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Correlations between stigma and self-esteem in mental health consumersPitts, Marilyn Dee 01 January 2004 (has links)
The purpose of this study was to measure correlations of stigma with self-esteem among individuals who are receiving treatment for a mental illness.
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I feel for you, therefore, I respond on your behalf: Social psychological processes leading to and consequences of vicarious humiliationVorster, Anja 10 1900 (has links)
Vicarious humiliation as a devaluing intergroup event is a rather common experience, which has the potential to adversely influence present and future intergroup relations. Based on an extensive literature review and previous research, we hypothesised that highly identified group members experience an intensified feeling of humiliation after witnessing an ingroup member being humiliated when compared to low identifiers (Hypothesis 1), that the role of visual exposure as situational determinant of humiliating events, the appraisals, and the emotional patterns elicited, differ between personally and vicariously humiliating events (Hypotheses 2a, 2b, 3 and 4), and lastly, that vicarious humiliation regulated through emotional blends leads to behavioural intentions that influence future intergroup relations (Hypotheses 5a to 5c). Evidence for our hypotheses was exploratively and experimentally provided in six studies. Results implied that vicarious humiliation is a common experience, that visual exposure as situational determinant is more important for personally than vicariously humiliating events, and that humiliation is indeed a blended emotion (Study 1, N = 1048). Moreover, results showed that highly identified group member feel relatively stronger humiliated (Study 2, N = 175), that the appraisal and emotional patterns are related to identity processes (i.e., personal and vicarious humiliation) (Study 3, N = 74; Study 4, N = 359; Study 5 = 376), and that the feeling of humiliation and accompanying emotions regulate the relationship between vicariously humiliating events and the intentional responses such as avoidance, non-normative approach, dehumanisation and social exclusion (Study 6, N = 998). Overall, our results imply that vicarious humiliation as an emotional experience has the potential to provoke intergroup conflict.
SUMMARY
The present research studied a phenomenon that we are all familiar with – being humiliated. Unfortunately, this is an experience that is rather common as we might not only experience to be humiliated personally but also to be humiliated on behalf of others. It is this vicarious experience of humiliation that the present research aimed at studying. We firstly explored people’s experiences with and understandings of humiliation through a cross-sectional survey (Study 1). Results indicated that vicarious humiliation is indeed a rather common experience, that personally and vicariously humiliating events differ in terms of the situational determinants that characterise these events, and that the feeling of humiliation is experienced as a blended emotion. We furthermore tested experimentally the effects of ingroup identification, identity processes and the presence of an audience on the appraisal processes of and the emotional and motivational responses to vicarious humiliation. We found that people who highly identified with the group they share with the humiliated person, experienced stronger feelings of humiliation (Study 2), and that being personally humiliated and being vicariously humiliated resulted in different appraisal patterns, which consequently elicited the different emotional blends of humiliation with self-focused and other-focused emotions, respectively (Studies 3 to 5). We were, however, unable to provide evidence that the presence of an audience aggravated the appraisal processes and the feeling of humiliation (which we attributed to methodological limitations of our studies). That the emotional blends of humiliation regulate the behavioural intentions, that people engage in as a result of being vicariously humiliated, was demonstrated in our last study (Study 6). More specifically, we found that humiliation accompanied by self-focused emotions was related to intentions to avoid, to non-normatively approach, and/or to socially exclude the humiliator(s) through dehumanising them. It is this latter finding that provides evidence for both the role of the social context that might determine the appropriateness of certain behaviours (e.g., social norms) and for the proposed cycle of humiliation in that humiliated persons are often believed to retaliate by humiliating the humiliator(s) in return, which has the potential to provoke intergroup conflicts. / Psychology / D. Phil. (Psychology)
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Äppelhyllan : Inkluderande eller intetsägande? / The Apple Shelf : Inclusive or ambiguous?Bjarås, Jeanette, Wetterlin, Felicia January 2023 (has links)
Introduction. The Apple shelf is an established concept at public libraries in Sweden. These shelves contain accessible books and other media for disabled people of varying ages. A recent discussion within the librarian profession challenges the name – is there a better alternative to “The Apple shelf”? Our study aimed to gather both librarian and target group opinions of the current name and its suggested alternatives, and attempts to understand potential stigmatization with the application of Goffmans stigma theory. Method. A multimethod (triangulation) approach was applied to collect data. An online survey was sent to all public libraries in the regions of Västerbotten, Västmanland and Uppsala; semi-structured interviews were conducted with librarians, parents of disabled children, and a disabled youth accompanied by an aide; and an instance of participant observation was done in a network meeting setting. Recorded and transcribed interviews, survey responses, and meeting notes respectively formed the basis for the study’s analysis. Analysis. A qualitative thematic analysis of the collected data found 4 common themes: (1) User and Target Group, (2) Name, (3) Shelf Arrangement, and (4) Awareness and Marketing. Goffman’s stigma theory was applied to each theme to highlight stigmatization risks related to both the existing name and proposed alternatives. Results. The Apple Shelf caters to a wider audience than originally intended. Both the current ”Apple Shelf” name and its proposed alternatives have advantages and disadvantages related to stigmatization. Conclusion. Regardless of what name is chosen for Apple shelf it must be explained and marketed to the public. We argue that including disabled people in library changes, as well as actively updating and promoting the shelf locally, are more important than this change of name. This is a two-year master’s thesis in Library and Information Science.
