Annals of Behavioral Medicine

, Volume 46, Issue 3, pp 285–294

Internalized Stigma, Social Distance, and Disclosure of HIV Seropositivity in Rural Uganda

  • Alexander C. Tsai
  • David R. Bangsberg
  • Susan M. Kegeles
  • Ingrid T. Katz
  • Jessica E. Haberer
  • Conrad Muzoora
  • Elias Kumbakumba
  • Peter W. Hunt
  • Jeffrey N. Martin
  • Sheri D. Weiser
Original Article

DOI: 10.1007/s12160-013-9514-6

Cite this article as:
Tsai, A.C., Bangsberg, D.R., Kegeles, S.M. et al. ann. behav. med. (2013) 46: 285. doi:10.1007/s12160-013-9514-6

Abstract

Background

HIV is highly stigmatized, compromising both treatment and prevention in resource-limited settings.

Purpose

We sought to study the relationship between internalized HIV-related stigma and serostatus disclosure and to determine the extent to which this association varies with the degree of social distance.

Methods

We fit multivariable Poisson regression models, with cluster-correlated robust estimates of variance, to data from 259 persons with HIV enrolled in an ongoing cohort study in rural Uganda.

Results

Persons with more internalized stigma were less likely to disclose their seropositivity. The magnitude of association increased with social distance such that the largest association was observed for public disclosures and the smallest association was observed for disclosures to sexual partners.

Conclusions

Among persons with HIV in rural Uganda, internalized stigma was negatively associated with serostatus disclosure. The inhibiting effect of stigma was greatest for the most socially distant ties.

Keywords

HIVSocial stigmaDisclosureUganda

Copyright information

© The Society of Behavioral Medicine 2013

Authors and Affiliations

  • Alexander C. Tsai
    • 1
    • 2
    • 3
    • 9
  • David R. Bangsberg
    • 2
    • 3
    • 4
  • Susan M. Kegeles
    • 5
  • Ingrid T. Katz
    • 3
    • 6
  • Jessica E. Haberer
    • 2
    • 3
  • Conrad Muzoora
    • 4
  • Elias Kumbakumba
    • 4
  • Peter W. Hunt
    • 7
  • Jeffrey N. Martin
    • 8
  • Sheri D. Weiser
    • 5
    • 7
  1. 1.Chester M. Pierce, MD Division of Global Psychiatry, Department of PsychiatryMassachusetts General Hospital (MGH)BostonUSA
  2. 2.MGH Center for Global HealthBostonUSA
  3. 3.Harvard Medical SchoolBostonUSA
  4. 4.Mbarara University of Science and TechnologyMbararaUganda
  5. 5.Center for AIDS Prevention Studies, Department of MedicineUniversity of California at San Francisco (UCSF)San FranciscoUSA
  6. 6.Department of Medicine, Brigham and Women’s HospitalBostonUSA
  7. 7.Division of HIV/AIDS, San Francisco General Hospital at UCSFSan FranciscoUSA
  8. 8.UCSF Department of Epidemiology and BiostatisticsSan FranciscoUSA
  9. 9.Center for Global Health, Room 1529-E3, Massachusetts General HospitalBostonUSA