The diagnosis of HIV is a life-changing event that requires people to deal with the disease, as well as cope with HIV stigma. Both people living with HIV or AIDS (PLHA) and their close family members (CFM) are stigmatized, but CFM also stigmatizes PLHA. This interaction affects the relationship between PLHA and their CFM. The aim of this study was to evaluate the effect of a comprehensive community-based HIV stigma reduction intervention on PLHA and their CFM as well as to explore and describe their experiences during and after the intervention. A holistic multiple case study design as well as a qualitative description approach was used. The study was conducted in both an urban and a rural setting. Purposive sampling was used for the PLHA and snowball sampling for the CFM. The case record for the case study consisted of several sources. In-depth-interviews were used to explore their experiences. The data was analysed using open coding and text document analysis. Both groups gained a richer understanding of HIV stigma and coping with it. The relationships enriched by PLHA feeling more supported and CFM realizing how they stigmatized and that they should be more supportive. Leadership was activated through the project. Bringing PLHA and CFM together during an intervention, proved to be affective, Recommendations focus on the inclusion of HIV-related stigma reduction awareness interventions in the curriculum of student nurses and the implementation thereof in the community, through community based nursing. It would be of benefit if the programme could also be offered as a workshop to traditional healers in the community. Nurses in clinics working with PLHA should invite PLHA and CFM to participate in groups to support each other in reducing HIV-related stigma and share problem-solving coping strategies. The researcher believes that the results of the current study have important implications for further research in HIV-related stigma reduction interventions in other countries and demographic groups. It has the potential to be used for long-term monitoring studies of HIV stigma reduction interventions and the change over time. / Thesis (MCur)--North-West University, Potchefstroom Campus, 2013

The aim of this novel piece of research was to explore experiences of self-stigma amongst a group of older people (aged 65+) currently using mental health services. In order to try and identify possible contributing factors to internalized stigma it was also decided to gather information on optimism and a baseline measure of distress. These scores were all compared with the individual’s likeliness to continue to use the mental health services as it was hypothesized that higher levels of self-stigma would be linked with a lower likelihood to continue to use services. Fourteen participants (age range 65-92) from three different geographical areas agreed to take part having been approached by a mental health professional known to them. Interviews were then arranged directly with each participant, with each interview being made up of three questionnaire measures to rate levels of distress, optimism and experiences of mental health stigma, a Likelihood to Continue to Use Services rating scale, and a repertory grid. The repertory grids had been specifically designed to explore the construct systems of the participants in relation to their age. The main finding was that experiences of mental health stigma were minimal, but that participants showed some signs of internalizing ageist attitudes. However, neither of these variables was correlated with a likelihood to continue to use services, suggesting that it is factors other than mental health stigma and age stigma and selfstigmatization that impact on an older person’s decision to continue to engage with mental health services or not. The small sample size also meant that power was lacking from the findings, indicating that further research needs to be carried out. This study has opened up a research area which needs further ongoing investigation in order to fully explore the clinical implications of self-stigma in relation to age and mental health problems. Areas of potential future research are offered and briefly explored.

Träning kan ses som en trend då det har blivit allt mer populärt att utföra någon form av fysisk aktivitet. Inom socialpsykologisk teori har trender förståtts som ett sätt för individer att tillfredsställa sina behov av att anpassa sig efter den sociala omgivning de lever i. Socialpsykologin har också visat att det är fruktbart att synliggöra normer genom att intervjua individer som definierar sig som normbrytare. Denna studie syftar därför till att undersöka träningstrenden ur icke-användares perspektiv genom tio kvalitativa intervjuer med individer som inte anser sig vara fysiskt aktiva. Resultatet visar att träningstrenden har en inverkan på individer som inte aktivt deltar i den då de upplever ett utanförskap. Dessutom finns det andra faktorer som tydliggör utanförskapet och individers upplevelse av det. Media och materiella ting är två sådana faktorer som båda har en stor del inom trenden. Icke-användares inställning till träningstrenden är delad på så sätt att träningens popularitet skapar förutsättningar för ett hälsosamt samhälle, samtidigt som dessa förutsättningar motarbetas då träningens popularitet medför en stress och press att prestera utefter ett ideal som är svårt att uppnå. Det innebär också en svårighet att gå emot träningstrenden då den speglar normen i samhället att vara hälsosam, vilket gör att ett icke-deltagande kan anses som avvikande från ett kollektivt handlande.

