HIV-related stigma and discrimination is a complex concept that affects HIV reduction interventions. HIV-related stigma occurs among healthcare providers resulting in reduction of quality of care of people living with HIV. Social psychological research into stigma reduction has led to the development of many stigma reduction interventions, but has not resolved the underlying problem. This study was designed to identify predictors of stigmatizing behavior among healthcare workers in Ghana using the social cognitive theory (SCT) for use in developing an evidence-based intervention. The study used a cross-sectional research design incorporating a preexisting survey, Measuring HIV Stigma and Discrimination Among Health Staff: Comprehensive Questionnaire. Survey data were analyzed using descriptive, multiple regression analysis and Pearson's coefficient to estimate the relationship between the dependent variable, HIV related stigmatizing behavior, and independent variables, personal attributes and environmental factors. The key findings from the analysis were that the personal attributes of healthcare workers predicted their stigmatizing behavior (R2= 0.674, p < 0.05). There was, however, no significant relationship between environmental factors and stigmatizing behavior and between personal attributes and environmental factors. The social change implications may be to reduce stigma among healthcare workers toward people living with HIV and in turn increase the willingness of healthcare workers to engage with people living with HIV and provide quality service to them.

Background: HIV- and MSM-related stigma are well documented as common for Chinese men who have sex with men (MSM) living with HIV, yet there is sparse literature on intimate partner violence (IPV) and its relationship with stigma in this vulnerable population. To evaluate the association between HIV-stigma and stigma related to homosexuality and IPV among newly HIV-diagnosed MSM in China. Methods: Data were collected in the baseline survey among newly HIV-diagnosed Chinese MSM in a randomized clinical trial via face-to-face interviews. Univariate logistic and multivariate logistic regression analyses were performed to assess the associations between IPV and HIV- and MSM-related stigma. Results: Of 367 newly HIV-diagnosed Chinese MSM, 23.7% experienced any IPV, including 16.6% physical, 7.4% psychological and 5.2% sexual IPV. Positive associations were found between HIV- and MSM-related stigma and IPV. Men with high HIV-related stigma (score ≥ 27) were 1.67 times as likely to experience any IPV as those with low stigma (adjusted odds ratio [AOR]: 1.67, 95% confidence interval [CI]: 1.02-2.76). Men with high MSM-related stigma (score ≥ 6) were 1.99 times as likely to experience any IPV as those with low stigma (AOR: 1.99, 95% CI: 1.18-3.36). Conclusions: HIV- and MSM-related stigmas was positively associated with IPV experiences among newly diagnosed MSM in China. The manner in which stigma may exacerbate IPV, and/or the influence of IPV on worsening stigma should be further evaluated. The high prevalence of IPV and stigma in this population suggests that interventions should be taken to reduce stigma and prevent this risky behavior among MSM.

Introduction: Men who have sex with men (MSM) are more likely to experience Intimate partner violence (IPV) during their lifetime than heterosexual couples. HIV-status and related HIV stigma may play an important role in IPV within intimate partnerships among MSM. HIV- and MSM-related stigmas are common among Chinese MSM, yet there is sparse literature on IPV and its relationship with stigma in this vulnerable population. We evaluate the prevalence of IPV and its relationship with HIV- and MSM-related stigma among newly diagnosed HIV-infected MSM in Beijing, China. Methods: Data were collected in the baseline survey among newly HIV-diagnosed Chinese MSM in a randomized clinical trial via face-to-face interviews. Simple and multiple logistic regression analyses were performed to assess the associations between IPV and HIV- and MSM-related stigma. Results: Of 367 newly HIV-diagnosed Chinese MSM, 23.7% experienced any IPV, including 16.6% physical, 7.4% psychological and 5.2% sexual IPV. Positive associations were found between HIV- and MSM-related stigma and IPV. Men with high HIV-related stigma (score ≥27) were 1.68 times as likely to experience any IPV as those with low stigma (adjusted odds ratio [AOR]: 1.68, 95% confidence interval [CI]: 1.03-2.76). Men with high MSM-related stigma (score ≥6) were 1.98 times as likely to experience any IPV as those with low stigma (AOR: 1.98, 95% CI: 1.19-3.31). Men with high HIV- and MSM-related stigma were 2.86 times as likely to experience any IPV as those with low stigma (AOR: 2.86, 95% CI: 1.44-5.69). Conclusion: HIV- and MSM-related stigma was positively associated with IPV experiences among newly diagnosed MSM in China. The manner in which stigma may exacerbate IPV, and/or the influence of IPV on worsening stigma should be further evaluated. The high prevalence of IPV and stigma in this population suggests that interventions should be taken to reduce stigma and prevent this risky behavior among MSM.

Marginalization and stigmatization heighten the vulnerability of sexual minorities to inequitable health outcomes. Although men who have sex with men (MSM) are at elevated risk for HIV infection in India in comparison with the general population, there is a lack of MSM-focused research—particularly regarding stigma and mental health outcomes. This dissertation aimed to explore the influence of sexual stigma, gender non-conformity stigma and HIV-related stigma on depression and life satisfaction among MSM in South India. This study used a cross-sectional survey design and was conducted with MSM (n=200) in two locations in Tamil Nadu, South India: Chennai (urban) and Kumbakonam (semi-urban). Due to multicollinearity between sexual stigma and gender non-conformity stigma, the stronger predictor of each outcome (gender non-conformity stigma) was included in regression models. Results were analyzed to identify the associations between independent (gender non-conformity stigma, HIV-related stigma), moderator (social support, resilient coping) and dependent (depression, life satisfaction) variables. Due to significant differences between locations across a substantial number of variables, block regression analyses were conducted separately for each location. Higher levels of depression were predicted by gender non-conformity stigma in both locations, and also by HIV-related stigma in Kumbakonam. Lower levels of depression in both locations were predicted by higher levels of social support and resilient coping. Higher life satisfaction was predicted by social support and resilient coping in both Chennai and Kumbakonam. Lower life satisfaction was predicted by gender non-conformity stigma and HIV-related stigma in Kumbakonam, but not in Chennai. Social support and resilient coping did not moderate the impact of stigma(s) on depression or life satisfaction in either location. The results indicate that the majority of participants experienced stigmatization based on same-sex sexual behaviour and/or gender non-conformity. Another striking finding of the study was the alarmingly high rates of depression, whereby over half of participants in each region reported moderate to severe depression scores. Practice and policy implications include the development, implementation and evaluation of: multi-level stigma reduction interventions that account for socio-environmental and contextual factors; mental health interventions that promote resiliency and build social support; and policy initiatives to advance human rights protection.

