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. 2015 Feb;19(2):270-82.
doi: 10.1007/s10461-014-0993-7.

Socioeconomic gradients in internalized stigma among 4,314 persons with HIV in sub-Saharan Africa

Alexander C Tsai  1
Affiliations

Socioeconomic gradients in internalized stigma among 4,314 persons with HIV in sub-Saharan Africa

Alexander C Tsai. AIDS Behav. 2015 Feb.

Abstract

The stigma attached to HIV is a major public health problem given its adverse impacts on HIV prevention and on the psychosocial wellbeing of persons with HIV. In this study, I apply a novel method to data from the Demographic and Health Surveys to identify persons with HIV who were aware of their seropositivity at the time of the survey. The pooled dataset includes 4,314 persons with HIV in Cameroon, Ethiopia, Gabon, Kenya, Lesotho, Malawi, Rwanda, Swaziland, Tanzania, Uganda, Zambia, and Zimbabwe. My findings indicate that nearly one-fifth of study participants provided survey responses consistent with internalization of stigmatizing beliefs. Furthermore, in multivariable regression models, striking socioeconomic gradients in internalized stigma were observed. A clear implication of my findings is that the adverse health and psychosocial impacts of HIV stigma are likely concentrated among those with the fewest socioeconomic resources for managing and resisting it.

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Figures

Figure 1
Figure 1. Possible chronologies of HIV infection, HIV testing, and survey administration in the Demographic and Health Surveys
(a) The participant tests negative for HIV, then acquires HIV (black arrow) and tests positive for HIV prior to the survey. At the time of the survey, this participant accurately perceives himself to be HIV-positive. (b) The participant tests negative for HIV and remains HIV-negative. At the time of the survey, this participant accurately perceives himself to be HIV-negative. (c) The participant tests negative for HIV once in the past, then acquires HIV but does not have another HIV test prior to the survey. At the time of the survey, the participant inaccurately perceives himself to be HIV-negative.
Figure 2
Figure 2. Cross-country correlation between acceptance of persons with HIV in the general population vs. internalized stigma among persons with HIV (N=12)
The x-axis denotes the percentage of persons in that country who provided survey responses consistent with accepting attitudes towards persons with HIV. The y-axis denotes the percentage of persons with HIV in that country who provided survey responses consistent with internalized stigma. Circle sizes are directly proportional to the sample size of persons with HIV in that country.
See this image and copyright information in PMC

References

    1. Rankin WW, Brennan S, Schell E, Laviwa J, Rankin SH. The stigma of being HIV-positive in Africa. PLoS Med. 2005;2(8):e247. - PMC - PubMed
    1. Pryor JB, Reeder GD, Vinacco R, Kott TL. The instrumental and symbolic functions of attitudes towards persons with AIDS. J Appl Soc Psychol. 1989;19(5):377–404.
    1. Tsai AC, Bangsberg DR, Weiser SD. Harnessing poverty alleviation to reduce the stigma of HIV in sub-Saharan Africa. PLoS Med. 2013;10(11):e1001557. - PMC - PubMed
    1. Cassens BJ. Social consequences of the acquired immunodeficiency syndrome. Ann Intern Med. 1985;103(5):768–771. - PubMed
    1. Link BG, Cullen FT, Struening E, Shrout PE. A modified labeling theory approach to mental disorders: an empirical assessment. Am Sociol Rev. 1989;54(3):400–423.

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