This research is an exploratory study, examining how people feel about HIV/AIDS and their reaction towards a person who tested HIV positive. The purpose of the study was to explore factors contributing to the stigma associated with HIV/AIDS in Mamelodi and Atteridgeville. Thirty fieldworkers interviewed a convenient sample of 1077 respondents from different ethnic groups, gender, educational level, marital status and age groups and found that respondents tend to stigmatising persons with HIV/AIDS. This research uses both quantitative and qualitative methods as a research approach. The two methodologies were used with the intention of making some contribution to the methodology of social psychological HIV/AIDS studies. The questionnaire was employed as a quantitative instrument with a view to identify the respondents’ views. The questionnaire consists of five (5) sections: Personal information, health related questions, an HIV knowledge scale consisting of 16 questions and two HIV stigma scales used to assess personal and perceived community stigma. The level of personal stigma attached to HIV/AIDS was found to be lower than the level of stigma perceived in the community. This indicates that people perceive a collective stigma in the community that is negative, blaming, judging and restrictive towards interaction with people with HIV/AIDS. The perception of highly stigmatising attitudes in the community was shared by all sub-groups in the study. Only 22% of people surveyed would be scared or felt uncomfortable sending their child to school with children living with AIDS. Almost 42% of respondents believe that people who were exposed to AIDS through sex got what they deserved. In general, research shows that knowledge of HIV is quite high (95%). / Dissertation (MA (Research Psychology))--University of Pretoria, 2008. / Psychology / unrestricted

The existence of HIV related stigma and discrimination in institutions of learning across the world is well-documented in the literature. It is also well known that factors such as knowledge about stigma and discrimination, fear of infection, social judgment, legal and policy environment act as actionable drivers and facilitators of HIV related stigma and discrimination. However, research works focusing on how various actionable drivers and facilitators are related to different forms of HIV related stigma and discrimination at universities in Nigeria are scanty. The purpose of this study was to explore and describe the individual correlates of HIV-related stigma among undergraduate students at a public university in Nigeria. Methods: Quantitative cross-sectional descriptive design was used. Ethical clearance was obtained from the Research Ethics Committee of the University of South Africa. Permission to access the participants was obtained. The study was conducted at Ambrose Alli University which has a population of over 20,000 students. Informed consent was obtained from the participants. Simple random sampling was used to select 404 participants who were handed self-administered questionnaire. Collected data was analysed using All Pearson Chi-square test and Fishers Exact Test (p<0.05). Validity and reliability were also considered. A total of 391 questionnaires (97%) were returned and considered for analysis. Descriptive summary statistics and cross tabulations were used to analyse The results showed that a high proportion of undergraduate students still have stigmatising behaviours toward people living with HIV. These stigmatising behaviours are associated with certain individual characteristics. Recommendation: There is an urgent need for political leaders and heads of universities to implement policies and programmes that will enhance knowledge regarding HIV AND AIDS and thereby reduce stigmatizing attitudes among undergraduate students. / Health Studies / M.P.H.

HIV has remained a public health problem in Nigeria. The purpose of this cross-sectional study was to examine the effect of social support and HIV-related stigma on depression in people living with HIV/AIDS (PLWHA) and to examine the moderating effect of sociodemographic factors, Quality of Life (QOL), and time since HIV diagnosis on this relationship. This study was based on the social cognitive theory. Data were collected from 98 PLWHA attending the antiretroviral clinic of Federal Medical Center, Umuahia, Nigeria. Regression analyses were used to examine the relationships between the variables. Some 24.5% of the study participants were depressed. Significant relationships identified included negative relationships between depression and social support, positive relationships between depression and negative self-image, and a combination of poor social support and HIV-related stigma having synergic effects in predicting depression. Sociodemographic variables, quality of life, and time since HIV diagnosis did not have a moderating effect on the relationship between social support, HIV-related stigma, and depression in PLWHA. There is a need to improve social support and reduce HIV-related stigma in PLWHA in order to improve their mental health. These findings can help in bringing about positive social change by informing the development of public health initiatives aimed at improving the mental health of PLWHA.

