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Wang X, Han S, Jia C, Yang X, Hu Y, Zhang Y, Yang Z, Zhang L, Wang Z. Psychometric and Circumplex Properties Evaluation of the International Personality Item Pool-Interpersonal Circumplex (IPIP-IPC) in Chinese People Living with HIV (PLWH). Psychol Res Behav Manag 2024; 17:705-724. [PMID: 38410379 PMCID: PMC10896111 DOI: 10.2147/prbm.s446547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 02/10/2024] [Indexed: 02/28/2024] Open
Abstract
Background and Purpose With the improved life expectancy of people living with HIV (PLWH) due to widespread use of antiretroviral therapy (ART), there is a greater emphasis on enhancing long-term well-being and overall quality of life for PLWH. Understanding interpersonal personalities of PLWH can gain further insight into how to improve the overall quality of life in this population. The International Personality Item Pool-Interpersonal Circumplex (IPIP-IPC) scale has been developed to assess interpersonal personalities of individuals, and this scale has been translated into Chinese. However, the Chinese version of IPIP-IPC has not been tested among PLWH in China. In this study, we aimed to test the psychometric properties and circumplex structure of this scale. Methods This study was based on cross-sectional, multi-center, large sample data. We employed the Chinese version of IPIP-IPC scale on 3040 PLWH from April 2022 to April 2023 in China to test its psychometric as well as circumplex properties. The structural summary method (SSM) was employed to analyze the circumplex structure of the scale. Results The total scale exhibited a Cronbach's alpha of 0.85 and McDonald's omega of 0.91. Out of the 288 possible relationships, 275 relationships satisfy the circular properties hypothesis. The scale demonstrates good reliability and validity, meeting the requirements of psychometrics. Conclusion Our findings demonstrate that the Chinese version of the IPIP-IPC scale is a reliable tool for evaluating interpersonal personalities in this population. These results highlight the validity and applicability of the IPIP-IPC scale specifically in the Chinese context, providing valuable insights into the intricacies of interpersonal traits among PLWH.
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Affiliation(s)
- Xiaomeng Wang
- School of Nursing, Peking University, Beijing, 100191, People’s Republic of China
| | - Shuyu Han
- School of Nursing, Peking University, Beijing, 100191, People’s Republic of China
| | - Changli Jia
- School of Medical and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People’s Republic of China
| | - Xianxia Yang
- School of Public Health, Wuhan University, Wuhan, Hubei, 430071, People’s Republic of China
| | - Yan Hu
- School of Nursing, Fudan University, Shanghai, 200032, People’s Republic of China
| | - Yukun Zhang
- School of Nursing, Fudan University, Shanghai, 200032, People’s Republic of China
| | - Zhongfang Yang
- School of Nursing, Fudan University, Shanghai, 200032, People’s Republic of China
| | - Lili Zhang
- Department of Nursing, Beijing Youan Hospital Affiliated with Capital Medical University, Beijing, 100069, People’s Republic of China
| | - Zhiwen Wang
- School of Nursing, Peking University, Beijing, 100191, People’s Republic of China
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Mpinga K, Lee SD, Mwale O, Kamwiyo M, Nyirongo R, Ruderman T, Connolly E, Kayira W, Munyaneza F, Matanje B, Kachimanga C, Zaniku HR, Kulisewa K, Udedi M, Wagner G, McBain R. Prevalence and correlates of internalized stigma among adults with HIV and major depressive disorder in rural Malawi. AIDS Care 2023; 35:1775-1785. [PMID: 37001058 PMCID: PMC10544700 DOI: 10.1080/09540121.2023.2195609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 03/20/2023] [Indexed: 04/03/2023]
Abstract
Internalized stigma is common among individuals with sexually transmitted infections such as HIV and among those with mental health conditions such as major depressive disorder (MDD). As part of a cluster randomized trial, we investigated the prevalence and correlates of internalized stigma among adults living with comorbid HIV and MDD in rural Malawi (n = 339). We found heightened stigma toward HIV and mental illness among those in the cohort: more than half of respondents (54%) endorsed negative perceptions associated with each health condition. Internalized HIV-related stigma was higher among those with no education (p = 0.04), younger adults (p = 0.03), and those with less social support (p = 0.001). Mental illness-related stigma was elevated among those with no source of income (p = 0.001), and it was also strongly associated with HIV-related stigma (p < 0.001). Our findings highlight potential avenues for reducing internalized stigma associated with high-prevalence health conditions in Malawi.Trial registration: ClinicalTrials.gov identifier: NCT04777006.
