Verbal and physical abuse and neglect as manifestations of HIV/AIDS stigma in five African countries.
OBJECTIVE
To explore the experience of HIV/AIDS-related stigma for people living with HIV/AIDS (PLWA) in Lesotho, Malawi, South Africa, Swaziland, and Tanzania.


METHODS
Descriptive study using 43 focus groups (n=251 participants), which included male and female PLWA from both rural and urban areas and nurses working with PLWA.


METHODS
Participants were asked to relate incidents of HIV/AIDS-related stigma that they had experienced or observed. Focus group discussions were taped, and data were content analyzed to identify examples of abuse (verbal and physical abuse and neglect) related to HIV/AIDS stigma. Data analysis also explored targets of abuse, abusers, and consequences of abuse.


RESULTS
Participant reports documented extensive verbal and physical abuse and neglect or negating (disallowing of access to services and opportunities) experienced by PLWA and observed by nurses caring for them, and identified negative consequences experienced by PLWA whose HIV-positive status was disclosed to family, friends, or community members.


CONCLUSIONS
Health care workers who encourage PLWA to disclose their HIV status must carefully consider the implications of encouraging disclosure in an environment with high levels of stigma, and must recognize the real possibility that PLWA may experience serious verbal and physical abuse as a consequence of disclosure.
Dlamini
Priscilla S
PS
Department of General Nursing Science, Faculty of Health Sciences, University of Swaziland, Mbabane, Swaziland. pdlamini@healthsci.uniswa.sz
Kohi
Thecla W
TW
Uys
Leana R
LR
Phetlhu
René Deliwe
RD
Chirwa
Maureen L
ML
Naidoo
Joanne R
JR
Holzemer
William L
WL
Greeff
Minrie
M
Makoae
Lucy N
LN
D000328:Adult; D001291:Attitude of Health Personnel / Q000208:ethnology*; D001294:Attitude to Health / Q000208:ethnology*; D013541:Eswatini / Q000453:epidemiology; D005260:Female; D017144:Focus Groups; D015658:HIV Infections / Q000208:ethnology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007927:Lesotho / Q000453:epidemiology; D008295:Malawi / Q000453:epidemiology; D008297:Male; D008960:Models, Psychological; D009726:Nurses / Q000523:psychology; D015404:Nursing Methodology Research; D011287:Prejudice; D036301:Qualitative Research; D012650:Self Disclosure; D013019:South Africa / Q000453:epidemiology; D013240:Stereotyping; D013636:Tanzania / Q000453:epidemiology; D014705:Verbal Behavior; D014754:Violence / Q000208:ethnology* / Q000706:statistics & numerical data; D014838:Volunteers / Q000523:psychology