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Experiences of Social Stigma and Implications For Healthcare Among a Diverse Population of HIV Positive Adults

Abstract

Stigma profoundly affects the lives of people with HIV/AIDS. Fear of being identified as having HIV or AIDS may discourage a person from getting tested, from accessing medical services and medications, and from disclosing their HIV status to family and friends. In the present study, we use focus groups to identify the most salient domains of stigma and the coping strategies that may be common to a group of diverse, low-income women and men living with HIV in Los Angeles, CA (n=48). We also explore the impact of stigma on health and healthcare among HIV positive persons in our sample. Results indicate that the most salient domains of stigma include: blame and stereotypes of HIV, fear of contagion, disclosure of a stigmatized role, and renegotiating social contracts. We use the analysis to develop a framework where stigma is viewed as a social process composed of the struggle for both internal change (self-acceptance) and reintegration into the community. We discuss implications of HIV-related stigma for the mental and physical health of HIV-positive women and men and suggestions for possible interventions to address stigma in the healthcare setting.

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Acknowledgments

Dr. Sayles was supported by a NIH National Research Service Award (NRSA) fellowship. Dr. Cunningham also received partial support from the NIMH (R-01#MH69087), the UCLA-Drew Project Export, NIH, National Center on Minority Health & Health Disparities, (P20-MD00148-01), and the UCLA Center for Health Improvement in Minority Elders/Resource Centers for Minority Aging Research, NIH, National Institute of Aging, (AG-02-004). Dr. Sarkisian was supported by a Paul B. Beeson Career Development Award in Aging from the National Institute on Aging, (1K23AG024811).

Author information

Correspondence to Jennifer N. Sayles.

Additional information

Sayles and Cunningham are with the Division of General Internal Medicine, University of California, Los Angeles, CA, USA; Ryan is with RAND Corporation, Santa Monica, CA, USA; Silver is with Fielding Graduate University, Santa Barbara, CA, USA; Sarkisian is with the Division of Geriatrics, University of California, Los Angeles, CA, USA; Cunningham is with UCLA School of Public Health, Los Angeles, CA, USA.

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Sayles, J.N., Ryan, G.W., Silver, J.S. et al. Experiences of Social Stigma and Implications For Healthcare Among a Diverse Population of HIV Positive Adults. J Urban Health 84, 814 (2007). https://doi.org/10.1007/s11524-007-9220-4

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Keywords

  • HIV
  • AIDS
  • Stigma
  • Healthcare
  • Gender
  • Minority
  • Framework
  • Qualitative