PLHIV (Adj. ᵦ=2.8; p=0.04), and those infected by sexual contact (Adj. ᵦ=2.1; P=0.006) experienced a higher internal stigma. Moreover, married people (Adj. ᵦ=-1.4; p=0.01), those with high school or higher education (Adj. ᵦ=-1.7; p=0.002), and those with other transmission routes (Adj. ᵦ=-1.4; P=0.01) experienced lower external stigma. Conclusions: People living with HIV feel considerable internal and external stigma. Addressing HIV stigma should be tailored based on gender, education, marriage, peer groups, and risk groups as these factors have different effects on stigma experiences.
International Journal of Preventive Medicine, 2015
Background: HIV/AIDS is one of the diseases which not only makes threats to physical health, but also, due to the negative attitudes of people and the social stigma, affects the emotional and social health of patients. The aim of this study was to identify the psychological, social, and family problems of people living with HIV/AIDS (PLWHA) in Iran. Methods: In this qualitative study, we used purposive sampling to enroll PLWHA, their families, and physicians and consultants in two cities of Kermanshah and Tehran. Each group of PLWHA, their families, physicians, and consultants participated in two focus group discussions (FGDs), and a total of eight FGDs were conducted. Six interviews were held with all key people, individually. Results: Based on the views and opinions of various groups involved in the study, the main problems of PLWHA were: Ostracism, depression, anxiety, a tendency to get revenge and lack of fear to infect others, frustration, social isolation, relationship problems, and fear due to the social stigma. Their psychological problems included: Marriage problems, family conflict, lack of family support, economic hardships inhibiting marriage, and social rejection of patient's families. Their family problems were: Unemployment, the need for housing, basic needs, homelessness, and lack of social support associations. Conclusions: It seems that the identification and focusing on psychological, social, and family problems of affected people not only is an important factor for disease prevention and control, but also enables patients to have a better response to complications caused by HIV/AIDS.
2006
People's attitudes towards people living with HIV/AIDS remain a major community challenge. There is a need to generate a climate of understanding, compassion and dignity in which people living with HIV/AIDS (PLWHA) will be able to voluntarily disclose their status and receive the support and respect all people deserve. However, many people experience discrimination because they have HIV/AIDS. In a certain area in Khayelitsha, a township in Cape Town, a young woman was killed after disclosing the HIV status after being raped by five men. This has become a barrier to testing, treatment, on quality of life and social responses to HIV/AIDS. While many previous studies have focused on the external stigma in the general population, there is a dearth of studies on stigma among PLWHA themselves and hence the aim of the present study was to investigate stigma attached to HIV/AIDS from the perspective of PLWHA. The focus group research method was used to collect the data. Six focus groups consisting of 8-10 people in each group were held in Khayelitsha drawn from organizations working with PLWHA and Treatment Action Campaign (TAC). Data was analyzed using discourse analysis and the PEN-3 Model was used to explain the themes that emerged from the data. Results showed that PLWHA are affected by both enacted and internal stigma related to HIV/AIDS. It was found that the experiences of discrimination and stigma often originate from the fear and perceptions of PLWHA as immoral or living dead. They suffer rejection at home, work, school and in the health care centres. Results also showed that PLWHA felt shame, guilt, hopelessness and useless. This internalized stigma leads to withdrawal, depression, not to disclose the HIV status and prevent people for testing for HIV and also affect health-seeking behaviour. However, participants who were well informed and those who were members of the support groups reported that they are coping with the illness and they are open about their HIV-status. This suggests that education efforts have been remarkably successful in changing attitudes. It is recommended that stigma reduction programmes should involve PLWHA, community leaders and the community members to be part of the planning and implementation. It is also important to look at the successful programmes already existing in the area and adapt them and also to evaluate the effectiveness. Prof. Leickness Simbayi for your support, encouragement and being patient with me until the end of this process. The Penn-State University and Human Science Research Council for providing me fellowship and the facilities which made it possible for me to finish my thesis. Chelsea Morroni for support, friendship, motivation and containment which kept me going. My husband, children and family for the inspiration, encouragement and providing me space to finish this thesis. PLWHA who participated in this study for sharing your experiences with me. Thank you for trusting me with your sensitive life stories, without you this project was not going to be possible.