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"去污名化"的政治: 中国乙肝携带者与公民社会组织的反歧视抗争. / 中国乙肝携带者与公民社会组织的反歧视抗争 / 去污名化的政治 / Politics of de-stigmatization: anti-discrimination social movements among HBVers and NGOs in China / CUHK electronic theses & dissertations collection / "Qu wu ming hua "de zheng zhi: Zhongguo yi gan xie dai zhe yu gong min she hui zu zhi de fan qi shi kang zheng. / Zhongguo yi gan xie dai zhe yu gong min she hui zu zhi de fan qi shi kang zheng / Qu wu ming hua de zheng zhiJanuary 2013 (has links)
近年来,针对就业和就学中遭遇歧视的困境,中国乙肝携带者发起一场要求消除歧视、维护合法权益的抗争运动。为什么乙肝携带者就业歧视问题在中国如此显著?面对国家和市场这两大最具权势的系统,公民社会将何以对抗?本文旨在从社会学的视角对这场“将‘乙肝’去除"的运动进行解读。 / 本文采用个案研究方法,以北京益仁平中心为主要研究对象,围绕 “乙肝"在中国的建构和重构过程,将研究聚焦于三个方面:第一,乙肝污名化过程以及国家、市场中的话语权;第二,反乙肝歧视维权运动的条件和动员机制;第三,“将‘乙肝’去除"中的政治和权力话语三角。 / 本文从社会运动理论中的资源动员、政治机会结构和框架理论出发解读中国乙肝携带者的维权运动;将运动中的微观景象与宏观社会结构结合起来,考察影响乙肝携带者维权运动的主要因素以及运动的动员机制。研究伊始分别从国家和市场两个领域审视乙肝歧视问题在中国的建构过程,阐明乙肝污名化是政府权威以及市场中医药商和医学权威共谋下的合力作用,从而为乙肝携带者反歧视抗争运动的后续研究选择一个合适的立足点。笔者在案例中发现,组织在维权运动中将乙肝携带者群体动员起来,采取有效的策略,充分利用其在资源获得方面的优势、建立乙肝维权组织网络、善于把握时机营造政治机会空间、并能够吸纳律师和媒体的专业力量是维权行动能取得成功的重要因素。 / 组织在维权行动中的话语框架对运动的发展至关重要。乙肝携带者群体对组织运动框架的认同是动员成功的基础;掌握定义“乙肝"的主动权、运动领袖的可信性、框架话语表达的日常化、与媒体的良好关系等策略有助于框架在动员中与参与者、旁观者产生共鸣;抗争精英通过话语框架为抗争活动提供合法性。 / 反乙肝歧视维权运动可以看作是一个“将‘乙肝’去除"的“去污名化"运动。一方面,中央政府与地方政府有着各自自主性利益;另一方面,乙肝携带者群体内部就抗争形式也难以统一,这两种分裂情况交叉形成了一个围绕“将‘乙肝’去除"的,以规则、效益和权利为话语的权力三角,支撑反歧视行动的抗争空间。权力三角的多变性决定去除“乙肝"的行动是有策略的、冒险的,但却相对稳定。 / Hepatitis B Virus carriers (HBVers) have launched series social movements targeting at eliminating discriminations against HBVers in job market and promoting fair employment in recent decade of years. Why does nowhere match the HBV discrimination in such country like China? How is contentious politics possible when the powerless engage in struggles with power holders, like state and market in China? The thesis attempts to learn the intricacies of body politics with sociological approaches. / Yirenping, a NGO located in Beijing, is selected as research object in this case study. Concentrating on the political nature of the HBV confrontations, this thesis is comprised of three parts: first, the stigmatization of HBV in China; second, tactics and strategies that employed against the system of discrimination; third, the politics of “Removing HBV" and the power triangle among state, market and civil society. / The analysis of the HBV movement is informed by three sociological theories of social movements: resource mobilization, political opportunity structure and framing, meanwhile macro structure and micro interaction are combined. It is postulated that this disease discrimination in China occurs when confronting an entrenched stigmatization conjoined from both state and market dedicated to keeping the HBVers excluded and marginalized, which serves as a departure point for further analysis of the struggles for power against this discrimination. Resources mobilized, leaderships and organizations, networks among HBVers and outside supporters, strategies in mobilization