This project is part of a larger study of the Serithi project in which semi-structured interviews were conducted with three hundred and seventeen HIV positive women from disadvantaged locations of Tshwane. In this study, the focus is on women’s experiences of an HIV positive diagnosis and the stigma associated with HIV and their level of disclosure. An analysis was made to whom they disclose, why they choose to disclose and the reaction of the people disclosed to, as well as reasons some people decided not to disclose. Theoretically, the Social Psychology approach was used to provide a theoretical framework as it attempts to understand the relationship between individuals, groups, and behaviour, invariably understanding the relationship between HIV related stigma experienced and the levels of disclosure of the women. As the aim of this study is to gain a deeper understanding of the experiences of HIV related stigma and disclosure encountered by South African HIV positive women, a combination of qualitative and quantitative measures was used. It was established from the research results that upon diagnosis, most women experience negative emotions and thoughts including shock, fear of death, sadness, anger, self-blame and denial. These reactions, however, over time seem to fluctuate and positive reactions such as acceptance of the HIV positive diagnosis and positive thinking come to the fore. Of the three hundred and seventeen respondents used in this study, only one hundred and ninety three women (61%) disclosed their HIV status to at least one person, being either partners (44%), family members (16%), parents (12%), friends (11%), in-laws (1,5%), and or people at work of which less than one percent of the women disclosed to, while 124 (39%) of the women did not disclose to anyone with the exception of the research assistants involved in this study. The issue of disclosure was analysed, and the most people disclosed to were partners, family members and parents. The women stated that it was easy for them to disclose to these people because they knew that they would not be judged and ridiculed. Instead, they felt assured that they would receive unconditional acceptance and support upon disclosure. Reasons for not disclosing included the fear of discrimination, rejection and blame, lack of trust and a supportive relationship. HIV related stigma was assessed through three different types of stigma, namely; 1) Experienced personal stigma (expectations of stigmatised individuals of how others will react to their condition), 2) Perceived community stigma (how the respondents think most people in the community feel and react towards HIV) and 3) Enacted stigma (the actual experiences of discriminatory acts due to their HIV positive status). From these assessments, it was established that respondents perceive community stigma to be the most prevalent and more negative than felt or personal stigma and enacted stigma, which was the least negative. Correlations between the various measures of stigma and disclosure showed that the women’s decision to disclose their HIV status is not only related to their stigma scores. Levels of personal stigma only played a role in disclosure to family members and friends and not in disclosure to partners. Perceived community stigma, which was high, did not have an impact on the level of disclosure. Therefore, the decision to disclose one’s HIV status is not totally influenced or dependent on HIV related stigma because other variables such as the quality of relationships also play a role. This raises the opportunity for further research as to what other aspects may have an impact on the issue of disclosure of one’s HIV positive status. / Dissertation (MA (Clinical Psychology))--University of Pretoria, 2007. / Psychology / unrestricted

Background Globally, external HIV-related stigma is a major threat to all HIV prevention, care and treatment interventions including the recently launched Universal Test and Treat (UTT) strategy in South Africa and the 90-90-90 targets set by UNAIDS for the global response by 2020. The 90-90-90 targets are put in place to track the progression from HIV testing to durable viral load suppression among people living with HIV. The targets guide HIV programmes to achieve 90% known HIV status, to access 90% antiretroviral therapy and to suppress 90% viral loads (UNAIDS, 2017). Achievement of the 90-90-90 targets has since become a part of South Africa's National Strategic Plan for HIV, TB and STIs 2017-2022. External HIV-related stigma in this study was defined as the presence of one or more of the following attitudes and behaviours: rejection, avoidance, intolerance, stereotyping, discrimination, and physical violence towards people living or perceived as having HIV. There have not been many efforts to attenuate HIV-related stigma in South Africa, as it continues to exist. There has been a scale up of other HIV responses, such as HIV