Perceived HIV stigma among children in a high HIV-prevalence area in central China: beyond  the parental HIV-related illness and death.
OBJECTIVE
(1) Examine the psychometric properties of two parallel measures of HIV-related stigma (i.e., perceived public stigma and children's personal stigma against people living with HIV/AIDS [PLWHA]) among children affected by HIV/AIDS. (2) Examine whether expressions of stigma measures differ by child's sex, developmental stage, family socioeconomic status (SES), or orphanhood status (i.e., AIDS orphans, vulnerable children, and comparison children). (3) Examine the association between HIV-related stigma and children's psychosocial adjustments among these children.


METHODS
Cross-sectional data were collected from 755 AIDS orphans (children who had lost one or both their parents to AIDS), 466 vulnerable children who lived with HIV infected parents, and 404 comparison children who did not experience HIV-related illness and death in their families. The measures included perceived public stigma, personal stigma, depressive symptoms, loneliness, self-esteem, future expectations, hopefulness about the future, and perceived control over the future.


RESULTS
Both stigma scales were positively associated with psychopathological symptoms (e.g., depression, loneliness) and negatively associated with psychosocial well-being (e.g., self-esteem, positive future expectation, hopefulness about future, and perceived control over the future). Both stigma measures contribute to children's psychosocial problems independent of their orphanhood status and other key demographic factors.


CONCLUSIONS
Community-wide stigma reduction and psychological support should be part of the care efforts for children affected by AIDS. Stigma reduction efforts should not only target the stigma against PLWHA but also possible stigma against the entire community (e.g., villages) with a high prevalence of HIV/AIDS. The stigma reduction efforts also needs to be appropriate for children's age, gender, family SES, and AIDS experience in the family. Future research should explore individual and contextual factors such as social support, coping, and attachment in mitigating the negative effect of stigma among these children.
Lin
Xiuyun
X
School of Psychology, Beijing Normal University, Beijing, China.
Zhao
Guoxiang
G
Li
Xiaoming
X
Stanton
Bonita
B
Zhang
Liying
L
Hong
Yan
Y
Zhao
Junfeng
J
Fang
Xiaoyi
X
D000163:Acquired Immunodeficiency Syndrome / Q000523:psychology*; D000222:Adaptation, Physiological; D000293:Adolescent; D002648:Child; D054540:Child, Orphaned / Q000523:psychology*; D002681:China; D015658:HIV Infections / Q000523:psychology*; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D012423:Rural Health; D012649:Self Concept; D012917:Social Adjustment; D057545:Social Stigma; D012944:Social Support; D012959:Socioeconomic Factors; D013240:Stereotyping; D035862:Vulnerable Populations / Q000523:psychology
J Adolesc Health. 2007 Jan;40(1):96-8
17185215
J Pediatr Psychol. 2009 Nov-Dec;34(10):1053-62
19208701
AIDS Care. 2005 Jul;17 Suppl 2:S117-27
16174623
Am J Epidemiol. 1990 Mar;131(3):538-51
2301363
Fam Plann Perspect. 2000 May-Jun;32(3):111-7
10894256
AIDS Behav. 2006 Sep;10(5):463-71
16374668
Soc Sci Med. 2003 Jul;57(1):13-24
12753813
AIDS Behav. 2005 Jun;9(2):135-43
15933833
J Health Popul Nutr. 2003 Dec;21(4):347-57
15038590
Res Nurs Health. 2001 Dec;24(6):518-29
11746080
J Assoc Nurses AIDS Care. 2005 Jan-Feb;16(1):13-20
15903274
J Assoc Nurses AIDS Care. 2008 Mar-Apr;19(2):147-57
18328965
AIDS. 2008 Aug;22 Suppl 2:S67-79
18641472
Qual Health Res. 2005 Feb;15(2):169-87
15611202
Soc Sci Med. 2003 Mar;56(6):1235-47
12600361
Health Transit Rev. 1995;5 Suppl:245-52
10159892
AIDS Care. 2009 Mar;21(3):261-70
19280403
AIDS Behav. 2008 Sep;12(5):759-71
18266101
AIDS Care. 2009 Jun;21(6):769-74
19437169
AIDS Patient Care STDS. 2008 Oct;22(10):823-31
18847389
Health Psychol. 2005 Mar;24(2):133-42
15755227
AIDS Care. 2007 Oct;19(9):1075-82
18058390
AIDS Educ Prev. 2005 Feb;17(1):1-11
15843106