positively facilitate the anti-discrimination movements. Utilizing the institutional advocacies as well as informal networks with officials, NPC & CPCCC delegates open more political opportunities within the preexisting political environment. / Framing is essential to the movement mobilization. Identifying closely with the visions and missions in movements, the self conceptualization of HBV-discrimination, charismatic leaders, the everyday narrative of the frame, as well as strategic media coverage help promoting resonance among movement participants and standers-by. Framing strategies provide legitimacy for HBV selves in collective movements. / Finally, the thesis came to the conclusion that anti-discrimination-against-HBVers social movements in China can be interpreted as a process of struggle to “Removing HBV" power. Central government and local ones have their autonomies and interests respectively, while weak but observed divisions in protesting strategies also exist within the HBVers, which shape a triangle of power struggles among the dominant and dominated groups. The power triangle is flexible, and the “Removing HBV" movements are strategic, risk-taking, while being routinized. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / 郭娜. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2013. / Includes bibliographical references (leaves 137-156) / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in Chinese and English. / Guo Nuo. / 中文摘要 --- p.i / 英文摘要 --- p.ii / 引言 --- p.1 / Chapter 第一章 --- 导论 乙肝:作为医学问题和作为社会问题 --- p.3 / Chapter 1.1 --- 作为医学问题的乙型肝炎及其全球地理分布 --- p.3 / Chapter 1.2 --- 乙型肝炎在中国 --- p.6 / Chapter 1.3 --- 作为社会问题的乙肝歧视 --- p.8 / Chapter 1.4 --- 研究方法 --- p.10 / Chapter 1.5 --- 小结 --- p.14 / Chapter 第二章 --- 研究问题与文献回顾 --- p.15 / Chapter 2.1 --- 社会运动理论的发展脉络 --- p.16 / Chapter 2.2 --- 认同与社会运动的动员 --- p.21 / Chapter 2.3 --- 中国底层社会与维权抗争研究回顾 --- p.24 / Chapter 2.4 --- 中国反乙肝歧视运动的分析框架 --- p.26 / Chapter 2.5 --- 小结 --- p.34 / Chapter 第三章 --- 政府与入职体检 --- p.35 / Chapter 3.1 --- 新中国成立之初的公共卫生政策 --- p.35 / Chapter 3.2 --- 中国人事制度改革和公务员职业声望 --- p.39 / Chapter 3.3 --- 体检标准与强制乙肝检测 --- p.43 / Chapter 3.4 --- 小结 --- p.47 / Chapter 第四章 --- 市场话语权与定义“乙肝" --- p.49 / Chapter 4.1 --- 市场中的虚假广告 --- p.50 / Chapter 4.2 --- 体检经济 --- p.54 / Chapter 4.3 --- 医药商与医学权威 --- p.56 / Chapter 4.4 --- 小结 --- p.58 / Chapter 第五章 --- 乙肝携带者的个人经验 --- p.61 / Chapter 5.1 --- 疾病的社会建构 --- p.62 / Chapter 5.2 --- 乙肝携带者的认知过程 --- p.66 / Chapter 5.3 --- 乙肝携带者的抗争选择 --- p.68 / Chapter 5.4 --- 小结 --- p.74 / Chapter 第六章 --- 从个体经验到集体行动:公民社会的回应 --- p.76 / Chapter 6.1 --- 从个人困境到集体行动 --- p.76 / Chapter 6.2 --- 反乙肝歧视运动中的资源动员 --- p.80 / Chapter 6.3 --- 反乙肝歧视组织网络 --- p.82 / Chapter 6.4 --- 反乙肝歧视运动中的机会空间 --- p.86 / Chapter 6.5 --- 小结 --- p.90 / Chapter 第七章 --- 框架策略:反乙肝歧视运动中的动员 --- p.91 / Chapter 7.1 --- 认同与社会运动 --- p.91 / Chapter 7.2 --- 反乙肝歧视运动的行动框架 --- p.95 / Chapter 7.3 --- 反乙肝歧视运动的动员策略 --- p.100 / Chapter 7.4 --- 小结 --- p.107 / Chapter 第八章 --- 身体的政治:将“乙肝"去除 --- p.108 / Chapter 8.1 --- 权力的维度 --- p.108 / Chapter 8.2 --- 反乙肝歧视行动的抗争轨迹 --- p.111 / Chapter 8.3 --- 国家、市场与公民社会:将“乙肝"去除 --- p.116 / Chapter 8.4 --- 小结 --- p.130 / Chapter 第九章 --- 总结与讨论 --- p.131 / 参考文献 --- p.137 / Chapter 附录A --- 访谈提纲 --- p.157 / Chapter 附录B --- 64名被访者基本信息概况 --- p.160 / 致谢 --- p.162
