This study forms part of a larger SANPAD project focusing on a comprehensive community-based HIV stigma reduction and wellness enhancement intervention, responding to the continuous burden of HIV stigma on both national and international levels and the paucity of research in sustainable HIV stigma reduction interventions. HIV stigma is considered all over the world as a complex, far-reaching and powerful phenomenon that continues to affect people living with HIV (PLWH) and also people living close to them (PLC). The impact of stigma has far reaching effects on aspects like the wellness of PLWH and PLC, but also on the health behaviour of PLWH. There is paucity in research on the lasting effect of HIV stigma reduction interventions, intervention within a community context, as well as in urban and rural settings. The research objectives of this study were to test the change-over-time in HIV stigma experiences of PLWH and stigmatization by PLC with regard to the psychosocial well-being of PLWH and PLC, and with regard to health behaviour of PLWH in both urban and rural settings, following a comprehensive community-based HIV stigma reduction intervention. A quantitative experimental single system research design with a pre-test and repetitive post-tests were conducted by means of purposive voluntary sampling for PLWH and snowball sampling for PLC. The intervention was based on three tenets, namely a) the sharing of information on HIV stigma and coping with it, b) the equalisation of relationships between PLWH and PLC through increased interaction and contact, and c) empowerment of both PLWH and PLC towards leadership in HIV stigma reduction through practical knowledge and experiences of planning and implementing HIV stigma reduction projects in their own communities. Several valid and reliable scales and instruments were used to measure effect. The initial analysis indicated no statistically significant difference between stigma experiences of PLWH and stigmatisation by PLC from urban and rural settings, or between psychosocial well-being of PLWH and PLC or health behaviour of PLWH from the two different settings. The urban-rural data was therefore pooled for the further analysis. The similarity of data could possibly be ascribed to the fact that most of the participants were Setswana-speaking and living in the North West Province. Stigma experiences as well as stigmatisation could be decreased and the decrease could be sustained over a year through the comprehensive community-based HIV stigma reduction intervention. The findings also showed that changes-over-time in psychosocial well-being following the intervention were better sustained by the PLC than the PLWH. Results furthermore indicated that HIV stigma reduction positively influenced the health behaviour of the PLWH. Recommendations for further HIV stigma reduction and wellness enhancement include the continued application of this comprehensive community-based HIV stigma reduction and wellness enhancement intervention, with its supporting tenets, content and methodology. This intervention should, however, be expanded into urban and rural communities, and to different cultures as well. It would be meaningful to build HIV stigma reduction community-based networks. More effort could be made to specifically include a workshop for PLWH on psychosocial well-being as well. HIV stigma interventions should be an indisputable part of health behaviour change workshops for PLWH. / PhD (Nursing), North-West University, Potchefstroom Campus, 2014

High levels of HIV stigma are reported for people living with HIV or AIDS (PLHA) and PLHA have to cope with this. These experiences may differ in a rural and urban setting. Obtaining a true reflection of the level of HIV stigma experienced by PLHA in a rural and urban setting and their level of coping self-efficacy, while dealing with this stigma, will be helpful in planning future intervention strategies. The study aims to compare qualitative expressed experiences with quantitative measures of levels of HIV stigma and coping self-efficacy of PLHA in a rural and urban setting. Secondly the aim is to establish the relationship between the levels of HIV stigma experiences of PLHA and coping self-efficacy of PLHA. The study took place in the North West Province, in both a rural (n=12) and urban (n=11) setting. Participants were selected by means of purposive sampling. A convergent parallel design was used within a mixed method approach. In-depth interviews provided qualitative data. Quantitative data came from two scales, the HIV and AIDS stigma scale-PLWA (HASI-P) (Holzemer et al., 2007a) and the Coping self-efficacy scale (CSE) (Chesney, Neilands, Chambers, Taylor, & Folkman, 2006). The study revealed that HIV stigma does exist, and is experienced by PLHA in the North West province in both a rural and an urban setting with no significant difference. Qualitative data confirmed the results of the HIV stigma measure, and also provided a rich understanding of the differences in contexts between the two settings. Additional types of stigma found to those included in the HASI-P point to shifts in the way people and communities experience HIV stigma. Results of the CSE scale showed that PLHA from both rural and urban settings employed the three types of coping self-efficacy as described by Chesney et al. (2006), with no significant difference between the two groups. Statistical correlations within the HASI-P revealed correlations between certain types of stigma experienced, indicating that HIV stigma is not experienced in a single dimension but can extend to more than one area of the lives of PLHA. Correlations within the CSE scale illustrate that ways PLHA cope may be related to each other Recommendations focus on further research options, policy development and implementation in practice. The goals of the research were reached in that it was confirmed that HIV stigma and coping self-efficacy of PLHA in rural and urban settings, using qualitative and quantitative methods, does exist. The relationship between HIV stigma and coping self-efficacy of PLHA was established through the correlation of scales and through the evidence found during in-depth interviews; that HIV stigma exists and that PLHA develop coping self-efficacy to deal with it. / Thesis (MA (Research Psychology))--North-West University, Potchefstroom Campus, 2013

