Gender differences in perceived stigma and hope in people living with HIV / AIDS: an exploratory study
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20170278Keywords:
AIDS, Gender, HIV, Hope, PLWHA, Perceived stigma, StigmaAbstract
Background: Stigma is a major hurdle in overcoming the HIV epidemic and affects almost all people living with HIV/AIDS (PLWHA). In India, though majority of PLWHA are men, gender gap is narrowing with rates of infection increasing in women, most commonly due to transmission from their partners. Gender inequality in social and economic context leads women to vulnerability. The purpose of this study was to assess gender differences in the perceived stigma and hope in PLWHA, and to study the correlation of perceived stigma with hope and age in this population.
Methods: The sample was 68 HIV patients attending HAART clinic of a tertiary government hospital. Patients were assessed using Barbara Berger stigma scale and Herth hope index, and their scores were subjected to inferential statistical methods such as t-tests and correlation analysis.
Results: Although there are no gender differences in perceived stigma, there is an inverse relationship of many components of perceived stigma with hope in women. It was also found that women members of PLWHA group feel significantly less hopeful than men. Age was noted to have an inverse relationship with perceived stigma in men.
Conclusions: Greater attention is warranted to this growing proportion of HIV positive women in health policies and to alleviate their suffering which is multiplied as being socially disadvantaged due to their gender. This study highlights the need of special attention to women with HIV in health settings. Further research is needed to understand the relation of social support and depression with perceived social support.Metrics
References
Goffman E. Stigma. Notes on the Management of Spoiled Identity. New York: Simon and Shuster, Inc;1963.
Alonzo AA, Reynolds NR. Stigma, HIV and AIDS: An exploration and elaboration of a stigma trajectory. Soc Sci Med. 1995;41(3):303-15.
Cogan A, Herek G. Stigma: An encyclopaedia of AIDS. A social, political, cultural and scientific record of the HIV epidemic. Routledge: Chicago ; 1998.
DeBrun T. HIV/AIDS and discrimination: A discussion paper. Montreal: Canadian HIV/AIDS legal network and Canadian AIDS society; 1998.
Ogden J, Nyblade L. Common at its core:HIV Related stigma across contexts. International Centre for Research on women (ICRW). Washington D.C, USA; 2003.
Green.G, Platt.S. Fear and loathing in health care settings reported by people with HIV. Social Health Illln. 1997;19(1):70-92.
Steward WT, Herek GM, Ramakrishna J, Bharat S, Chandy S, Wrubel J, Ekstand M. HIV related Stigma: Adapting a Theoretical Framework for use in India. Soc Sci Med. 2008;67(8):1225-35.
Bennett L, Rose D, Jackson A, Thomas S. Psychosociomedical aspects of AIDS/HIV: A reflection on publications in AIDS Care. AIDS Care. 1998;15(2):1360-71.
Kumarasamy N, Safren SA, Raminani SR, Pickard R, James R, Krishnan AK, Solomon S, Mayer KH. Barriers and facilitators to antiretroviral medication adherence among patients with HIV in Chennai, India: A qualitative study. AIDS Patient Care STD. 2005;19:526-37.
Rao D, Kekwaletswe TC, Hosek S, Martinez J, Rodrigez F. Stigma and social barriers to medication adherence with urban youth living with HIV. AIDS Care. 2007;19:28-33.
Ciesla JA, Roberts JE. Meta-Analysis of the relationship between HIV infection and risk for depressive disorders. Am J Psychiatry. 2000;158:725-30.
Cederfjall C, Languis-Eklof A, Lidman K, Wredling R. Gender Differences in Perceived Health-Related Quality of Life Among Patients with HIV Infection. AIDS Patient Care and STDs. 2001;15(1):31-9.
Taylor B. HIV, Stigma and Health: Integration of Theoretical concepts and the lived experiences of the individuals. J Adv Nurs. 2001;35:792-8.
Whiteside A. Poverty and HIV/AIDS in Africa. Third World Q. 2002;23:313-32.
Robles AM, Stringer HG. HIV-AIDS in minorities. Clin Chest Med. 2006;27:511-9.
UNAIDS. Reports on the Global HIV/AIDS epidemic ; 2006.
Centers for Disease Control and Prevention. HIV/AIDS and women. Atlanta GA, Centers for Disease Control and Prevention ; 2007.
UNAIDS. Gender and HIV/AIDS: taking stock of research and programme ; 1999.
Rodrigues J, Mehendale SM, Shepherd ME, Divekar AK, Gangakhedkar G, Quinn TC, et al. Risk factors for HIV infection in people attending clinics for sexually transmitted diseases in India. BMJ. 2005;311:283-5.