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Veterans and non-veterans with schizophrenia : a grounded theory comparison of perceptions of self, illness, and treatmentFirmin, Ruth L. 31 July 2014 (has links)
Indiana University-Purdue University Indianapolis (IUPUI) / This study investigates differences between Veterans and non-Veterans with severe mental illness (SMI) regarding perceptions of their illness, themselves, and treatment. I compare patient interviews (using the Indiana Psychiatric Illness Interview, IPII) of Veterans (N=20) and non-Veterans (N=26). Modified grounded theory and qualitative coding software Atlas-TI were used to develop codebooks for each group, and these were compared for differences. I examined differences in both code frequency and meaning. Statistically, more Veterans were male, employed, married, had higher income, and had higher education. Statistical differences in code frequency included: more Veterans discussing boredom, regret/guilt/loss, and wanting to be “normal.” More non-Veterans had codes of pessimism and religion/spirituality, wanting a different future, bringing up mental health, family, future: no change, life goals, and relapse. Key differences in narrative themes included: (1) Veterans’ “military mindset”/discussion of anger as part of mental illness, (2) non-Veterans’ focus on mental-illness, (3) differing attitudes regarding stigma, (4) active versus passive attitudes toward treatment, and (5) degree of optimism regarding the future. Differences are described and then potential
relationships and interactions are proposed. Veterans appear to have several protective factors (i.e., finances, employment, marriage). Additionally, Veterans’ military-mindset seems to encourage greater stigma-resistance, and thereby also facilitate Veterans being more active and optimistic toward treatment and recovery. By contrast, non-Veteran focus on mental illness may be related to increased self-stigma, passive and pessimistic attitudes. I propose that Veteran identity can serve as an additional protective factor against stigma, pessimism, and passivity. Veteran-identity may also be a useful framework clinically, to help promote active approaches to treatment (e.g., “fighting symptoms”). Further, Veterans emphasized issues relating to anger as important and part of their mental health. It may be that Veterans are more comfortable discussing mental health in the language of “anger,” given stigma. Finally, findings suggest that helping individuals in both groups engage in meaningful, non-mental illness-related life activities may help shape self-perception, and thereby responses to stigma, attitudes toward treatment, and hope for the future.
