title: Relative importance of various measures of HIV-related stigma in predicting psychological outcomes among children affected by HIV.
abstract: To assess the relative importance of four different measures of HIV-related stigma in predicting psychological problems among children affected by HIV in rural China. Cross-sectional data were collected from 755 orphans (i.e., children who lost one or both of their parents to HIV), 466 vulnerable children (children who were living with HIV-infected parents), and 404 comparison children who were from the same community and did not have HIV-related illness or death in their families. Four HIV-related stigma measures include perceived public stigma against people living with HIV/AIDS (PLWHA), perceived public stigma against children affected by HIV (orphans and vulnerable children), personal stigmatizing attitudes against PLWHA, and enacted stigma among children affected by HIV. Psychological problems included depression and adjustment problems. Various measures of HIV-related stigma independently and differentially contribute to children's psychological problems. Enacted stigma and children's perceived public stigma against PLWHA or children affected by HIV are generally stronger predictors of psychological problems than their own feelings or attitudes towards PLWHA. Various aspects of HIV-related stigma are important for us to understand the perception, attitudes, and experience of children affected by HIV, including both children experiencing HIV-related parental illness and death in their own family and children who were living in the communities hardly hit by HIV. Future health promotion and psychological care efforts for children affected by HIV need to consider the effect of various forms of HIV-related stigma on these children's psychosocial well-being and mobilize the community resources to mitigate the negative effect of HIV-related stigma on PLWHA and their children.
authors.affiliation: Institute of Behavior and Psychology, Henan University, Kaifeng, China.
authors.forename: Guoxiang
authors.initials: G
authors.lastname: Zhao
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Li
authors.forename: Junfeng
authors.initials: J
authors.lastname: Zhao
authors.forename: Liying
authors.initials: L
authors.lastname: Zhang
authors.forename: Bonita
authors.initials: B
authors.lastname: Stanton
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D002648:Child; D054540:Child, Orphaned / Q000523:psychology / Q000706:statistics & numerical data; D002681:China; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007389:Internal-External Control; D008297:Male; D010465:Perception; D011159:Population Surveillance; D011237:Predictive Value of Tests; D011287:Prejudice; D012044:Regression Analysis; D012424:Rural Population / Q000706:statistics & numerical data; D012649:Self Concept; D012917:Social Adjustment; D057545:Social Stigma; D012959:Socioeconomic Factors; D013315:Stress, Psychological; D035862:Vulnerable Populations / Q000523:psychology