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.

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)

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

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.

This study examined a mediational model of mental illness stigma, parent-child communication about mental health concerns, and help seeking attitudes/behaviors among young adults with at least one immigrant parent while considering the possible moderating effect of acculturation gap. The primary goal of this study was to examine whether the acculturation gap changed the relation between mental illness stigma and communication about personal mental health concerns with immigrant parents, which in turn could become a significant predictor of their help-seeking attitudes, as well as a barrier to seeking professional mental health services. Findings provided support to the direct and indirect effects of mental illness stigma through communication about mental health concerns on attitudes about help-seeking. The acculturation gap hypothesized to be a possible moderator for the stigma-communication about mental health concerns relationship among young adult ABCI was found to be significant for ABCI with a low mainstream culture acculturation gap. Discussion on the findings, limitations of the study, future research directions, and counseling implications are addressed.

This research focused on the experiences of HIV disclosure to significant others amongst people living with HIV. The aim of the research was to explore how people living with HIV experience disclosure of their HIV positive status to their significant others. The social constructionist perspective was utilized to gain a deeper understanding of the experience of HIV positive status disclosure to significant others. The study’s sample comprised of five participants who were recruited using purposive sampling strategy. Data was collected with using face to face semi structured interviews. Themes were extracted and analysed using thematic content analysis. An analysis was made as to whom participants choose to disclose to, the reaction of the people they disclosed to, as well as their reasons for disclosing. Results were reported as the participants’ experiences and noted as is or unadulterated. / Psychology / M.A. (Psychology)

Indiana University-Purdue University Indianapolis (IUPUI) / This study is a hermeneutic phenomenology of transgenderism as it is valued and appreciated by adults who self-identify along the transgender spectrum. As a population-at-risk due to a social environment reliant on a dualistic notion of gender, transgender people are of particular concern to social workers, who are charged with identifying and building on client strengths. Yet the preponderance of the academic literature has reinforced a negative, problematic, or even pathological view of transgenderism. The literature also has tended to focus narrowly on transsexualism, leaving a gap in our knowledge of other forms of transgenderism. The present study—grounded primarily in the philosophy and methodology of Heideggerian phenomenology, but also drawing on Gadamerian hermeneutics—sought to understand the lived experience of transgenderism as it is appreciated by a range of transgender adults. A purposive sample of fifteen self-identified transgender adults who reported appreciating being transgender was recruited using snowball sampling across three Midwestern states. Each participated in an individual, open-ended interview designed to tap their lived experience with transgenderism as a valued aspect of life. Transcribed interview data were analyzed using Heideggerian hermeneutic phenomenological processes as suggested by various researchers in nursing, social work, and other disciplines. The results of this study suggest that intimate connections (with one’s self, with others, and with a larger purpose) constitute the essence of the lived experience of appreciating one’s transgenderism. These findings help prepare social workers to recognize the strengths of the transgender population and to engage in culturally competent practice. In addition, this research offers new knowledge for improving social work curricular content on transgenderism and for justifying trans-inclusive social policies. The study also contributes to the overall research literature on transgenderism and qualitative methods.

Indiana University-Purdue University Indianapolis (IUPUI) / Shelby County has the fastest growing rate of HIV infection in the State of Tennessee and the majority of the people with HIV/AIDS are African Americans. 2011 CDC report stated Memphis had the fifth highest proportion of new HIV infections. The African American church is a natural and potentially powerful venue to facilitate health awareness. The purpose of this qualitative study was to explore the views of African American faith-based leaders (FBLs) toward offering HIV prevention services in faith-based organizations (FBOs). The theoretical framework for this study was the Consolidated Framework for Implementation Research (CFIR). The fourth domain of CFIR, characteristics of the individuals, is concerned with organizational change which occurs on the individual level. CFIR provided a means to ensure effective implementations, data coding and analysis. Interpretative Descriptive (ID) design, which seeks to discover associations, relationships, and patterns within the described phenomenon, was used. The targeted population was African American Faith-based Leaders from areas known to have high rates of HIV and sexually transmitted infections (STIs). Purposeful sampling was employed to recruit participants. Data was generated through face-to-face, semi-structured interviews. The researchers categorized and analyzed the data to form the concepts and themes identified using a coding scheme which was applied to all data. Faith-based leaders revealed that they had a role in HIV prevention. The themes that emerged were their role to provide education on HIV, minister with compassion, teach Biblical doctrine, maintain a community focus, and partner with expert healthcare professionals. Perceived barrier concepts identified were lack of knowledge, denial, stigma, fear, keeping issues private, and the breakdown of family and community values. Findings suggest that FBLs had some knowledge of the health disparities and ongoing stigma concerning HIV remains a major barrier. The participants interviewed were open to HIV preventions on different levels to address HIV but needed more education.

Indiana University-Purdue University Indianapolis (IUPUI) / Stigma is a barrier to recovery for people with mental illness. Problematically, stigma also has been documented among mental health practitioners. To date, however, most research has focused on explicit attitudes regarding mental illness. Little research has examined implicit attitudes, which has the potential to reveal evaluations residing outside of conscious control or awareness. Moreover, research has tended to use a mixed sample of practitioners and programs. The extent to which both explicit and implicit stigma is endorsed by mental health practitioners utilizing evidence-based practices is unknown. The purposes of the current study were to 1) carefully examine implicit and explicit stigmatizing attitudes, or biases, among Assertive Community Treatment (ACT) staff and 2) explore the extent to which explicit and implicit biases predicted the use of treatment control mechanisms. Participants were 154 ACT staff from nine states. They completed implicit (Implicit Association Test) and explicit measures of stigma. Overall, participants exhibited positive explicit and implicit attitudes towards people with mental illness. When modeled using latent factors, implicit, but not explicit bias significantly predicted the endorsement of restrictive or controlling clinical interventions. Practitioners who perceived individuals with mental illness as relatively more dangerous and helpless (both explicit and implicit), as well as participants from Indiana and those with less education were more likely to endorse use of control mechanisms. Thus, despite overall positive attitudes toward those with mental illness for the sample as a whole, even low levels of stigma at the individual level were found to affect clinical care. Mental health professionals, and specifically ACT clinicians, should work to be aware of ways in which their biases influence how they intervene with consumers.

AIDS-related bereavement counselling programmes / The aim of this study was to determine whether there is a need for specific bereavement counselling programmes for women affected by HIV/AIDS in Indonesia, where death is believed to be fated. Six AIDS-bereaved women were recruited. Data analysis was conducted based on the women's interview transcripts and journal entries. The women experienced at least three traumatic life events. The most challenging experience was learning that they have contracted a disease they knew to be mostly associated with prostitution. Given the short lapse of time between their husbands' deaths and learning about their seropositivity, biographical disruption appeared to have acted as an "analgesic", while concerns to protect their children seemed to have triggered biographical reinforcement. This phenomenon may have brought about a positive bereavement outcome. Specific counselling programmes for women affected by HIV/AIDS are needed, but emphasis should first be placed on improving their wellbeing and their perception of stigma. / Sociology / M.A. (Sociology (Social Behaviour Studies in HIV/AIDS))