Transgender and gender-nonconforming (TGNC) individuals in the United States experience significant marginalization due to stigma enacted at the structural, interpersonal, and individual levels. As a result, this population has reported increased behavioral and physical health needs, as well as unique barriers to healthcare. Moreover, TGNC individuals have reported greater experiences of childhood abuse compared to cisgender individuals. The cumulative experiences of stigma-related stressors and adverse childhood experiences put this population at risk for the development of mental and physical health problems, increasing need for health services. However, TGNC individuals have reported being denied medical care and postponing seeking care due to fear of discrimination, which may increase complications and severity of illness, and result in increased hospitalizations and healthcare costs. Utilizing the Andersen Behavioral Model of Health Services Use and Theory of Planned Behavior, the current study examined robust associations among stigma-related stressors, adverse childhood experiences, personal and physician-related enabling factors, mental, behavioral, and physical health needs, and healthcare utilization, intention, and delay among an online convenience sample of 109 TGNC adults in the United States. A series of multivariate and mediational analyses were conducted to determine the connections among predisposing factors, enabling resources, needs, health beliefs, and healthcare intention, delay, and behavior. Although predisposing factors were not directly associated with healthcare behavior, they were directly associated with healthcare delay. Moreover, mediation analyses indicated an indirect effect of victimization and adverse childhood events to decreased healthcare utilization and increased delay through mental health needs, internalized stigma, negative personal beliefs, perceived TGNC-inclusivity of healthcare providers, and finally, behavioral intention. Thus, the present study illuminated a possible cascade of detrimental effects that are initiated by stigma-related stress and adverse childhood experiences through enabling resources, needs, and beliefs, that ultimately are associated with healthcare utilization intent, behavior, and delay. These findings highlight the need to address both TGNC individuals’ timely use of care, and the quality of care they receive. It is imperative that future research takes a multi-level approach by creating and testing evidence-based interventions to improve both healthcare providers’ competency, as well as for TGNC individuals’ ability to coping with stressors.

Det finns många människor i dagens samhälle som har svårigheter som hindrar dem från att arbeta. Det finns olika alternativ för dem när det kommer till arbete och ett av dessa är att arbeta nivåanpassat. Denna studie undersöker vad innebär det för individen att arbeta nivåanpassat? För att få svar på denna fråga har studien gjorts med grundad teori som metodologisk grund. Jag gick in i undersökningen med ett öppet förhållningsätt och lät empirin leda mig. Datainsamlingen består av intervjuer med fem personer. De arbetar på ett företag som arbetar med att låta personer med olika funktionsnedsättningar arbeta nivåanpassat. Vad jag kom fram till i undersökningen är tio kategorier vilka är: gränslandet, inse sina begränsningar, att trivas med något, anpassa och gå vidare, förståelse och stöd från andra, viljan att arbeta, ”diagnos” som möjlighet, ”diagnos” som hinder, rädslan för att oförmåga ska synas samt statusförlust. Kärnkategorin för upplevelsen av att arbeta nivåanpassat visade sig vara gränslandet och de övriga kategorierna befann sig i detta gränsland. Tillsammans utgjorde de innebörden av att arbeta nivåanpassat. För att ge en teoretisk referensram till mitt resultat använde jag mig av två teorier från Goffman vilka var stigma och den bakre och den främre regionen. Jag använde mig även av Ehn och Löfgrens teori om klassifikationens makt. Dessa tre teorier hjälper till att belysa mitt resultat och ge en djupare förståelse för innebörden av det nivåanpassade arbetet.

My aim with this research has been to see how surrogate mothers' situation in Georgia looks like, and how different aspects affect the understanding of the process itself and create different prerequisites for surrogate mothers. I interviewed staffs who meet surrogate mothers in their work. I conducted five interviews. The theories I have chosen to use in the study is Maslow's hierarchy of needs and Goffman's labeling theory. I concluded that surrogacy is a controversial subject that is interesting to analyze, based on these theories. After I had interviewed people, it turned out that there are some hierarchical differences between surrogate mothers and biological mothers. The study shows those surrogate mothers' motives and perception is different in society, leading to stigma and categorized ring of the phenomenon. In the future it will be interesting to formulate, visualize, debate and discuss how surrogacy affects society and the professionals' assessments of the phenomenon. I hope that the study raises future interest in others and brings new perspectives which professionals can benefit from. / Mitt mål med denna uppsats har varit att se hur surrogatmödrars situation i Georgien ser ut, och hur olika aspekter påverkar förståelsen för själva processen och skapar olika förutsättningar för surrogatamödrar.  Jag gjorde detta genom att intervjua personal som träffar surrogatamödrar i sin verksamhet. Jag genomförde fem intervjuer. De teorier jag valt att använda i studien är Maslows behovstrappa och Goffmans stämplingsteori. Jag kom fram till att surrogatmödraskap är ett omdiskuterat ämne som är intressant att analysera utifrån dessa teorier. Efter att jag intervjuat personerna visade det sig att det förekommer en del hierarkiska skillnader mellan surrogatmödrar och biologiska mammor. Studien visar att surrogatmödrarnas motiv och uppfattning ser olika ut i samhället, vilket leder till stigmatisering och kategorisering av själva fenomenet. I framtiden kommer det bli intressant att formulera, synliggöra, problematisera och diskutera hur surrogatmödraskap påverkar samhället och professionellas bedömningar på fenomenet. Jag hoppas att studien väcker framtida intresse för andra och bidrar med nya perspektiv som professionella kan ha nytta av.