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Dementia : what comes to mind? : an exploration into how the general public understands and responds to dementiaMcParland, Patricia January 2014 (has links)
This thesis explores how the general public understands and responds to dementia. In the context of this study the word ‘understanding' is used to convey the complex co-construction of knowledge and establishing of beliefs that constitutes public understandings of dementia. The study also examines the responses of members of the public to dementia, in the context of their understanding. Data were collected over a 12 month period and included a module in the Northern Ireland Life and Times (NILT) survey, five focus groups and nine interviews with participants from the focus groups. The survey module included thirty measures examining levels of knowledge and attitudes towards dementia. 1200 participants were targeted and the survey was administered by the Northern Ireland Research & Statistics Agency with a response rate of 58%. The focus groups and interviews provided the mechanism to gather a more nuanced picture, exploring the beliefs behind the attitudes and the self-reported responses of participants to people with dementia. Findings indicate that the general public has a reasonable knowledge of the symptoms and pathway of dementia in line with a bio medical model. However the findings also indicate that the general public holds a mix of theoretical and empirical knowledge and that this is often contradictory. A complex mix of scientific or medical information, experience, anecdote and assumptions contribute to the discourse. This information is stored and conveyed in the form of stories and a consequence of this interplay is that individual experiences told in the form of stories are generalised to become building blocks in the construction of what the general public understands dementia to be. The current construction of dementia among the general public is found to be both nihilistic and ageist with clear evidence that dementia is stigmatised. I will argue that that the relationship between dementia and ageing in the minds of the general public is a symbiotic one. Dementia has become a cultural metaphor for unsuccessful ageing marking entry to the fourth age. The stigmatising response of the general public is the result of a complex interplay of multiple factors. I have expanded on previous ideas of multiple jeopardy and intersectionality, suggesting that the stigma associated with dementia is unique and driven as much by emotional responses as by the social location of the person with dementia. I have borrowed Brooker’s (2003) term “Dementia-ism’ to describe this stigma. This thesis argues for a more complex and sophisticated approach to changing public attitudes and reducing stigma. Dementia-ism must be addressed with the same strength of purpose currently applied to sexism, racism and ageism.
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Males' and Females' Attitudes Toward a Prospective Social Group Member with a History of Mental IllnessWalburn, Kathryn H 01 January 1986 (has links)
Attitudes of male and female subjects toward a prospective social group member who did/did not have a history of mental illness were investigated. The cognitive, behavioral and affective components of subjects' attitudes were measured. Results from the cognitive measure indicated that: 1) Subjects in the experimental condition perceived the confederate less positively on personal characteristics indicative of moral character. 2) Male subjects perceived the confederate as more dependable when she had a history of mental illness, while female subjects perceived her as less dependable when she disclosed history of mental illness. On the behavioral and affective component measures, there were no significant differences between the groups.
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Experiences of living with epilepsyEastman, Emma 01 1900 (has links)
Approximately 50 million people worldwide and one in every 100 South Africans, live with epilepsy. The challenges of epilepsy are not limited to the physical manifestations of the disease i.e. seizures. Public perceptions of epilepsy contribute significantly to an individual’s experience of living with epilepsy. Stigmatisation of epilepsy occurs worldwide and presents in varying forms. Enacted stigma refers to overt acts of discrimination against people with epilepsy and perceived (or “felt”) stigma is the feeling of shame and fear of being stigmatised as a person with epilepsy. Epilepsy stigma is considered to be one of the most important factors that have a negative influence on people with epilepsy. There is a noticeable difference in the nature of epilepsy stigma between developed and developing countries, and even between communities within the same country. This difference suggests that epilepsy stigma is shaped by differences in education, cultural values, access to healthcare, quality of care and legal rules. There is very little research on epilepsy-associated stigma emerging from South Africa. The aim of this study is to describe the lived experience of living with epilepsy and the associated stigma. Following qualitative methods, using an ethnographic approach, 10 semi-structured interviews with people with epilepsy were conducted. The complexity of studying the subjective experience of stigmatisation lends itself well to this approach. Participants were identified through the Western Cape branch of Epilepsy South Africa and recruited from various communities in Cape Town, South Africa. Data was analysed using Braun and Clarke’s (2006) principles of thematic analysis. The participants reported a broad range of subjective experiences and perspectives of living with epilepsy. Across all participants, the factors which played an impactful role on their lives was the social support they received, the public understanding of the community they lived in, the daily reminders of being “different” and living with the fear of not knowing when the next seizure will occur. By nature of this study’s design, the findings from this study cannot be generalised to South Africa. However, this study offers a glimpse into the subjective experience of living with epilepsy from individuals residing in different communities in Cape Town, South Africa. The findings show a broad range of experiences which are mediated by external influences. The findings suggest a need for further research into the challenges people with epilepsy face across communities within South Africa. / Psychology / M.A. (Psychology)