Newmann S, Sarin P, Kumarasamy Amalraj E, Rogers M, Madhivanan P, Flanigan T, Cu-Uvin S, McGarvey S, Mayer K. Solomon S. Marriage, monogamy and HIV: a profile of HIV infected women in South India. Int J STD AIDS. 2000;11:250-3.
Nyblade LC. Measuring HIV stigma: existing knowledge and gaps. Psychol Health Med. 2006;11(3):335-45.
Berger B, Ferrans CE, Lashley FR. Measuring stigma in people with HIV: Psychometric assessment of the HIV Stigma Scale. Res Nurs Health. 2001;24(6):518-29.
Herth K. Abbreviated instrument to measure hope: Development and psychometric evaluation. J Adv Nurs. 2005;17:1251-9.
UNAIDS. Report on the global HIV/AIDS epidemic. Geneva ; 2000.
UNAIDS/WHO. AIDS epidemic update. Geneva ; 1999.
Women &HIV/AIDS. The Federal Government Source for Women’s Health Information.http://www.hhs.gov.
Gupta GR. Gender, sexuality and HIV/AIDS: The what, the why and the how? Plenary address. XIIIth International AIDS Conference, Durban, South Africa. ICRW ; 2008.
Mane P, Rao-Gupta G, Weiss E. Effective communication between partners: AIDS and risk reduction in women. AIDS. 1994;8(1):S325-31.
Weiss E, Gupta GR. Bridging the gap: Addressing gender and sexuality in HIV prevention. ICRW, Washington DC ; 1998.
Bharat S. AIDS related discrimination, stigmatization and denial in India. Geneva: UNAIDS ; 1999.
Bond V. Understanding HIV and AIDS related Stigma in Urban and Rural Zambia. Kanayaka--”The Light is On” Lusaka: Zambart Project and KCTT ; 2003.
Nyblade LR, Pande B. Disentangling HIV and AIDS Stigma in Ethiopia,Tanzania and Zambia. Washington, DC: International Center for Research on Women ; 2003.
Castle S. Rural children’s attitudes to people with HIV/AIDS in Mali: the causes of stigma. Culture Health Sex. 2004:6(1):1-18.
Swendeman D, Rotheram-Borus MJ, Comulada S, Weiss R, Ramos ME. Predictors of HIV-related Stigma among Young People Living with HIV. Health Psychol. 2006;25(4):501-9.
Hudson RW. When shame proneness hinders HIV disclosure: New evidence based practice for approach of chronic and enduring problem. Paper presented at NACSW convention, Orlando, 2008.
Reece M, Shacham E, Monahan P, Yebei V, Ong'Or WO, Omollo O, Ojwang C. Psychological distress symptoms of individuals seeking HIV-related psychosocial support in western Kenya. AIDS Care. 2007;19(10):1194-200.
Scambler G. Stigma and disease: Changing paradigms. Lancet. 1998;352(9133):1054-5.
Sechrist GB, Swim JK, Mark MM. Mood as information in making attributions to discrimination. Pers Soc Psychol Rev. 2003:29(4);524-34.
Nolen-Hoeksema S. Gender differences in depression. Curr Dir Psychol Sci 2001;10:173-6.
Riggs SA, Vosvick M, Stallings.S. Attachment style, stigma and psychological distress among HIV+ adults. J Health Psychol. 2007;12:922-5.
Bharat S. Facing the challenge: household and community response to HIV/AIDS in Mumbai, India. Geneva, UNAIDS ; 1996.
Bharat S, Singhanetra-Renard. A, Aggleton P. Household and community response to HIV/AIDS in Asia: the case of Thailand and India. In: Kaldor J et al., eds. AIDS in Asia and the Pacific, 2nd ed; 1998. S117–S22.
Bharat S, Aggleton PJ. Facing the Challenge: Household responses to AIDS in India. AIDS Care. 1999;11:31-44.
Aggleton P, Wood K, Malcolm A, Parker R. HIV Related Stigma,Discrimination and Human Rights Violations: Case studies of successful programme.Joint United Nations Programme On HIV/AIDS(UNAIDS), Geneva ; 2005.
Lee RS, Kochman A, Sikkema KJ. Internalized stigma among people living with HIV-AIDS. AIDS Behav. 2002;6(4):303-19.
Emlet CA. A Comparison of HIV stigma and Disclosure patterns in Younger and Older adults living with HIV/AIDS. AIDS Patient Care STD. 2005;20(6):1-20.
Earnshaw VA, Chaudoir SR. From conceptualizing to measuring HIV stigma: a review of HIV stigma mechanism measures. AIDS Behav. 2009;13(6):1160-77.
Anderson G. Providing services to elderly people with HIV. In: Aronstein DM, Thompson B.J, eds. HIV and social work: A practitioner’s guide. The New York. The Harrington Park Press. 1998:443-50.