This study forms part of a larger SANPAD project focusing on a comprehensive community-based HIV stigma reduction and wellness enhancement intervention, responding to the continuous burden of HIV stigma on both national and international levels and the paucity of research in sustainable HIV stigma reduction interventions. HIV stigma is considered all over the world as a complex, far-reaching and powerful phenomenon that continues to affect people living with HIV (PLWH) and also people living close to them (PLC). The impact of stigma has far reaching effects on aspects like the wellness of PLWH and PLC, but also on the health behaviour of PLWH. There is paucity in research on the lasting effect of HIV stigma reduction interventions, intervention within a community context, as well as in urban and rural settings. The research objectives of this study were to test the change-over-time in HIV stigma experiences of PLWH and stigmatization by PLC with regard to the psychosocial well-being of PLWH and PLC, and with regard to health behaviour of PLWH in both urban and rural settings, following a comprehensive community-based HIV stigma reduction intervention. A quantitative experimental single system research design with a pre-test and repetitive post-tests were conducted by means of purposive voluntary sampling for PLWH and snowball sampling for PLC. The intervention was based on three tenets, namely a) the sharing of information on HIV stigma and coping with it, b) the equalisation of relationships between PLWH and PLC through increased interaction and contact, and c) empowerment of both PLWH and PLC towards leadership in HIV stigma reduction through practical knowledge and experiences of planning and implementing HIV stigma reduction projects in their own communities. Several valid and reliable scales and instruments were used to measure effect. The initial analysis indicated no statistically significant difference between stigma experiences of PLWH and stigmatisation by PLC from urban and rural settings, or between psychosocial well-being of PLWH and PLC or health behaviour of PLWH from the two different settings. The urban-rural data was therefore pooled for the further analysis. The similarity of data could possibly be ascribed to the fact that most of the participants were Setswana-speaking and living in the North West Province. Stigma experiences as well as stigmatisation could be decreased and the decrease could be sustained over a year through the comprehensive community-based HIV stigma reduction intervention. The findings also showed that changes-over-time in psychosocial well-being following the intervention were better sustained by the PLC than the PLWH. Results furthermore indicated that HIV stigma reduction positively influenced the health behaviour of the PLWH. Recommendations for further HIV stigma reduction and wellness enhancement include the continued application of this comprehensive community-based HIV stigma reduction and wellness enhancement intervention, with its supporting tenets, content and methodology. This intervention should, however, be expanded into urban and rural communities, and to different cultures as well. It would be meaningful to build HIV stigma reduction community-based networks. More effort could be made to specifically include a workshop for PLWH on psychosocial well-being as well. HIV stigma interventions should be an indisputable part of health behaviour change workshops for PLWH. / PhD (Nursing), North-West University, Potchefstroom Campus, 2014

BAKGRUND: Humant Immunbrist Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) är en pandemi som hårdast drabbat utvecklingsländer i världen. I Sydafrika är 6,300 000 HIV/AIDS positiva. Studier visar att människor som lever i fattigdom utsätts för den största risken att bli drabbad av HIV/AIDS, då utbildning och möjligheten till val av livsstil är låg. Skam och stigmatisering drabbar både människan i fråga och dess närstående. SYFTE: Syftet med studien är att beskriva Sydafrikanska människor upplevelse av sin livssituation efter en HIV/AIDS diagnos. METOD: Litteraturöversikt, åtta artiklar har analyserats för att nå arbetets resultat. RESULTAT: Resultatet är uppbyggt under tre huvudteman; Egenupplevt och samhällets skuldbeläggande hos HIV/AIDS-positiva människor, Viktiga faktorer för att uppnå en känsla av hälsa hos HIV/AIDS-positiva människor samt Behov och längtan av stöd från närstående. Resultatet beskriver att den drabbade värderar anonymitet högt för att undvika samhällets stigmatisering. Gott bemötande hos vårdpersonalen visade sig också vara en viktig faktor för välbefinnande hos människan, men även stöd från familj. Stödet från familjen upplevdes dock i vissa fall som svårt att finna. DISKUSSION: Stigma som är ett stort problem hos den drabbade skulle kunna minskas med utbildning och spridning av kunskap hos allmänheten. Bemötande som ger människan en känsla av trygghet och ett system som är gynnsamt för individens anonymitet är eftersökt. Detta trots att forskning visar att en öppenhet uppmuntras hos de HIV positiva för att minska stigma. Rädslan är dock för stor för att detta skulle kunna bli aktuellt för många