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Affiliation(s)
| | - Sarita D. Lee
- Healthcare Delivery, RAND Corporation, Washington DC, USA
| | | | | | | | | | | | | | | | | | | | - Haules Robbins Zaniku
- College of Medicine, Kamuzu University of Health Sciences, Blantyre, Malawi
- Ministry of Health, Neno District Office, Neno, Malawi
| | - Kazione Kulisewa
- College of Medicine, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Michael Udedi
- Clinical Services, Ministry of Health, Lilongwe, Malawi
| | - Glenn Wagner
- Healthcare Delivery, RAND Corporation, Washington DC, USA
| | - Ryan McBain
- Healthcare Delivery, RAND Corporation, Washington DC, USA
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3
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Armstrong-Mensah E, Ofori E, Alema-Mensah E, Agyarko-Poku T. HIV destigmatization: perspectives of people living with HIV in the Kumasi Metropolis in Ghana. FRONTIERS IN REPRODUCTIVE HEALTH 2023; 5:1169216. [PMID: 37799493 PMCID: PMC10548132 DOI: 10.3389/frph.2023.1169216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 09/07/2023] [Indexed: 10/07/2023] Open
Abstract
Background Human immunodeficiency virus (HIV)-related stigma has been identified as one of the principal factors that undermines HIV prevention efforts and the quality of life of people living with HIV (PLWH) in many developing countries including Ghana. While studies have been conducted on HIV-related stigma reduction, very few have sought the views of PLWH on how this might be done. The purpose of the study was to (i) identify factors that cause HIV-related stigma in Ghana from the perspective of PLWH, (ii) identify challenges that HIV-related stigma poses to the treatment and care of PLWH, and (iii) to obtain recommendations from PLWH on what they think various groups (community members, health care providers, and adolescents) including themselves should do to help reduce HIV-related stigma in Ghana. Methods A mixed methods cross-sectional study design was used to collect data from 404 PLWH at the Suntreso Government Hospital in the Kumasi Metropolis of Ghana across six domains using Qualtrics from November 1-30, 2022. Quantitative data was analyzed using the Statistical Package for Social Sciences (SPSS) version 26 and the Statistical Analysis System (SAS) version 9.4. Qualitative data was analyzed using a thematic approach. Results Most of the study participants (70.5%) said HIV-related stigma in Ghana is due to ignorance. Of this population, 90.6% indicated that they had experienced stigma because they have HIV, causing them to feel depressed (2.5%), ashamed (2.2%), and hurt (3.0%). Study participants (92.8%) indicated that the challenges associated with HIV-related stigma has affected their treatment and care-seeking behaviors. Recommendations provided by study participants for HIV destigmatization include the need for PLWH not to disclose their status (cited 94 times), community members to educate themselves about HIV (96.5%), health care providers to identify their stigmatizing behaviors (95.3%), health care providers to avoid discriminating against PLWH (96.0%), and the need for adolescents to be educated on HIV and how it is transmitted (97.0%). Conclusion It is important for the government and HIV prevention agencies in Ghana to target and address co-occurring HIV-related stigma sources at various levels of intersection simultaneously This will help to shift harmful attitudes and behaviors that compromise the health and wellbeing of PLWH effectively.
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Affiliation(s)
- Elizabeth Armstrong-Mensah
- Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, United States
| | - Emmanuel Ofori
- Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana
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4
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Dong Y. "Premature" Girls with "Illegitimate" Diseases: A Qualitative Exploration of the Stigma of Gynecological Diseases for Unmarried Young Women in China. JOURNAL OF HEALTH COMMUNICATION 2023; 28:111-120. [PMID: 36855814 DOI: 10.1080/10810730.2023.2185322] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Stigma has been a prominent barrier in women's pursuit of better sexual and reproductive health (SRH). Specifically, evidence supports the stigmatization of gynecological diseases (GDs) for unmarried young women. Drawing upon the model of social identity threats, this study explored the GD stigma and social identity threats faced by unmarried young women in China with 26 in-depth interview data. The interpersonal, socio-cultural, and intrapersonal layers of GD stigma were identified. First, participants' disclosure and concealment of GDs concerning different significant others were contrasted as an interpersonal layer and voluntary response to social identity threats. In participants' GD experiences, peers stood out for providing emotional, tangible, and informational support, while parents were most often avoided for anticipated stigma. Second, collective representations of GDs and the cultural rationale in the socio-cultural layer were probed. The traditional and modernized sexual norms centering on the legitimacy of premarital sex and SRH knowledge were unveiled. At last, the interpersonal layer was identified. Unmarried young patients suffered social identity threats regarding their independence, sexual agency, and bodily awareness. This is one of the first studies that investigated the underappreciated GD stigma in China. Theoretical and practical implications are discussed.
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Affiliation(s)
- Yujie Dong
- School of Media and Communication, Shanghai Jiao Tong University, Shanghai, China
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5
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Chu Q, Zhang X, Lan J, Zhang Q, Wei T, Fu Y, Fan Y. Prevalence and factors associated with late diagnosis among older adults living with HIV in liuzhou, China: 2010-2020. J Med Virol 2023; 95:e28288. [PMID: 36349389 DOI: 10.1002/jmv.28288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 10/23/2022] [Accepted: 11/06/2022] [Indexed: 11/11/2022]
Abstract
This paper aimed to quantify and characterize the prevalence and associated factors for late diagnosis in older adults living with human immunodeficiency virus (HIV) in Liuzhou, China, from 2010 to 2020. The characteristics of older adults living with HIV were described separately in time, space and population. Multivariate logistic regression analysis evaluates the factors influencing late diagnosis in HIV-positive adults ≥ 50 years of age. The majority of older adults living with HIV were over 60 years old, male, and with CD4 counts < 200 cells/μl at diagnosis, with most late diagnoses being more likely to report heterosexual transmission. These two factors may potentially provide a positive influence on late diagnosis: older and CD4 counts < 500 cells/μl. In contrast, females and those with homosexual or other transmission provide a negative. These results suggest that late diagnosis of HIV-positive adults ≥ 50 years of age remains a severe and growing epidemiological issue.