Marginalization and stigmatization heighten the vulnerability of sexual minorities to inequitable health outcomes. Although men who have sex with men (MSM) are at elevated risk for HIV infection in India in comparison with the general population, there is a lack of MSM-focused research—particularly regarding stigma and mental health outcomes. This dissertation aimed to explore the influence of sexual stigma, gender non-conformity stigma and HIV-related stigma on depression and life satisfaction among MSM in South India. This study used a cross-sectional survey design and was conducted with MSM (n=200) in two locations in Tamil Nadu, South India: Chennai (urban) and Kumbakonam (semi-urban). Due to multicollinearity between sexual stigma and gender non-conformity stigma, the stronger predictor of each outcome (gender non-conformity stigma) was included in regression models. Results were analyzed to identify the associations between independent (gender non-conformity stigma, HIV-related stigma), moderator (social support, resilient coping) and dependent (depression, life satisfaction) variables. Due to significant differences between locations across a substantial number of variables, block regression analyses were conducted separately for each location. Higher levels of depression were predicted by gender non-conformity stigma in both locations, and also by HIV-related stigma in Kumbakonam. Lower levels of depression in both locations were predicted by higher levels of social support and resilient coping. Higher life satisfaction was predicted by social support and resilient coping in both Chennai and Kumbakonam. Lower life satisfaction was predicted by gender non-conformity stigma and HIV-related stigma in Kumbakonam, but not in Chennai. Social support and resilient coping did not moderate the impact of stigma(s) on depression or life satisfaction in either location. The results indicate that the majority of participants experienced stigmatization based on same-sex sexual behaviour and/or gender non-conformity. Another striking finding of the study was the alarmingly high rates of depression, whereby over half of participants in each region reported moderate to severe depression scores. Practice and policy implications include the development, implementation and evaluation of: multi-level stigma reduction interventions that account for socio-environmental and contextual factors; mental health interventions that promote resiliency and build social support; and policy initiatives to advance human rights protection.

Stigma is broadly considered as an important obstacle in HIV prevention and treatment. In Mozambique, more PLWHIV have access to treatment than ever. ART increased their QoL and created a new context for stigma production. This cross-sectional study conducted in Northern Mozambique explored a possible association between stigma and QoL. The Berger Stigma Scale and WHOQOL-BREF were used to measure levels of HIV-related stigma and perceived QoL in two groups of PLWHIV receiving ARV, with participation in a HBC programme as the independent variable. The study uncovered a weak to moderate negative correlation between stigma and QoL scores. Statistically significant differences were discovered between the groups’ scores on the Berger Stigma Scale and a higher perceived QoL for PLWHIV in the HBC group on three WHOQOL-BREF subscales and on the overall score. The scores on the social relationships subscale indicated lower perceived QoL for PLWHIV in the HBC group. / Sociology / M.A. (Social Behaviour Studies in HIV/AIDS)

Stigma is broadly considered as an important obstacle in HIV prevention and treatment. In Mozambique, more PLWHIV have access to treatment than ever. ART increased their QoL and created a new context for stigma production. This cross-sectional study conducted in Northern Mozambique explored a possible association between stigma and QoL. The Berger Stigma Scale and WHOQOL-BREF were used to measure levels of HIV-related stigma and perceived QoL in two groups of PLWHIV receiving ARV, with participation in a HBC programme as the independent variable. The study uncovered a weak to moderate negative correlation between stigma and QoL scores. Statistically significant differences were discovered between the groups’ scores on the Berger Stigma Scale and a higher perceived QoL for PLWHIV in the HBC group on three WHOQOL-BREF subscales and on the overall score. The scores on the social relationships subscale indicated lower perceived QoL for PLWHIV in the HBC group. / Sociology / M.A. (Social Behaviour Studies in HIV/AIDS)

This study explores the subjective experiences of mothers living with HIV from Southeastern Ontario when accessing health and social services. Drawing on principles of feminist participatory action research, 5 MLWH were brought together in order to share their stories of accessing health and social services and to participate in the creation of a collage as part of the storytelling process. Intersectional feminist theory was chosen as a theoretical lens for this project to highlight the ways women’s multiple identities intersect and contribute to HIV-stigma. Emerging from the storytelling and arts based process were stories about the women’s interactions with the criminal justice system, Children’s Aid Societies, social welfare programs and women-specific supports. The key concerns that the women raised in connection to these interactions included having to re-tell their story, concerns about confidentiality and disclosure and experiencing a loss of control as a result of depending on a myriad of health and social services. In addition, the participants identified changes they would like to see within health/social services including more opportunities for peer support and an increase in services available to support the unique psychosocial challenges of MLWH. / Thesis / Master of Social Work (MSW)