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HIV and AIDS-related stigma and discrimination reduction-intervention strategy in health care settings of Amahara region EthiopiaBefekadu Sedata Wodajo 06 1900 (has links)
Stigma and discrimination (SAD) attached to Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) has been recognised as a major obstacle to HIV prevention, treatment, care and support throughout the world. SAD is more devastating when it occurs in health care settings where it is least expected. Health care providers (HCPs) are supposed to provide physical, social and psychological support to people living with HIV (PLWHA) but HIV and AIDS-related SAD has been extensively documented among the HCPs. Different studies have pointed out that there are three major actionable causes of HIV-related SAD in health care settings. These are lack of awareness among HCPs, fear of casual contacts and associating the SAD to immoral behaviour. The main objective of the current study is to determine the magnitude of HIV and AIDS-related SAD and its associated factors in hospitals and then to propose appropriate SAD reduction-intervention strategy in the health care settings. The study employed pre-test-post-test design with non-equivalent control group. Two paradigms were used in this study including quantitative and qualitative approaches. The sampling method for the quantitative part of the study was probability sampling in which the respondents were randomly selected using stratified sampling technique. The study was able to determine the magnitude of HIV and AIDS-related SAD among the HCPs. Moreover, the study has identified the factors that are attributed to the prevalence of SAD in the hospitals. The major factors identified for causing the SAD in the hospitals were sex, age, work experience, low level of knowledge, negative attitudes and percieved risk of HIV infection of some HCPs toward the PLWHA. The intervention made on the respondents in the treatment group was able to reduce the overall prevalence of the SAD among the HCPs. The study suggests that to reduce the SAD, HIV and AIDS-related trainings before and after graduation is critical to improve
the knowledge, attitudes and practices of the HCPs. Besides, ensuring the availability of the protective supplies in hospitals is crucial in reducing the fear of HIV infection among the HCPs while providing care for HIV positive patients. Effective implementation of the hospital policies, strategies, guidelines and protocols along with good institutional support is also vital in creating safe and user-friendly hospitals for PLWHA. / Health Studies
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The lived experiences of HIV-positive women in povertyMsengana, Sweetlener Thobeka January 2014 (has links)
The focus of this study was on the experiences of a small sample of local women who are HIVpositive and are living in poverty. The researcher was interested in exploring the psychological and social experiences of these women using Interpretive Phenomenological Analysis. This research aimed at giving these women a voice to express their first-hand, personal accounts of living with HIV in poverty. Data was analysed for meaningful units, which were interpreted inductively and hermeneutically, and categorised into super-ordinate themes. Six themes within the participants' experiences of living with HIV were determined, namely: (I) experiences of diagnosis, (2) disclosure experiences, (3) stigma, (4) ARV experiences, (5) experiences of social support and (6) poverty. This research found that after an HIV-positive diagnosis, most women experience a variety of emotional reactions. These reactions however seem to change overtime into positive acceptance of the HIV diagnosis. Most of the women in this study preferred to use partial disclosure than to fully disclose their HJV-positive status openly to families, friends and to their community. Reasons for not using full disclosure included fear of discrimination and stigma, which included a fear of being rejected or being blamed for their status and a fear of losing relationships. It was also evident from the findings that most of the women had experienced stigma directly and therefore partial disclosure was used as a coping mechanism to protect the self from further harm. It was also revealed that stigma not only has a negative impact on disclosure but also on social support and ARV experiences. Because ofHIV-related stigma, lack of social support was a struggle that almost all the women in this study had experienced. Lack of understandings about their medication also had a negative impact of the ARV experiences. Stigmas along with poverty are the major struggles that HIV -positive women have to deal with in their day to day living. The findings of this study reveal a need for further research in this experiential area as well as campaigns and education around issues such as stigma, medication, and emotional difficulties associated with HIV.
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