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Affiliation(s)
- Qinshu Chu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, PR China.,Anhui Province Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, Hefei, Anhui, PR China
| | - Xinhong Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, PR China.,Anhui Province Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, Hefei, Anhui, PR China
| | - Jianguo Lan
- Liuzhou Center for Disease Control and Prevention, Liuzhou, Guangxi Zhuang Autonomous Region, PR China
| | - Qi Zhang
- Hefei Center for Disease Control and Prevention, Hefei, Anhui, PR China
| | - Tao Wei
- Liuzhou Center for Disease Control and Prevention, Liuzhou, Guangxi Zhuang Autonomous Region, PR China
| | - Yuansheng Fu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, PR China.,Anhui Province Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, Hefei, Anhui, PR China
| | - Yinguang Fan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, PR China.,Anhui Province Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, Hefei, Anhui, PR China
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6
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Zeng J, Zhang J, Xie J, Hao C, Li J, Li L, Gu J. Association Between the Awareness of Antiretroviral Drugs-Related Services and Drug Accessibility During the COVID-19 Pandemic Among Patients Undergoing Antiretroviral Therapy: A Cross-Sectional Study. AIDS Behav 2023; 27:891-900. [PMID: 36169780 PMCID: PMC9516505 DOI: 10.1007/s10461-022-03825-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2022] [Indexed: 11/30/2022]
Abstract
In a cross-sectional survey from 21 February to 6 March, 2020, we analyzed the awareness and utilization of antiretroviral drugs (ARVs)-related services among people living with HIV during the COVID-19 pandemic in Guangzhou, China. In addition, a subgroup analysis was performed among those who needed to go to hospital to access their drugs, and we explored the association between the awareness of ARVs-related services and the accessibility of ARVs. Of 375 participants, 89.9% were aware of drug-borrowing service, 90.7% were aware of drug-delivery service and 86.9% were aware of information-assistance service. Knowing about the drug-borrowing service or the information-assistance service, knowing about at least two services and knowing about all of the three services were all positively associated with ARVs accessibility. In addition, 35 (39.3%) of those who had acquired their drugs on time received them via the drug-delivery service. To some extent, the three ARVs-related services have alleviated the difficulties in accessing ARVs during the pandemic, especially the drug-delivery service.
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Affiliation(s)
- Jing Zeng
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong China
| | - Jing Zhang
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong China
| | - Jinzhao Xie
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong China
| | - Chun Hao
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong China ,Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, Guangdong China
| | - Jinghua Li
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong China ,Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, Guangdong China
| | - Linghua Li
- Department of Infectious Diseases, Guangzhou Eighth People’s Hospital, Guangzhou Medical University, Guangzhou, Guangdong China
| | - Jing Gu
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China. .,Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, Guangdong, China. .,School of Public Health, Sun Yat-sen University, No. 74, Zhongshan Road II, 510080, Guangzhou, China.
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7
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Ismail R, Voss JG, Yona S, Nurachmah E, Boutain D, Lowe C, John-Stewart G, Woods NF. Classifying stigma experience of women living with HIV in Indonesia through the social ecological model. Health Care Women Int 2021; 43:345-366. [PMID: 34379051 DOI: 10.1080/07399332.2021.1929989] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Little is known how stigma theories apply to women living with HIV (WLWH). To apply stigma theories to WLWH, and locate within the dimensions of the Social-Ecological Model (SEM). Using a literature review and a theoretical subtraction to apply stigma forms to the SEM dimensions. WLWH begin to self-stigmatize, receive stigma based on fear from the family and community. Healthcare providers and society stigmatize WLWH by ascribing character flaws to them. The SEM allowed us to locate the dimensions of stigma and identify areas for future interventions for WLWH in Indonesia and other countries.
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Affiliation(s)
- Rita Ismail
- Ministry of Health Republic of Indonesia, Jakarta, Indonesia
| | - Joachim G Voss
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA
| | - Sri Yona
- Department of Medical Surgical Nursing, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
| | - Elly Nurachmah
- Department of Medical Surgical Nursing, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
| | - Doris Boutain
- Psychosocial and Community Health, School of Nursing, University of Washington, Seattle, Washington, USA
| | - Celia Lowe
- Department of Anthropology, University of Washington, Seattle, Washington, USA
| | - Grace John-Stewart
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | - Nancy Fugate Woods
- Biobehavioral Nursing and Health Systems, School of Nursing, University of Washington, Seattle, Washington, USA
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8
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Chubb LA, Fouché CB. Domestic stigmatisation: refocusing interventions for people living with HIV. AJAR-AFRICAN JOURNAL OF AIDS RESEARCH 2021; 19:276-286. [PMID: 33337981 DOI: 10.2989/16085906.2020.1834416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Domestic stigmatisation serves as an umbrella term for acts of enacted or felt stigma experienced in a person's domestic environment. This article reports on the term which transpired from a narrative inquiry in 2011 with people living with HIV (PLWH) who reported humiliation or segregation, experienced or perceived, within the domestic environment that rendered the individual disabled, diseased, unworthy, unhealthy, or deficient. A literature review about this form of stigma was conducted using the following inclusion criteria: 1) a peer-reviewed source; 2) published between 2011 and 2018; 3) access to full-text articles; 4) accessible in English; 5) reported from any country; and 6) using qualitative or mixed-method approaches. A total of 37 studies were included in the review - documenting 51 specific experiences of domestic stigmatisation (referred to as acts for the purpose of the review) across all studies. A matrix was developed detailing each study's' publication date, geographical context, participant gender (where possible) and the reported acts. A critical analysis is offered on the concept "domestic stigmatisation" and its relevance to domestic or family interventions. Deliberate attention to this concept can potentially refocus HIV stigma-reducing interventions to benefit families and promote coping strategies to reduce stigma-related stress associated with seropositive identities.