Counselling and Testing (HCT) and treatment, with the argument made that in scaling up these biomedical approaches, stigma would disappear. Furthermore, its exact magnitude, trends over the years and correlates have not been explored fully at national level, hence the present study known as Stigma Assessment Study in South Africa (SASSA). SASSA is based on the Institutional Social Construction theory framework. It explores the external HIV-related stigma magnitude and its trends between 2005 and 2012, as well as the associated factors which influence its prevalence in South Africa at a national level. The study further explores the mediating and moderating factors of external HIV-related stigma and tries to explore external HIV-related stigma by viewing individuals with HIV living in families, societies and structures, with the hope of contributing to the development of new systematic HIV-related stigma interventions in South Africa as well as, strengthening existing ones. Methodology The project used secondary data obtained from three South African national population HIV surveys which were conducted in 2005, 2008 and 2012 by a research consortium led by the Human Sciences Research Council. Sub-samples of the original surveys consisting of respondents aged 15 years and older who had responded to the stigma questions in the three surveys were extracted and included in the SASSA analysis. A nationally representative sample of a total of 16 140 individual respondents from the 2005 survey, 13 134 from the 2008 survey and 30 748 from the 2012 survey was used in the study. Two different measures of external HIV stigma are used in this analysis, one is a summary measure from the latest survey data, i.e. 2012, which was used to do a regression analysis. The summary measure was regarded as reliable to use for the regression analysis as it provides crude effect of the exposure factors on external HIV stigma. However, this summary measure was not included in the previous surveys, i.e. 2005 and 2008, and therefore could not be used for trends analysis. We therefore used 4 individual stigma items for the trends analysis as these were included in all 3 surveys. The use of 4 individual stigma items was important because when data from a variety of sources or categories have been joined together, the meaning of the data can be difficult to see. It was therefore considered ideal to assess the performance of the individual constructs on their individual contribution to the impact on HIV external stigma. Furthermore, analysis using individual constructs provided an opportunity to see specific patterns which could have remained obscure in crude analysis. The first measure of external HIV-related stigma used in the regression analysis was measured by five individual items which elicited attitudes towards people living with HIV (PLHIV). The five items were based on a 9-item scale that was originally developed and tested in a South African population, and the 9-item scale was found to be internally consistent (alpha = 0.75) and reliable (r = 0.67). The 5 items were (1) People who have AIDS are dirty; (2) People who have AIDS are cursed; (3) People who have AIDS should be ashamed; (4) People with AIDS must expect some restrictions on their freedom; (5) A person with AIDS must have done something wrong and deserves to be punished. As explained above, the specific external HIV stigma patterns second measure, which was utilized to explore stigma trends over the years 2005, 2008 and 2012, consists of four individual stigma items which elicited attitudes towards PLHIV. The four individual stigma items included: (1) If you knew that a shopkeeper or food seller had HIV, would you buy food from them? (2) Would you be willing to care for a family member with AIDS? (3) Is it a waste of money to train or give a promotion to someone with HIV/AIDS? (4) Would you want to keep the HIV positive status of a family member a secret? Findings Overall, external HIV-related stigma was found to exist among 38.3% of adult South Africans in 2012. Multiple regression analysis showed that predictors of external HIV-related stigma were race, sex, education level, self-perceived risk of HIV infection and HIV knowledge (p< 0.01). Females were less likely to report external HIV-stigma than males (AOR = 0.9, P< 0.001). Those who perceived themselves to be at high risk of HIV infection were less likely to display some stigma than those who believed they were at low risk (AOR = 0.89, p < 0.01). The study did not find any significant associations between HIV testing or awareness of HIV status, with external HIV-related stigma in this study. Looking at the individual external HIV stigma items used to measure trends, the study reveals a slight decrease in the reporting of stigma over the three time periods (2005 vs 2008 vs 2012) on responses for two of the stigma items (Q1: If you knew that a shopkeeper or food seller had HIV, would you buy food