Negative labeling and social exclusion of people living with human immunodeficiency virus/acquired immune deficiency syndrome in the antiretroviral therapy era

Insight from attitudes and behavioral intentions of female heads of households in Zambézia Province, Mozambique

Dados Bibliográficos

ID19439348
AutoresAbraham Mukolo (Vanderbilt University, autor correspondente), Meridith Blevins (0000-0002-3861-9859, Vanderbilt Health), Nicole Hinton (Vanderbilt Health), Bart Victor (Vanderbilt University), Lara M E Vaz (0000-0002-9072-8091, Vanderbilt University), Mohsin Sidat (0000-0002-8378-2014, Eduardo Mondlane University), Alfredo E Vergara, Alfredo Vergara (Vanderbilt Health)
Ano2014
Volume26
Fascículo7
Páginas821-826
Data de publicação2014-07-03
Peer ReviewedSim
Open AccessNão
TipoARTICLE
PeriódicoAIDS Care (JOURNAL)
Identificadores do periódicoISSN: 0954-0121 • E-ISSN: 1360-0451
EditoraInforma UK Limited (PUBLISHER • GB)
DOI10.1080/09540121.2013.861570
PMID24274172
OpenAlexW2072193997
IdiomaEN
Citações recebidas1
Referências citadas26

In the age of antiretroviral therapy (ART), unraveling specific aspects of stigma that impede uptake and adherence to human immunodeficiency virus (HIV) services and the complex intersections among them might enhance the efficacy of stigma-reduction interventions targeted at the general public. Few studies have described community stigma in high HIV prevalence regions of Mozambique where program scale-up has been concentrated, but fear of stigma persists as a barrier to HIV service uptake. Principal components analysis of attitudinal data from 3749 female heads of households surveyed in Zambézia Province was used to examine patterns of agreement with stigmatizing attitudes and behavior toward people living with HIV. Inferences were based on comparison of factor loadings and commonality estimates. Construct validity was established through correlations with levels of knowledge about HIV transmission and consistency with the labeling theory of stigma. Two unique domains of community stigma were observed: negative labeling and devaluation (NLD, α = 0.74) and social exclusion (SoE, α = 0.73). NLD is primarily an attitudinal construct, while SoE captures behavioral intent. About one-third of the respondents scored in the upper tertile of the NLD stigma scale (scale: 0-100 stigma points) and the equivalent was 41.3% in the SoE stigma scale. Consistent with literature, NLD and SoE stigma scores were inversely correlated with HIV transmission route knowledge. In item level analysis, fear of being labeled a prostitute/immoral and of negative family affect defined the nature of stigma in this sample. Thus, despite ART scale-up and community education about HIV/acquired immune deficiency syndrome (AIDS), NLD and SoE characterized the community stigma of HIV in this setting. Follow-up studies could compare the impact of these stigma domains on HIV services uptake, in order to inform domain-focused stigma-reduction interventions

Psychiatry · Psychological intervention · Adolescent Sexual and Reproductive Health · Clinical Psychology · HIV, Drug Use, Sexual Risk · HIV/AIDS Research and Interventions · Psychology · Social Psychology