There is ample academic evidence indicating high levels of HIV stigma among BSSA communities. The research suggests that disadvantaged and marginalised social groups like the BSSA communities experience high levels of HIV and sexually transmitted infections. There is a significant amount of quantitative research in the public domain on HIV and stigma. Quantitative research has shown that BSSA communities present late with HIV and sexually transmitted infections often owing to HIV stigma. Currently there is limited published qualitative information on the factors influencing HIV stigma and sexual health seeking behaviour among BSSA communities, particularly from the perspective of the communities themselves. This research study explored beliefs and perceptions in the construction of HIV stigma and sexual health seeking behaviour among Black sub-Sahara African (BSSA) communities in one city in the UK. The Silences Framework, which sits within aspects of feminism, criticalist and ethnicity-based approaches, provided the theoretical underpinning for this study. An exploratory qualitative study methodology was used to identify and explore the key factors influencing the construction of HIV stigma and sexual health seeking behaviour among BSSA communities. Five focus groups and fifteen one-to-one semi-structured follow-up interviews were conducted to collect the data. The institution of Marriage, Religion, Reported HIV statistics, Politics and Immigration, HIV as a Sensitive subject, sexual health professionals Cultural competence, gender stereotyping, Sexual Orientation and Social Media emerged as key pillars underpinning the social scripts associated with the construction of HIV stigma and sexual health seeking behaviour. The experiences emanating from the pillars of HIV stigma, identified in this study, showed the impact of social, political and personal contexts associated with specific sexual scripts among the participants impacting on the construction of HIV stigma and sexual health seeking behaviour. The 'silences' contained in the socially determined scripts were important in understanding the phenomenon under investigation. The findings from this study were reviewed in light of current sexual health policies and strategies to consider how sexual health professionals and services can best meet the health care needs of BSSA communities. This thesis contributes to current knowledge of HIV stigma and ethnicity, by concluding that the construction of HIV stigma and sexual health seeking behaviour among BSSA communities takes place during different contexts of socialization, in a bid to conform to the perceived expectations of society which may be real or imagined. Furthermore, conformity is also influenced by commonly shared and personal appraisal of socially determined relevant issues. These contexts form the bases on which sexual scripts are given meaning and HIV stigma is constructed alongside a socially sanctioned pattern of sexual health seeking behaviour. This study makes an additional contribution in that it is the first time that The Silences Framework has been used to research HIV and stigma among BSSA communities. This research study compliments the currently available pool of quantitative data linking issues of HIV stigma and ethnicity in the United Kingdom. The findings from this exploratory qualitative research study reveal a wide range of critical issues to encourage further qualitative research in the area, while indicating new issues to consider in developing UK based interventions to address HIV stigma and sexual health seeking behaviour among BSSA communities.

abstract: This document analyzes the use of the Principles of Design within the applied project It’s My Party, a multimedia dance theatre production, as a means to address and overcome the stigmatization of the Human Immunodeficiency Virus (HIV). Through the orchestration of dance, music, props, acting, video, and spoken word, this interdisciplinary work investigates how these production elements synthesize into a transformative theatrical experience for audiences. Outlined in this document is the eight month design process. The process included concept design, assessing, processing, customizing the message, script development, rehearsals, and video production, and concluded with an evening length production. Analyzed through the structural narrative of The Hero’s Journey, this autobiographic work details the author’s HIV-positive (HIV+) coming out story from a restorative narrative perspective. By addressing the subject of HIV from a contemporary point-of-view, this project strives to reencode the troubling associations affiliated with HIV with an empowered and hopeful understanding. / Dissertation/Thesis / Masters Thesis Dance 2016