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Affiliation(s)
- Laura Ann Chubb
- Department of Counselling, Human Services and Social Work, University of Auckland, Auckland, New Zealand
| | - Christa B Fouché
- Department of Counselling, Human Services and Social Work, University of Auckland, Auckland, New Zealand
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9
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Mason KA. Epidemiologizing Culture: Scaling Chineseness through Narratives of Stigma in New York City. Med Anthropol Q 2020; 35:43-63. [PMID: 32681809 DOI: 10.1111/maq.12582] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 03/26/2020] [Accepted: 03/26/2020] [Indexed: 12/16/2022]
Abstract
Drawing on 18 months of participation on an epidemiological research team and close analysis of in-depth interviews the team conducted with 30 Chinese immigrants to New York City, this article traces a process I call epidemiologizing culture. In producing qualitative interview data from Chinese immigrants at risk for HIV, team members smoothed over individual variation to extract elements thought to be relevant to population-level experiences of "Chinese culture." Relevance was determined based on how closely the experiences of participants mirrored the behavior of a Chinese ideal type. Interviewer and interviewee collaborated in articulating and reproducing homophobic and HIV-phobic discourses associated with Chinese culture while erasing details of lived experience, and conflating race and culture. I conclude that differing epistemic virtues make an epidemiological embrace of contemporary anthropological understandings of culture difficult. A model of "parallel play" may be an alternative approach to interdisciplinary synthesis.
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10
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Yang Y, Wang W, Kelifa MO, Li J, Yao X, Li S, Yan H. HIV Disclosure Patterns and Psychosocial Correlates Among People Living with HIV in Nanjing, China: A Latent Class Analysis. AIDS Res Hum Retroviruses 2020; 36:220-226. [PMID: 31793328 DOI: 10.1089/aid.2019.0212] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Little is known about the patterns of HIV disclosure and the predictors of such group memberships. Therefore, our study aimed to explore the relationship between HIV disclosure patterns and psychosocial factors. From July to August 2016, totally 466 people living with HIV (PLWH) were recruited from a tertiary hospital. Latent class analysis was performed to ascertain HIV disclosure patterns, and multinomial logistic regression was used to examine predictors of HIV disclosure patterns. Four classes were identified and characterized as the systematic disclosure (11.2%), systematic concealment (39.5%), disclosure to spouse (29.0%), and disclosure to parents (20.4%). Relative to the systematic concealment class, respondents of the systematic disclosure and disclosure to spouse classes were more likely to report a high level of social support (adjusted odds ratio (aOR) = 1.112, 95% CI = 1.039-1.189; aOR = 1.144, 95% CI = 1.084-1.208). PLWH in the disclosure to spouse class tended to have increased perceived stigma (aOR = 1.040, 95% CI = 1.008-1.073). These findings provide practical implications for effective intervention targeting the different subgroups. Urgent attention should be paid to perceived stigma and social support to encourage PLWH to disclose their HIV status.
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Affiliation(s)
- Yinmei Yang
- School of Health Sciences, Wuhan University, Wuhan, China
| | - Wei Wang
- School of Public Health, Xuzhou Medical University, Xuzhou, China
| | | | - Jingjing Li
- Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Tucker, Georgia
| | - Xing Yao
- School of Health Sciences, Wuhan University, Wuhan, China
| | - Shiyue Li
- School of Health Sciences, Wuhan University, Wuhan, China
| | - Hong Yan
- School of Health Sciences, Wuhan University, Wuhan, China
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11
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Ferris France N, Macdonald SHF, Conroy RR, Chiroro P, Ni Cheallaigh D, Nyamucheta M, Mapanda B, Shumba G, Mudede D, Byrne E. 'We are the change' - An innovative community-based response to address self-stigma: A pilot study focusing on people living with HIV in Zimbabwe. PLoS One 2019; 14:e0210152. [PMID: 30759114 PMCID: PMC6373928 DOI: 10.1371/journal.pone.0210152] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 12/17/2018] [Indexed: 12/31/2022] Open
Abstract
Introduction Self-stigma–negative self-judgements resulting in shame, worthlessness and self-blame–may play a crucial role in emotional reactions and cause emotional distress among many people living with HIV and other chronic illnesses. Furthermore, self-stigma negatively impacts on self-agency, quality of life, adherence to treatment, and access to services. High levels of self-stigma have been reported across many countries, however few programmes or interventions exist to specifically tackle this phenomenon. This paper reports the findings of a pilot study carried out in Zimbabwe using a programme incorporating “Inquiry-Based Stress Reduction (IBSR): The Work of Byron Katie”–a guided form of self-inquiry which helps users to overcome negative thoughts and beliefs. Objectives The primary objective of this uncontrolled pilot study was to examine the potential role of the IBSR intervention in helping people living with HIV to overcome self-stigma and associated states. Methods 23 people living with HIV (17 Female, 6 male, average age 41 years) were recruited from a local HIV support network, via open call for volunteers. All participants received the intervention, consisting of a 12-week facilitated programme using techniques derived from IBSR: The Work of Byron Katie. Qualitative and quantitative data were collected and analysed pre- and post-programme. Results After taking part in the intervention, participants reported significant improvements in factors including self-stigma (1-month follow-up vs baseline Z = 2.1, p = 0.039; 3-month follow-up vs baseline Z = 3.0, p = 0.003, n = 23, Wilcoxon Matched Pairs Signed Rank Test) and depression (1mo vs baseline Z = 3.7, p = <0.001; 3mo vs baseline Z = 3.3, p = 0.001). Qualitatively, participants reported improvements including lessened fears around disclosure of their HIV status, reduced feelings of life limitations due to HIV, and greater positive mentality. Improvements persisted at three-month follow-up. Conclusion With further development and larger comparative studies to confirm effects, the IBSR programme could become a novel tool to enable people living with HIV to support themselves in overcoming self-stigma.
