title: Emotional, physical and financial burdens of stigma against people living with HIV/AIDS in China.
abstract: Numerous researches have shown pernicious effects of stigma against people living with HIV/AIDS (PLWHA). However, no available studies have reported these negative effects including emotional, physical to financial burdens to PLWHA. In the current study, we aim to explore different types of stigma (e.g., perceived, internalized and enacted) and the relevant consequences among PLWHA in China. A cross-sectional study was conducted from 2012 to 2013 in the Guangxi Autonomous Region in China. The validated Berger HIV Stigma Scale was used to measure various types of stigma. We employed a series of linear, logistic and polytomous regression models to assess the association between stigma and different consequences while accounting for potential confounders for each specific model. Of the total sample, 2987 PLWHA provided valid responses with 63% being male and having an average age of 42.9 years. Perceived, internalized and enacted HIV stigma were prevalent among participants, and resulted in various burdens with different magnitudes in their life contexts. Specially, PLWHA who reported higher perceived and internalized stigma were more likely to be imposed on emotional and physical burdens (p < .05). People who reported higher enacted stigma had heavier financial burden compared to their peers (p < .05). Our findings revealed that devastating consequences of HIV-related stigma in China. The prevalent stigmatizing attitudes have pushed PLWHA to the fringes of society and affected them at multiple aspects in their life context. We call for tailored efforts to overcome stigma and discrimination against PLWHA.
authors.affiliation: a Vanderbilt Institute of Global Health , Vanderbilt University , Nashville , TN , USA.
authors.forename: Chen
authors.initials: C
authors.lastname: Zhang
authors.affiliation: b Arnold School of Public Health , University of South Carolina , Columbia , SC , USA.
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Li
authors.affiliation: a Vanderbilt Institute of Global Health , Vanderbilt University , Nashville , TN , USA.
authors.forename: Yu
authors.initials: Y
authors.lastname: Liu
authors.affiliation: b Arnold School of Public Health , University of South Carolina , Columbia , SC , USA.
authors.forename: Shan
authors.initials: S
authors.lastname: Qiao
authors.affiliation: c Department of Pediatrics , Wayne State University , Detroit , MI , USA.
authors.forename: Liying
authors.initials: L
authors.lastname: Zhang
authors.affiliation: d Guangxi Center for Disease Control and Prevention , Nanning , People's Republic of China.
authors.forename: Yuejiao
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: d Guangxi Center for Disease Control and Prevention , Nanning , People's Republic of China.
authors.forename: Zhiyong
authors.initials: Z
authors.lastname: Shen
authors.affiliation: d Guangxi Center for Disease Control and Prevention , Nanning , People's Republic of China.
authors.forename: Zhengzhu
authors.initials: Z
authors.lastname: Tang
mesh_terms: D000328:Adult; D002681:China / Q000453:epidemiology; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000523:psychology*; D004192:Discrimination, Psychological; D004644:Emotions; D005260:Female; D015658:HIV Infections / Q000191:economics / Q000208:ethnology / Q000523:psychology*; D006801:Humans; D007389:Internal-External Control; D008297:Male; D008875:Middle Aged; D010465:Perception; D011788:Quality of Life; D057545:Social Stigma; D013240:Stereotyping
keywords: China; HIV-related stigma; PLWHA; various burdens