from them, and Q2: Would you be willing to care for a family member with AIDS). While an increase was observed in the reporting of stigma over the three years on responses for two of the stigma items (Q3: Is it a waste of money to train or give a promotion to someone with HIV/AIDS, and Q4: Would you want to keep the HIV positive status of a family member a secret). The structural equation modelling (SEM) showed likelihood ratio test results with a p-value greater than 0.05, a root mean square error of approximation (RMSE) of 0.008 and Tucker–Lewis index (TLI) value of 0.985. The model fit assessment results allow us to accept that an hypothesized model of the study is not far from a perfect model. The SEM results also showed a direct effect of sex on HIV knowledge statistically significant at p < 0.001, with race having an effect of 3.3% and education a direct effect of 9.5%, and both of these showed a statistically significant effect (p < 0.001) respectively. HIV knowledge showed to have a statistically significant inverse relationship on external HIV stigma of -10.4% (95% CI: -12.3-0.09) p< 0.001. Awareness of HIV status had the highest positive direct effect on external stigma of 10% (95% CI: 4.41-15.67%) p<0.001. With regard to indirect effects, sex, race, and education had minimal negative indirect effects on external stigma, which was statistically significant for all the three covariates. With the said effects of external HIV-related stigma, it was found that HIV knowledge independently mediates the relationship between Level of Education, Awareness of HIV status, Race, HIV testing history, and Sex, with External HIV-related stigma. Conclusion External HIV-related stigma still exists in South Africa despite previous success in massive ART rollout, HTC campaigns, and most recently test-and-treat programmes, which were arguably thought to have a parallel effect in the decrease of HIV related stigma. The focus on individualistic health structural approaches that do not generally have stigma-reduction as a specific aim, as discussed, is likely to undermine the successes achieved in the fight against HIV thus far. There is a need to develop innovative holistic interventions which are specifically intended for HIV stigma reduction. These should be inclusive of both social institutional elements and health structural elements to address the challenge of external HIV-related stigma.

Philosophiae Doctor - PhD / The growing interest in the well-being of children who have been orphaned due to HIV/AIDS is widely reflected in the emerging body of research. Children orphaned by AIDS-related causes are identified as a vulnerable population of youth who display lower levels of psychosocial well-being and experience increased psychosocial distress. While HIV-related stigma remains a salient risk factor hindering the psychosocial well-being of children orphaned by AIDS, the concept remains elusive and poorly understood. Hence, the call for a comprehensive understanding to support an effective response to stigma reduction, and for the systematic identification and response to the psychosocial needs and challenges of children in the context of HIV/AIDS. The overall aim of this study was therefore to develop a model to understand the manner in which HIV-related stigma affects the psychosocial well-being of children orphaned by AIDS. A mixed method, exploratory, sequential design situated within a theory generative research approach was implemented in four sequential phases geared towards model development. The specific objectives of this study were to: (1) review existing literature focusing on the relationship between HIV-related stigma and the psychosocial well-being of children orphaned by AIDS (systematic review); (2) explore children orphaned by AIDS perceptions and experiences of HIV-related stigma (qualitative exploratory design); (3) develop a model that offers an understanding of the manner in which HIV-related stigma affects the psychosocial well-being of children orphaned by AIDS (a theory generative design); and (4) determine the functionality of the developed model through the use of the Delphi technique (a modified Delphi technique). The systematic review conducted in Phase I indicated the presence of HIV-related stigma, which inhibited the psychosocial well-being of children orphaned by AIDS. The findings further highlighted the mediating role of maladaptive coping strategies and social support likely to reduce healthy psychosocial well-being and cause psychosocial distress among children orphaned by AIDS. Similarly, the findings arising from the qualitative exploration in Phase II indicated that children orphaned by AIDS were highly perceptive and experienced HIV-related stigma as a result of parental illness and death. These experiences negatively affected the psychological, emotional, and social well-being, self-concept and self-esteem, and future orientation of children orphaned