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Affiliation(s)
- Nadine Ferris France
- The Work for Change / Irish Forum for Global Health, c/o Department of Epidemiology and Public Health Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Stephen H.-F. Macdonald
- The Work for Change / Irish Forum for Global Health, c/o Department of Epidemiology and Public Health Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
- * E-mail:
| | - Ronan R. Conroy
- Department of Epidemiology and Public Health Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | | | - Masimba Nyamucheta
- Zimbabwe National Network of People Living with HIV (ZNNP+), Harare, Zimbabwe
| | | | - Godsway Shumba
- Independent Consultant to Trócaire, Maynooth, Co. Kildare, Ireland
| | - Dennis Mudede
- Connect Zimbabwe Institute of Systemic Therapy (ZIST), Harare, Zimbabwe
| | - Elaine Byrne
- RCSI Institute of Leadership, Royal College of Surgeons in Ireland, Dublin, Ireland
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12
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Lu HF, Sheng WH, Liao SC, Chang NT, Wu PY, Yang YL, Hsiao FH. The changes and the predictors of suicide ideation and suicide attempt among HIV-positive patients at 6-12 months post diagnosis: A longitudinal study. J Adv Nurs 2018; 75:573-584. [PMID: 30334591 DOI: 10.1111/jan.13883] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 08/19/2018] [Accepted: 09/13/2018] [Indexed: 02/05/2023]
Abstract
AIMS This study examined the changes and the predictors of suicide ideation/suicide attempt and the moderating effects of psychosocial factors on the suicide ideation/suicide attempts among human immunodeficiency virus (HIV)-positive patients at 6-12 months post-diagnosis. BACKGROUND Suicide behaviours are prevalent among newly diagnosed HIV-positive patients, but the changes in suicide behaviours after diagnosis and the role of psychosocial factors in these behaviours are not well studied. DESIGN This study used a prospective longitudinal design. METHODS A total of 113 participants diagnosed as HIV-positive for 6-12 months were recruited from the outpatient department. Data were collected from June 2015 - October 2016. They were asked to complete Beck's Scale for Suicide Ideation, the Beck Depression Inventory-II, the Body Image Scale, the Meaning in Life Questionnaire and the Multidimensional Scale of Perceived Social Support at baseline, the third month and the sixth month. RESULTS The results showed the high occurrence rates for suicide ideation ranging from 27.2%, 21.6%, and 25.8% and suicide attempt ranging from 14.7%, 8.6%, and 13.3% at the baseline, the third month and the sixth month, respectively. The education level, social support from family and depressive symptoms were the predictors of suicide ideation. The history of depression disorders, depressive symptoms and social support from friends significantly predicted suicide attempt. Meaning in life-presence moderated the relationship between depressive symptoms and suicide ideation. CONCLUSIONS After diagnosed for 6-12 months, HIV-positive patients remain the high-risk group for suicide ideation and attempt. Suicide intervention targeting the risk and protective factors are required for HIV-positive patients.
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Affiliation(s)
- Hsing-Fei Lu
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan.,Department of Nursing, Hsin Sheng Junior College of Medical Care and Management, Taoyuan, Taiwan
| | - Wang-Huei Sheng
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Shih-Cheng Liao
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Nien-Tzu Chang
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Pei-Ying Wu
- Department of Infectious disease, National Taiwan University Hospital, Taipei, Taiwan
| | - Ya-Ling Yang
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Fei-Hsiu Hsiao
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan.,Nursing Department, National Taiwan University Hospital, Taipei, Taiwan
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13
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Wu F, Zhang A, Babbitt A, Ma Q, Eyal N, Pan X, Cai W, Hu F, Cheng Y, Tucker JD. Overcoming HIV Stigma? A Qualitative Analysis of HIV Cure Research and Stigma Among Men Who Have Sex with Men Living with HIV. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:2061-2069. [PMID: 29149399 PMCID: PMC5957764 DOI: 10.1007/s10508-017-1062-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 08/09/2017] [Accepted: 08/14/2017] [Indexed: 06/07/2023]
Abstract
Despite global progress in HIV stigma reduction, persistent HIV stigma thwarts effective HIV service delivery. Advances in HIV biomedical research toward a cure may shift perceptions of people living with HIV and HIV stigma. The purpose of this study was to examine how men who have sex with men (MSM) living with HIV in Guangzhou, China perceive HIV cure research and its potential impact on MSM and HIV stigma. We conducted in-depth interviews with 26 MSM living with HIV about their perceptions of HIV cure research and the potential impact of an HIV cure on their lives. Thematic coding was used to identify themes and structure the analysis. Two overarching themes emerged. First, participants stated that an HIV cure may have a limited impact on MSM-related stigma. Men noted that most stigma toward MSM was linked to stereotypes of promiscuity and high rates of sexual transmitted diseases in the MSM community and might persist even after a cure. Second, participants believed that an HIV cure could substantially reduce enacted, anticipated, and internalized stigma associated with HIV. These findings suggest that a biomedical cure alone would not remove the layered stigma facing MSM living with HIV. Comprehensive measures to reduce stigma are needed.