Background: Human immunodeficiency virus (HIV) remains a global challenge with an estimate of 37.9 million confirm cases. Testing remains a critical indicator of HIV diagnosis and treatment, as it is the primary step towards taking accountability for the protection of oneself and the protection of others. Aim: This secondary analysis of Liberia Demographic and Health Survey data from 2013 aimed to statistically describe the association between Knowledge, Attitude, and Practices (KAP), demographics factors such as age, education, marital status, wealth, religion, place of residence, and testing uptake.  Methods: A cross-sectional study of Liberian women (n=7353, aged 15 - 49 ) was performed. Statistical analysis of the chi-square test and logistics regression was employed to identify the association between independent variables (KAP), selected demographics factors, and the dependent variable (HIV testing).   Results: The key findings of the study are that there is a statistically significant relationship between comprehensive knowledge and testing for HIV. The attitude in terms of stigmatizing behavior is also significantly associated with testing uptake. Demographic factors age, education, being ever married, being a Muslim, belonging to the middle class, and living in the rural area are positive determinants of HIV testing in Liberia. The study confirmed that there is no statistically significant association between high-risk behavior and testing uptake among women aged 15-49 in Liberia. Conclusion: Knowledge, stigmatizing attitude, and some demographic factors are determinants of testing uptake in Liberia.

Experiences of stigma, including stigma in religious settings, among individuals who are HIV positive have been widely documented. However, research related to stigma has predominantly focussed on urban locations. As a result, stigma incurred via religious settings in non-urban areas has been underexplored. The aim of this study is to uncover the experiences of individuals who are HIV positive with religious institutions, leaders and congregants in the non-urban American South. A total of 22 participants were interviewed. Experiences with stigma were pervasive with participants often describing anticipation of future stigma (often based on past negative experiences), the experience of stigma, and, for some participants, intersectional or layered stigma related to being both gay, or being perceived as gay, and HIV positive. Our findings suggest that the conditions of the non-urban setting in which this research took place made specific contributions to participants’ experiences of stigma.

The present study investigated the influence of HIV-related stigma, social support, and impact of HIV diagnosis on posttraumatic growth (PTG) in adults living with HIV (N = 126). In addition, the study aimed to identify if social support moderated the relationship between stigma and PTG. Lastly, the study attempted to determine how impactful receiving an HIV diagnosis was to the sample. One hundred and twenty-six adults living with HIV within the state of Florida (41% response rate) participated in the research. Participants were recruited from a series of support groups and HIV focused agencies throughout the state, and responded through face to face survey administration. Each assessment packet consisted of the following assessments: (a) Posttraumatic Growth Inventory; [PTGI], Tedeschi & Calhoun, 1996, (b) Multidimensional Scale of Perceived Social Support; [MSPSS], Zimet, Dahlem, Zimet, & Farley, 1988, (c) Berger HIV Stigma Scale; Berger, Ferrans, & Lashley, 2001, (d) Impact of Event Scale [IES-R . Weiss & Marmar, 1996], (e) Reynolds Short Form Social Desirability Scale; Reynolds, 1982, and (f) a demographic questionnaire. Multiple regression analysis was used to determine whether the independent variables were predictive of the outcome of PTG. Findings from the study revealed that each of the predictor variables (i.e., stigma, social support, and impact of diagnosis) contributed significantly (p<.05) to the model, and accounted for 12% of the variance in PTGI scores. In examining the moderating presence of social support between stigma and PTG, there was no found significant interaction between stigma and social support. Significant differences in PTG scores were also identified amongst differing demographic groups, specifically participant ethnicity and religious orientation. Findings also revealed that 38.5% of the sample reported their HIV diagnosis as so impactful that they would likely qualify for a clinical diagnosis of posttraumatic stress disorder (PTSD). Furthermore, a detailed discussion of previous literature, study procedures and methodology, counselor implications, counselor educator implications, and recommendations for future research are discussed.

This interdisciplinary study combines epidemiological data with anthropological theory to investigate the relationship between HIV transmission rates and systemic homophobia. Previous research has illustrated the link between high levels of structural violence and structural stigma to increased risk of diseases such as the link between African-Americans and heart disease. This study investigates the relationship between systemic homophobia and HIV transmission rates. Through operationalizing homophobia into seven distinct factors, I evaluated systemic homophobia in six countries, assigning a score 1-10 to each factor using secondary source aggregation. I compared composite scores, as well as scores in each operationalized factor to HIV transmission rates in those countries. The results of this study indicate a correlation between systemic homophobia and increased HIV transmission, particularly in respect to the factors Marriage Equality, LGBT Laws, Religiosity, LGBT Visibility, and Hate Crimes. Though various sociocultural factors play a role in HIV transmission, this study indicates that homophobia plays an integral role in HIV transmission. This project has pertinent applications in epidemiology, anthropology and public health illustrating the integral role of sociocultural and systemic factors that increase structural violence and risk for a disease.