title: Experiences of social stigma and implications for healthcare among a diverse population of HIV positive adults.
abstract: Stigma profoundly affects the lives of people with HIV/AIDS. Fear of being identified as having HIV or AIDS may discourage a person from getting tested, from accessing medical services and medications, and from disclosing their HIV status to family and friends. In the present study, we use focus groups to identify the most salient domains of stigma and the coping strategies that may be common to a group of diverse, low-income women and men living with HIV in Los Angeles, CA (n = 48). We also explore the impact of stigma on health and healthcare among HIV positive persons in our sample. Results indicate that the most salient domains of stigma include: blame and stereotypes of HIV, fear of contagion, disclosure of a stigmatized role, and renegotiating social contracts. We use the analysis to develop a framework where stigma is viewed as a social process composed of the struggle for both internal change (self-acceptance) and reintegration into the community. We discuss implications of HIV-related stigma for the mental and physical health of HIV-positive women and men and suggestions for possible interventions to address stigma in the healthcare setting.
authors.affiliation: Division of General Internal Medicine, University of California, Los Angeles, CA, USA. jsayles@mednet.ucla.edu
authors.forename: Jennifer N
authors.initials: JN
authors.lastname: Sayles
authors.forename: Gery W
authors.initials: GW
authors.lastname: Ryan
authors.forename: Junell S
authors.initials: JS
authors.lastname: Silver
authors.forename: Catherine A
authors.initials: CA
authors.lastname: Sarkisian
authors.forename: William E
authors.initials: WE
authors.lastname: Cunningham
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D030881:Disclosure; D005260:Female; D017144:Focus Groups; D006679:HIV Seropositivity / Q000523:psychology* / Q000628:therapy; D006297:Health Services Accessibility; D054625:Healthcare Disparities; D006801:Humans; D015141:Los Angeles; D008297:Male; D008875:Middle Aged; D017008:Negotiating; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D011203:Poverty; D011287:Prejudice; D013240:Stereotyping; D019037:Urban Health Services / Q000592:standards / Q000706:statistics & numerical data*; D035862:Vulnerable Populations / Q000523:psychology*