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Affiliation(s)
- Feng Wu
- University of North Carolina Project-China, 2 Lujing Road, Guangzhou, Guangdong Province, China
| | - Alice Zhang
- University of North Carolina Project-China, 2 Lujing Road, Guangzhou, Guangdong Province, China
- Department of Family Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Andrew Babbitt
- University of North Carolina Project-China, 2 Lujing Road, Guangzhou, Guangdong Province, China
| | - Qingyan Ma
- University of North Carolina Project-China, 2 Lujing Road, Guangzhou, Guangdong Province, China
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Nir Eyal
- Harvard University Program in Ethics and Health, Harvard University, Boston, MA, USA
| | - Xin Pan
- University of North Carolina Project-China, 2 Lujing Road, Guangzhou, Guangdong Province, China
| | - Weiping Cai
- Infectious Diseases Institute, Guangzhou Eighth People's Hospital, Guangzhou, China
| | - Fengyu Hu
- Infectious Diseases Institute, Guangzhou Eighth People's Hospital, Guangzhou, China
| | - Yu Cheng
- School of Sociology and Anthropology, Sun Yat-Sen University, Guangzhou, China
| | - Joseph D Tucker
- University of North Carolina Project-China, 2 Lujing Road, Guangzhou, Guangdong Province, China.
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
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Fitzgerald-Husek A, Van Wert MJ, Ewing WF, Grosso AL, Holland CE, Katterl R, Rosman L, Agarwal A, Baral SD. Measuring stigma affecting sex workers (SW) and men who have sex with men (MSM): A systematic review. PLoS One 2017; 12:e0188393. [PMID: 29190642 PMCID: PMC5708696 DOI: 10.1371/journal.pone.0188393] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 10/23/2017] [Indexed: 12/03/2022] Open
Abstract
Background Stigma involves discrediting a person or group based on a perceived attribute, behaviour or reputation associated with them. Sex workers (SW) and men who have sex with men (MSM) are key populations who are often at increased risk for the acquisition and transmission of HIV and who are affected by stigma that can negatively impact their health and well-being. Although stigma was included as an indicator in the US National HIV/AIDS Strategic Plan and there have been consultations focused on adding a stigma indicator within PEPFAR and the Global Fund in relation to potentiating HIV risks among key populations, there remains limited consensus on the appropriate measurement of SW- or MSM-associated stigma. Consequently, this systematic review summarizes studies using quantitative, qualitative, or mixed methods approaches to measure stigma affecting sex workers and men who have sex with men. Methods and findings This systematic review included English, French, and Spanish peer-reviewed research of any study design measuring SW- or MSM-associated stigma. Articles were published from January 1, 2004 to March 26, 2014 in PsycINFO, PubMed, EMBASE, CINAHL Plus, Global Health, and World Health Organization Global Health Library Regional Indexes. Of the 541 articles reviewed, the majority measured stigma toward MSM (over 97%), were conducted in North America, used quantitative methods, and focused on internalized stigma. Conclusions With the inclusion of addressing stigma in several domestic and international HIV strategies, there is a need to ensure the use of validated metrics for stigma. The field to date has completed limited measurement of stigma affecting sex workers, and limited measurement of stigma affecting MSM outside of higher income settings. Moving forward requires a concerted effort integrating validated metrics of stigma into health-related surveys and programs for key populations.