2007
People's attitudes towards people living with HIV/AIDS remain a major community challenge. There is a need to generate a climate of understanding, compassion and dignity in which people living with HIV/AIDS (PLWHA) will be able to voluntarily disclose their status and receive the support and respect all people deserve. However, many people experience discrimination because they have HIV/AIDS. In a certain area in Khayelitsha, a township in Cape Town, a young woman was killed after disclosing the HIV status after being raped by five men. This has become a barrier to testing, treatment, on quality of life and social responses to HIV/AIDS. While many previous studies have focused on the external stigma in the general population, there is a dearth of studies on stigma among PLWHA themselves and hence the aim of the present study was to investigate stigma attached to HIV/AIDS from the perspective of PLWHA. The focus group research method was used to collect the data. Six focus groups consisting of 8-10 people in each group were held in Khayelitsha drawn from organizations working with PLWHA and Treatment Action Campaign (TAC). Data was analyzed using discourse analysis and the PEN-3 Model was used to explain the themes that emerged from the data. Results showed that PLWHA are affected by both enacted and internal stigma related to HIV/AIDS. It was found that the experiences of discrimination and stigma often originate from the fear and perceptions of PLWHA as immoral or living dead. They suffer rejection at home, work, school and in the health care centres. Results also showed that PLWHA felt shame, guilt, hopelessness and useless. This internalized stigma leads to withdrawal, depression, not to disclose the HIV status and prevent people for testing for HIV and also affect health-seeking behaviour. However, participants who were well informed and those who were members of the support groups reported that they are coping with the illness and they are open about their HIV-status. This suggests that education efforts have been remarkably successful in changing attitudes. It is recommended that stigma reduction programmes should involve PLWHA, community leaders and the community members to be part of the planning and implementation. It is also important to look at the successful programmes already existing in the area and adapt them and also to evaluate the effectiveness. Prof. Leickness Simbayi for your support, encouragement and being patient with me until the end of this process. The Penn-State University and Human Science Research Council for providing me fellowship and the facilities which made it possible for me to finish my thesis. Chelsea Morroni for support, friendship, motivation and containment which kept me going. My husband, children and family for the inspiration, encouragement and providing me space to finish this thesis. PLWHA who participated in this study for sharing your experiences with me. Thank you for trusting me with your sensitive life stories, without you this project was not going to be possible.
An Exploratory Survey Measuring Stigma and Discrimination Experienced By People Living With HIV/AIDS
National Journal of Community Medicine, 2018
Background: The continued presence of stigma makes it an extraordinarily important, yet difficult issue to eradicate. The study aimed to assess HIV/AIDS related stigma and discrimination trends experienced by people living with HIV/AIDS (PLHA). Methodology: The cross sectional study was conducted in ICTC and STI clinic among 378 PLHA. Convenience sampling method was used as the study was limited to only participants who had voluntarily disclosed their HIV status could be involved for ethical reason. Consent was taken. A pre-tested questionnaire was used. Result: Findings suggest that PLHA have experienced significant levels of stigma and discrimination. Internalized stigma was among 89% of the participants and they blamed themselves for their status. While 86% respondents facing discriminatory attitudes from the society. Stigma and discrimination observed more in female and it was statistically significant. Conclusion: The current measures for dealing with stigma should be expanded to incorporate the issues related to health, education and discrimination experienced in various places. Family, Peer and Individual counseling should be an essential component for care of PLHA.
Evaluation of Stigma Index Among People Living With HIV/AIDS (PLWHA) in Six Cities in Iran
Thrita Journal of Medical Sciences, 2013
Background: Stigma and discrimination are among the main barriers for health workers to provide appropriate and necessary services for People Living with HIV/AIDS (PLWHA). Objectives: We conducted this study in Iran, to evaluate Stigma Index and the correlates. Materials and Methods: In this cross-sectional study, 289 HIV positive patients were recruited from six cities in Iran (including Tehran, Shiraz, Mashhad, Tabriz, Ahvaz and Kermanshah) to fill out the Farsi version of Stigma Index questionnaires through interviews that were arranged by two HIV infected persons for each city who were experienced data collectors. Results: Two hundred eighty nine HIV infected patients were interviewed by the trainers, out of which 90.3% and 9.7% were male and female, respectively. Most participants (47.8%) were in 30-39 years old age group. Sixty two point two percent of participants experienced external stigma and 98.62% subjects reported internal stigma. Significant associations between the cities and some items including external stigma, level of awareness regarding policies, rights and laws, feeling pressure to disclose HIV status and access to anti-retroviral therapy (ART) were observed. Conclusions: HIV patients have limited access to occupation, educational and health services. Policies should be made to target the high level of both perceived and external stigma among Iranian PLWHA.