Sub-Saharan Africa is the region in the world most severely affected by HIV, and Tanzania is among the most severely affected countries in the region. The introduction of antiretroviral treatment has offered hope to people living with HIV/AIDS, improving their quality of life significantly. Still, there are individuals living with HIV who either lack access to ART, or choose not to make use of the available treatments. The purpose of this thesis is to identify underlying factors perceived as barriers for HIV- positive individuals to initiate and maintain Antiretroviral treatment in Babati District, Tanzania. Twenty semi-structured interviews were carried out between the 15th of February and 6th of March 2016. The interviews were conducted with ART-patients, health workers and members of the community. An analysis was made within a theoretical framework based upon Goffman's notion of stigma and the Initial Behavioral Model by Andersen. The following obstacles to access to ART were indicated by the findings: HIV/AIDS related stigma issues, discrimination, economic barriers, ignorance due to lack of education, counseling on HIV treatment, and beliefs that HIV can be cured by traditional healers.

This study focuses on how minorities are stigmatized in the French media. It limits itself to the case of the proposal of the denaturalization law and the consequent discourse about it. The subject is introduced through a short background on the law and its relevance to the possible racist nature of the debate, followed by some background on racism in France, an overview of the theory on new racism and how it can explain stigmatizating discourses. Critical Discourse Analysis is used as the method to uncover said discourses as it is a method related to the in-depth analysis of implicit dominant ideologies and power-structures. The study analyzes twenty articles from two French newspapers in order to determine how stigmatizing discourses are expressed. The results in the discussion show recurrent racist narratives that systematically denigrate and stereotype Muslims and immigrants. They also show a pattern of the dominant culture negating space to minorities.

While advancements in treatment have made HIV a more manageable disease, only recently have psychosocial variables associated with the health of persons living with HIV (PLH) began to receive increased scrutiny. HIV-related stigma, considered by some researchers to be a “second epidemic,” is one such psychosocial variable and is associated with negative physiological and psychological health outcomes. In an effort to alleviate the effects of stress, increased research attention has focused on forgiveness as a teachable coping strategy. Current forgiveness interventions demonstrate encouraging results in decreasing anger and neutralizing stress but have not been applied to HIV-positive populations. In this study, Lazarus and Folkman’s transactional model of stress and coping (1984) and Prochaska and Velicer’s transtheoretical model of health behavior (1997) were utilized as theoretical frameworks to inform a randomized clinical trial that examines coping skills, particularly forgiveness, in PLH and perceived HIV-related stigma. An ethnically diverse sample of HIV-positive adults (n = 57) was randomized into a treatment or control group. The treatment group participated in six weeks of cognitive-behavioral group therapy that focused on the teaching of forgiveness as an effective coping tool while the control group was psychoeducational in nature and did not involve mention of forgiveness. Data was obtained on a variety of medical and psychosocial variables, including types of forgiveness (dispositional forgiveness, forgiveness of self, forgiveness of others, and forgiveness of situations) and perceived HIV-related stigma. Data were collected at three time points: at baseline (Time 1) prior to randomization of participants to the treatment or control group, immediately post intervention (Time 2), and at six-month follow-up (Time 3). Importantly, forgiveness was shown to be a teachable skill that PLH can use to potentially improve mental health. Men in the treatment group reported significantly higher levels of dispositional forgiveness and self-forgiveness than men in the control group at six-month follow up. Additionally, self-forgiveness at Time 1 and self-forgiveness at Time 3 significantly accounted for 34% and 28% of the variance, respectively, in HIV-related stigma at Time 3. Though self-forgiveness was shown to be better than forgiveness of others in predicting HIV-related stigma, the forgiveness intervention was not effective in reducing overall HIV-related stigma in PLH. HIV-related stigma is likely more complex than originally conceptualized. Implications and future directions in improving interventions to mitigate HIV-related stigma are discussed.

OBJECTIVE: The current study explored the applicability of the social norms approach to a new domain of study: psychological help-seeking. A number of questions that must be answered to determine whether the social norms model can be applied effectively to the help-seeking domain guided the study. METHOD: Data were collected from freshmen at five colleges and universities in the Mid-Atlantic region (N = 3021) during freshman orientation week. The study used a cross sectional design to examine personal attitudes and behaviors related to help-seeking as well as perceptions about others’ attitudes and behaviors related to help-seeking. RESULTS: Most participants reported that they were willing to seek help and viewed seeking help as a personal strength rather than personal weakness. However, discrepancies between “reality” and perception indicate that most freshmen in this sample misperceived reality. Most participants underestimated the extent to which peers are accepting of seeking psychological help and most participants were not accurate in their perceptions of peer help seeking behaviors. This misperception significantly influenced personal willingness to seek help. CONCLUSIONS: The data indicate that the social norms method of intervention is applicable to the domain of help seeking and efforts to reduce stigma. Implications, next steps for future research, and limitations of the current study are discussed.