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Affiliation(s)
- Alanna Fitzgerald-Husek
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- * E-mail:
| | - Michael J. Van Wert
- Community Psychiatry Program, Johns Hopkins Bayview Medical Center, Baltimore, Maryland, United States of America
| | - Whitney F. Ewing
- Centre for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Ashley L. Grosso
- Centre for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Claire E. Holland
- Centre for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Rachel Katterl
- HIV/AIDS, STIs & Viral Hepatitis Programme, World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Lori Rosman
- Welch Medical Library, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Arnav Agarwal
- School of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Stefan D. Baral
- Centre for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
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Stigmatizing attitudes toward people living with HIV among general adult Thai population: Results from the 5th Thai National Health Examination Survey (NHES). PLoS One 2017; 12:e0187231. [PMID: 29145519 PMCID: PMC5690635 DOI: 10.1371/journal.pone.0187231] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 10/16/2017] [Indexed: 11/30/2022] Open
Abstract
Background HIV-related stigma and discrimination is a significant driver of the HIV and AIDS epidemic. UNAIDS encourages all nations to monitor progress toward elimination of this problem. This study measured the level of stigmatizing attitudes toward people living with HIV (PLHIV) among Thai adults in the general population using recommended global tools. Methods Data from the 5th National Health Examination Survey, conducted in 2014 were used. The survey utilized six questions recommended by the Global Stigma and Discrimination Indicator Working Group and was administered to participants aged 20–59 years old. All analyses were weighted to take into account of the probability of sampling the same-age Thai population. Factors related to a discriminatory attitude according to UNAIDS, defined as agreed to at least one of the two discriminatory issues, were evaluated using Chi square tested and multivariable logistic regression. Results Of the 10,522 respondents, the most prevalent stigmatizing attitude was anticipated stigma (76.9%), followed by perceived stigma (69.2%), fear of HIV infection (57.0%), and social judgment (38.2%). Fifty-eight point six percent had discriminatory attitudes according to the UNAIDS global indicator. Independent predictors were being female (AOR = 1.21: 95% CI 1.14–1.29), aged 20–39 (AOR = 1.19: 95% CI 1.09–1.30) or 50–59 (AOR = 1.18: 95%CI 1.12–1.26), being Muslim (AOR = 2.03: 95%CI 1.55–2.66), earning < 10,000 Baht/month (AOR = 0.93: 95%CI 0.88–0.99), and living in the Northeast (AOR = 1.67: 95%CI 1.39–2.00) or in Bangkok (AOR = 1.73: 95%CI 1.45–2.07). Conclusions More than half of the general adult Thai population had stigmatizing attitudes toward PLHIV. The study provided valuable baseline information which could be used as comparison for follow-up surveys with other countries. Interventions to improve Thai society’s knowledge and attitudes toward HIV/AIDS are urgently needed.
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16
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Ferlatte O, Salway T, Oliffe JL, Trussler T. Stigma and suicide among gay and bisexual men living with HIV. AIDS Care 2017; 29:1346-1350. [PMID: 28278571 DOI: 10.1080/09540121.2017.1290762] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
HIV positive gay and bisexual men (GBM) continue to struggle with the pervasiveness of HIV stigma, but little is known about the health effects of stigma. In this article, suicidal ideation and attempts are measured among GBM living with HIV, evaluating the extent to which these experiences are associated with stigma and suicide. Drawing from an online national survey of Canadian GBM completed by 7995 respondents, a sub-set of data provided by respondents self-reporting HIV-positive status was used for the current study. The associations between suicidal ideation (SI) and attempts (SA) and four measures of HIV stigma were measured: social exclusion, sexual rejection, verbal abuse and physical abuse. A total of 673 HIV-positive men completed the survey (8% of total sample). Among this group, 22% (n = 150) reported SI and 5% (n = 33) SA in the last 12 months. After adjusting for sociodemographic factors, SI and SA were associated with each of the four measures of HIV stigma: being excluded socially for being HIV positive (SI adjusted odds ratio, AOR 2.0 95% CI 1.4-3.1; SA AOR 3.8 95% CI 1.9-7.9), rejected as a sexual partner (SI AOR 1.6 95% CI 1.1-2.4; SA AOR 2.6 95% CI 1.1-6.0), verbally abused (SI AOR 2.9 95% CI 1.9-4.5; SA AOR 2.4 95% CI 1.1-5.1), and physically abused (SI AOR 4.5 95% CI 1.8-11.7; SA AOR 6.4 95% CI 2.0-20.1). Furthermore, experiencing multiple forms of stigma was associated with significantly increased risk of SI and SA. The authors conclude that HIV positive GBM experience significant levels of stigma that are associated with heightened risk for suicide. The findings affirm the need for targeted interventions to prevent suicide amid public health efforts to de-stigmatize HIV and mental illness.
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Affiliation(s)
- Olivier Ferlatte
- a Men's Health Research program , University of British Columbia , Vancouver Canada
| | - Travis Salway
- b Dalla Lana School of Public Health , University of Toronto , Toronto , Canada
| | - John L Oliffe
- a Men's Health Research program , University of British Columbia , Vancouver Canada
| | - Terry Trussler
- c Community-Based Research Centre for Gay Men's Health , Vancouver , Canada
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17
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Li Z, Hsieh E, Morano JP, Sheng Y. Exploring HIV-related stigma among HIV-infected men who have sex with men in Beijing, China: a correlation study. AIDS Care 2016; 28:1394-401. [PMID: 27137205 DOI: 10.1080/09540121.2016.1179713] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Human immunodeficiency virus (HIV)-related stigma among HIV-infected men who have sex with men (MSM) has been associated with adverse health outcomes, including poor adherence to antiretroviral therapy and care, and increased participation in behaviors linked to higher rates of HIV transmission. In China, the incidence of HIV is growing more rapidly among MSM than among other subgroups. This study characterizes and quantifies HIV stigma among HIV-infected MSM in Beijing, China, which arguably may be driving this epidemic. A cross-sectional survey study was performed among 266 HIV-positive MSM in Beijing, China, in 2014. The Berger HIV Stigma Scale was used to measure levels of HIV-related stigma. Participants additionally answered questions regarding socio-demographic characteristics and HIV-associated risk factors; previously validated Mandarin-language scales assessed depression, coping style, and social support networks. Multivariable linear regression models were used to identify variables significantly associated with HIV stigma. The mean overall HIV stigma score among the study population was 112.78 ± 18.11 (score range: 40-160). Higher HIV stigma scores were positively associated with depression (β = 7.99, 95% CI:3.69, 12.29, p < .001) and negative coping skills (β = 0.64, 95% CI:0.21,1.08, p < .01), and was negatively associated with disclosed HIV status (β = -6.45, 95%CI:-11.80, -1.11, p < .05), and availability of social support networks (β = -0.12, 95%CI:-0.22, -0.02, p < .05). Other variables such as poor self-rated health status and presence of opportunistic infections were positively associated with individual dimensions of HIV-related stigma. The results of this study can inform the development of culturally sensitive interventions to reduce HIV-related stigma among MSM with HIV in China, with the overarching goal of reducing HIV transmission in this vulnerable population.
