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Conflict Transformation, Stigma, and HIV-Preventive Structural Change

  • Original Article
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American Journal of Community Psychology

Abstract

Over the prior decade, structural change efforts have become an important component of community-based HIV prevention initiatives. However, these efforts may not succeed when structural change initiatives encounter political resistance or invoke conflicting values, which may be likely when changes are intended to benefit a stigmatized population. The current study sought to examine the impact of target population stigma on the ability of 13 community coalitions to achieve structural change objectives. Results indicated that coalitions working on behalf of highly stigmatized populations had to abandon objectives more often than did coalitions working for less stigmatized populations because of external opposition to coalition objectives and resultant internal conflict over goals. Those coalitions that were most successful in meeting external challenges used opposition and conflict as transformative occasions by targeting conflicts directly and attempting to neutralize oppositional groups or turn them into strategic allies; less successful coalitions working on behalf of stigmatized groups struggled to determine an appropriate response to opposition. The role of conflict transformation as a success strategy for working on behalf of stigmatized groups is discussed.

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Notes

  1. The difference in completion time between high stigma and low stigma coalitions became more dramatic and attained statistical significance in an Analysis of Variance with Welch’s correction when we reclassified the low stigma coalition that reported symbolic stigma was a significant barrier to their work. With it reclassified as a high stigma coalition, the low stigma coalitions completed objectives in an average of 6 months (SD = 5.65). Moreover, when this coalition was reclassified, Games-Howell post-hoc analyses indicated a significant difference between high stigma, low-success coalitions and low stigma, low-success coalitions in how long it took to complete objectives. The high stigma low success coalitions took 7.5 months to complete objectives compared with 4 months for the low stigma low success coalitions.

  2. When the low-stigma coalition reporting symbolic stigma was reclassified, no universal objectives were completed by low stigma low success coalitions.

  3. Reclassification of the coalition reporting symbolic stigma to the high stigma group increases references to stigma barriers among the high stigma coalitions to 80% and decreases references to stigma barriers among the low stigma coalitions to 20%. Close examination of this coalition suggested it represents the most extreme experiences of symbolic AIDS stigma among the low stigma sites, though it is the only coalition in this group to have its work so dramatically impeded by symbolic AIDS stigma.

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Acknowledgments

The Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) is funded by Grant No. 2 U01 HD040533 from the National Institutes of Health through the National Institute of Child Health and Human Development (B. Kapogiannis, MD), with supplemental funding from the National Institute on Drug Abuse (N. Borek, PhD), National Institute on Mental Health (P. Brouwers, PhD), and National Institute on Alcohol Abuse and Alcoholism (K Bryant, PhD). The study was scientifically reviewed by the ATN’s Community and Prevention Leadership Group. Network scientific and logistical support was provide by the ATN Coordinating Center (C. Wilson, C. Partlow), at the University of Alabama at Birmingham. The ATN 079 Protocol Team members are Vincent Francisco (University of North Carolina-Greensboro), Robin Lin Miller (Michigan State University), Jonathan Ellen (Johns Hopkins University), Peter Freeman (Children’s Memorial Hospital), Lawrence B. Friedman (University of Miami School of Medicine), Grisel-Robles Schrader (University of California-San Francisco), Jessica Roy (Children’s Diagnostic and Treatment Center), Nancy Willard (Johns Hopkins University), and Jennifer Huang (Westat, Inc.). Research assistantship was provided by Sarah J. Reed (Michigan State University), Ella Dolan (Michigan State University), and Greer Cook (University of North Carolina-Greensboro). The authors thank Miles McNall and five anonymous reviewers for their insightful feedback on prior versions of this paper.

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Authors and Affiliations

  1. Department of Psychology, Michigan State University, East Lansing, MI, 48824, USA

    Robin Lin Miller & Sarah J. Reed

  2. Department of Public Health Education, University of North Carolina at Greensboro, Greensboro, NC, 27402, USA

    Vincent T. Francisco

  3. Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, 21224, USA

    Jonathan M. Ellen

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Correspondence to Robin Lin Miller.

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Miller, R.L., Reed, S.J., Francisco, V.T. et al. Conflict Transformation, Stigma, and HIV-Preventive Structural Change. Am J Community Psychol 49, 378–392 (2012). https://doi.org/10.1007/s10464-011-9465-7

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