title: "An unspoken world of unspoken things": a study identifying and exploring core beliefs underlying self-stigma among people living with HIV and AIDS in Ireland.
abstract: BACKGROUND
  Human immunodeficiency virus (HIV) related self-stigma--negative self-judgements resulting in shame, worthlessness and self-blame - negatively influences access to care and treatment, and overall quality of life for people living with HIV (PLHIV). Despite evidence that high levels of self-stigma exist among PLHIV, and is experienced to a far greater extent than stigma received from the broader community, there is a paucity of research aimed at understanding causes and functions of self-stigma, and an absence of interventions to mitigate its harmful effects. Understanding the core beliefs underlying self-stigma is therefore essential.
  
  
  METHODS
  This pilot study used a qualitative approach to analyse interviews and written statements to uncover core beliefs underlying self-stigma, the functions thereof, and strategies used to overcome it, among a heterogeneous group of PLHIV in Ireland.
  
  
  RESULTS
  Core beliefs underlying HIV-related self-stigma were uncovered and grouped into four categories: disclosure; sexuality and sexual pleasure; self-perception; and body, illness and death. Reported functions of self-stigma included contributing to maintaining a "victim" status; providing protection against stigma received from others; and justifying non-disclosure of HIV status. To cope with self-stigma, participants highlighted: community involvement and professional development; personal development; and connection to others and sense of belonging. Findings were also used to create a conceptual framework.
  
  
  CONCLUSIONS
  This study helps fill identified gaps in knowledge about self-stigma as experienced by PLHIV. By understanding the core beliefs driving self-stigma, it will be possible to create targeted interventions to challenge and overcome such beliefs, supporting PLHIV to achieve improved wellbeing and lead productive lives free of self-limitation and self-judgement.
authors.affiliation: Irish Forum for Global Health/Trinity College, Dublin, Ireland.
authors.forename: Nadine Ferris
authors.initials: NF
authors.lastname: France
authors.affiliation: Irish Forum for Global Health/Trinity College, Dublin, Ireland.
authors.forename: Steve H
authors.initials: SH
authors.lastname: Mcdonald
authors.affiliation: Royal College of Surgeons in Ireland, Dublin, Ireland.
authors.forename: Ronan R
authors.initials: RR
authors.lastname: Conroy
authors.affiliation: Royal College of Surgeons in Ireland, Dublin, Ireland.
authors.forename: Elaine
authors.initials: E
authors.lastname: Byrne
authors.affiliation: UNAIDS, Geneva, Switzerland.
authors.forename: Chris
authors.initials: C
authors.lastname: Mallouris
authors.affiliation: Independent Consultant.
authors.forename: Ian
authors.initials: I
authors.lastname: Hodgson
authors.affiliation: Irish Forum for Global Health/Trinity College, Dublin, Ireland.
authors.forename: Fiona N
authors.initials: FN
authors.lastname: Larkan
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000523:psychology*; D000223:Adaptation, Psychological; D000328:Adult; D005260:Female; D006167:Guilt; D006304:Health Status; D006801:Humans; D007407:Interviews as Topic; D007494:Ireland; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D011788:Quality of Life / Q000523:psychology; D012647:Self-Assessment; D019529:Sexuality / Q000523:psychology*; D012752:Shame; D014342:Truth Disclosure