by AIDS. The theory generative design in Phase III identified, classified, and defined six focal concepts upon which the model is based, namely, (1) enacted stigma, (2) perceived stigma, (3) internalized stigma, (4) coping strategies, (5) psychosocial well-being, and (6) interpersonal relations. The developed relationship statements of the model indicated: (1) the bidirectional relationship between enacted, perceived, and internalized stigma; (2) the mediating role of coping strategies; (3) the direct and indirect influences of HIV-related stigma on the psychosocial well-being of children orphaned by AIDS; and (4) the contextual role of interpersonal relationships in which the process of stigmatization may unfold. The modified Delphi technique conducted in Phase IV indicated that the developed model was simplistic, clear, generalizable, accessible, and important for use in research and practice. The developed model will aid future studies by providing a theoretical lens through which HIV-related stigma and its influence on the psychosocial well-being of children orphaned by AIDS may be viewed. HIV-related stigma should be considered strongly when addressing the well-being of orphaned children, so that tailored programs, interventions, and services may be set in place to effectively bring about the reduction of stigma and ensure the psychosocial well-being of children. The recommendations set out serves to further inform practice and programs and form a baseline for future empirical research focusing on HIV-related stigma and the psychosocial well-being of children orphaned by AIDS.

HIV has remained a public health problem in Nigeria. The purpose of this cross-sectional study was to examine the effect of social support and HIV-related stigma on depression in people living with HIV/AIDS (PLWHA) and to examine the moderating effect of sociodemographic factors, Quality of Life (QOL), and time since HIV diagnosis on this relationship. This study was based on the social cognitive theory. Data were collected from 98 PLWHA attending the antiretroviral clinic of Federal Medical Center, Umuahia, Nigeria. Regression analyses were used to examine the relationships between the variables. Some 24.5% of the study participants were depressed. Significant relationships identified included negative relationships between depression and social support, positive relationships between depression and negative self-image, and a combination of poor social support and HIV-related stigma having synergic effects in predicting depression. Sociodemographic variables, quality of life, and time since HIV diagnosis did not have a moderating effect on the relationship between social support, HIV-related stigma, and depression in PLWHA. There is a need to improve social support and reduce HIV-related stigma in PLWHA in order to improve their mental health. These findings can help in bringing about positive social change by informing the development of public health initiatives aimed at improving the mental health of PLWHA.

BACKGROUND: Despite advances at every stage of the HIV care continuum, HIV-related stigma still presents a significant barrier to accessing care globally for people living with HIV (PLWH). The effect of stigma and discrimination on treatment adherence and health outcomes is especially worsened for younger PLWH belonging to key vulnerable populations and identifying within intersectional gender and/or sexual minorities. In Latin America young PLWH, especially those identifying as MSM (men who have sex with men) and TGW (transgender women) are at a disproportionately higher risk of facing HIV-related stigma, and subsequent under-utilization of HIV prevention and treatment services. Social media-based HIV stigma-reduction campaigns present a growing area of research in designing interventions to disseminate health resources, normalize prevention and treatment, and reduce the harmful HIV-related stigmas PLWH may face. This project’s aims are two-fold: to understand the stigmatizing beliefs and experiences young PLWH living in Lima, Peru encounter, and to identify the key messages and features they believe would be most effective for dissemination in a future HIV stigma-reduction social media campaign. METHODS: This study was conducted as a qualitative focus group interview study in Lima, Peru from November 2022 to February 2023. Interview questions covered their experiences of stigma and suggested messages for social media, and were structured using an interview guide. Participants were recruited from 4 key groups of PLWH: adolescents/young adults with perinatally-acquired infection, adolescents/young adults with recently-acquired infection, young MSM, and young TGW. Creation of a pilot codebook and subsequent qualitative analysis of focus group data were conducted using thematic content analysis and conceptual frameworks determined to be in line with objectives. RESULTS: 7 focus group interviews