Relationship between HIV stigma and self-isolation among people living with HIV in Tennessee.
BACKGROUND
HIV stigma is a contributing factor to poor patient outcomes. Although HIV stigma has been documented, its impact on patient well-being in the southern US is not well understood.


METHODS
Thirty-two adults participated in cognitive interviews after completing the Berger HIV or the Van Rie stigma scale. Participant responses were probed to ensure the scales accurately measured stigma and to assess the impact stigma had on behavior.


RESULTS
Three main themes emerged regarding HIV stigma: (1) negative attitudes, fear of contagion, and misperceptions about transmission; (2) acts of discrimination by families, friends, health care providers, and within the workplace; and (3) participants' use of self-isolation as a coping mechanism. Overwhelming reluctance to disclose a person's HIV status made identifying enacted stigma with a quantitative scale difficult.


CONCLUSIONS
Fear of discrimination resulted in participants isolating themselves from friends or experiences to avoid disclosure. Participant unwillingness to disclose their HIV status to friends and family could lead to an underestimation of enacted HIV stigma in quantitative scales.
Institute for Global Health, Vanderbilt University and Department of Preventive Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America. carolyn.m.audet@vanderbilt.edu
Carolyn M
CM
Audet
Catherine C
CC
McGowan
Kenneth A
KA
Wallston
Aaron M
AM
Kipp
D000328:Adult; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011287:Prejudice; D012934:Social Isolation / Q000523:psychology*; D057545:Social Stigma; D013714:Tennessee / Q000453:epidemiology