were conducted with 48 participants aged 17 to 29 years old. Participants represented a diverse range of gender and sexual identities. Participants across all groups faced a range of HIV-related discriminatory/stigmatizing behaviors and stereotypes affecting multiple aspects of everyday life, from relationships with close family and friends to schooling and employment prospects and accessing medical care. Suggestions for future messaging content and design included creating content addressing health-related misconceptions for PLWH navigating their diagnosis and the general public, portraying PLWH with more positivity and normalcy, recruiting influencers from backgrounds not typically targeted in HIV messaging to disseminate content to larger audiences, and creating both short- and long-form content formats to share on social media platforms for engaging users of different ages/demographics. CONCLUSION: Based on the range of different encountered stigmas and messaging suggestions shared by young PLWH, future HIV stigma-reduction social media campaigns should feature accurate health and social messages from a diversity of societal leaders and PLWH, span a breadth of content formats, and do so with tones of optimism to educate the general public and shift attitudes to empower young PLWH as they move forward in their lives. / 2026-03-08T00:00:00Z

Certain individual and institutional factors such as knowledge about stigma and discrimination, fear of infection, social judgement, legal and policy environment act as actionable drivers and facilitators of HIV-related stigma and discrimination. These factors may hinder the utilisation and quality of care provided to people living with HIV. Purpose: The purpose of the study was to establish the actionable drivers and facilitators that determine the different forms of HIV-related stigma and discrimination among healthcare professionals at a district hospital in Malawi. Methods: The study used a descriptive correlational study. Data was collected through self-administered questionnaire. Data were analysed using SPPS and STATA 12. Fisher's Exact Test was used to conclude the association and binary logistic regression was used to model the degree of the statistical relationships. Results: The results showed statistically significant relationship between knowledge of stigma and discrimination, social judgement and awareness of workplace policy and HIV-related stigma and discrimination. Recommendations: Interventions aimed at increasing knowledge about HIV-related stigma, reducing social judgement, reinforcing HIV-related workplace policies are needed to reduce HIV-related stigma and discrimination in healthcare settings. / Health Studies / M. Ph. (Health Studies)

HIV/AIDS research has proven crucial in an effort to prevent and manage this epidemic. However, there is little research being done in an attempt to understand the internal worlds of those living with HIV/AIDS. The purpose of this research was to begin to explore the relationship that exists between the person living with HIV/AIDS and the virus, as an internal object, inside them. This study focused on 6 women who were on Anti-Retroviral Medication (ARVs), and who have been diagnosed for at least one year. The participants’ mental representations of the virus as an object inside them was explored, as well as how they experienced and viewed the triangular relationship that exists between themselves, the HI Virus, and the ARVs. This exploratory research utilised a qualitative framework in order to understand and explore these relationships and perceptions, with psychoanalytic theory being used a lens through which to view the data that emerged. In depth semi-structured interviews were conducted with the participants, and the corpus of data was analyzed using a thematic content analysis. In addition, the participants were asked to draw the virus inside their bodies. These were analyzed using a technique devised by Paola Luzzatto (1987) in a study exploring the internal world of drug-abusers. For the purpose of this study, a variation of the same art therapy technique was used in that the participants were asked the ‘draw the virus in their bodies’. Whilst the drawings allowed for insight into the internal worlds of the participants, the drawings were also used as a point of departure. For most of the women, HIV was drawn using a red crayon, whilst the ARVs were drawn in either yellow or green. As depicted in the drawings, post diagnosis the HIV/red seemed to cover most of the body, but later when the ARVs/green was added, more of a balance was achieved. Results show that for these women, HIV was often perceived as dangerous and criminal, whilst the ARVs were often associated with security. From the perspective of Kleinian theory, the perception of the HIV and the ARVs seemed to be dependent upon the position from where they were functioning: either a paranoid-schizoid or a depressive position.