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Affiliation(s)
- Zhen Li
- a School of Nursing , Peking Union Medical College , Beijing , People's Republic of China
| | - Evelyn Hsieh
- b Department of Internal Medicine , Yale School of Medicine , New Haven , CT , USA
| | - Jamie P Morano
- c Division of Infectious Diseases and International Medicine , University of South Florida, Morsani College of Medicine and College of Public Health , Tampa , FL , USA.,d Yale University Center for Interdisciplinary Research on AIDS (CIRA) , New Haven , CT , USA
| | - Yu Sheng
- e Department of Basic Nursing, School of Nursing , Peking Union Medical College , Beijing , People's Republic of China
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Abstract
In Spain little research has focused on assessment of health indicators, both physical and psychological, in people living with HIV. The aim of this study is to evaluate a set of different indicators that allow us to identify psychological factors that may be influencing the quality of life of these people. The sample consist of 744 people infected with HIV aged between from 18 to 82 years (M = 43.04; SD = 9.43). Results show that factors such as self-esteem and leading a healthy lifestyle act as protectors in both, physical and mental health. On the other hand, financial problems, body disfigurement, and depressive mood could have harmful effects on both, physical and mental health. The structural model reveals depressed mood as the factor with greatest influence upon mental health, which in turn can be largely explained by factors such as the stress generated by HIV and personal autonomy. This work has allowed us to identify the vulnerability and protective factors that play a significant role in the physical and mental HRQOL of persons with HIV, providing guidelines for design and implementation of psychological intervention programs aimed to improve HRQOL in this population.
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Wu YL, Yang HY, Wang J, Yao H, Zhao X, Chen J, Ding XX, Zhang HB, Bi P, Sun YH. Prevalence of suicidal ideation and associated factors among HIV-positive MSM in Anhui, China. Int J STD AIDS 2014; 26:496-503. [PMID: 25060699 DOI: 10.1177/0956462414544722] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Accepted: 06/30/2014] [Indexed: 11/15/2022]
Abstract
The aim of this study was to investigate the prevalence and factors associated with suicidal ideation among HIV-positive men who have sex with men (MSM) in Anhui, China. A cross-sectional study was conducted to recruit HIV-positive MSM in Anhui, China. A total of 184 HIV-positive MSM gave informed consent and completed the interview. Correlates of suicidal ideation were assessed using multivariable logistic regression. Fifty-seven (31%) of HIV-positive MSM had suicidal ideations within six months before the interview. Multivariable analyses showed that learning of their HIV status in the past 12 months (adjusted odds ratio (AOR) = 3.4, 95% CI = 1.6-7.3), perceived HIV stigma (AOR = 2.4, 95% CI = 1.1-5.2), depression symptoms (AOR = 2.6, 95% CI = 1.1-5.9) and anxiety symptoms (AOR = 2.7, 95% CI = 1.2-6.1) were significantly associated with the suicidal ideation among HIV-positive MSM. The results indicated that suicidal ideation was common among HIV-positive MSM in Anhui, China. There is an urgent need to establish psychological counselling services among HIV-positive MSM in China. Targeting of these potential risk factors could be an effective approach to reduce the suicide risk among this high-risk subgroup by the implementation of early intervention measurements.
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Affiliation(s)
- Yi-Le Wu
- Department of Epidemiology and Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Hui-Yun Yang
- Department of Epidemiology and Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Jun Wang
- Department of Epidemiology and Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Hui Yao
- Center for Disease Control and Prevention of Hefei City, Hefei, China
| | - Xue Zhao
- Department of Epidemiology and Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Jian Chen
- Department of Epidemiology and Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Xiu-Xiu Ding
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Hong-Bo Zhang
- Department of Epidemiology and Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Peng Bi
- Discipline of Public Health, the University of Adelaide, Adelaide, SA, Australia
| | - Ye-Huan Sun
- Department of Epidemiology and Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
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20
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Henderson G, Maman S, Huang Y, Muessig K, Pan S. Social contexts of heterosexual transmission of HIV/STI in Liuzhou City, China. AIDS Behav 2014; 18 Suppl 2:S111-7. [PMID: 24337698 DOI: 10.1007/s10461-013-0666-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In this special issue of AIDS and Behavior, we focus on the social contexts of sexual transmission of HIV/STI in one South China city. Our multiple projects grew from partnerships across the social and biomedical sciences, and with public health experts in Liuzhou City, to address critical gaps in knowledge about how social factors drive heterosexual transmission. The eleven articles that comprise this special issue feature multidisciplinary and mixed method approaches, collecting data in Liuzhou from different populations, environments, and social venues where individuals often find sexual partners. They document heterosexual behaviors and their meanings. They investigate the experiences and behaviors of women and men in social venues, exploring the networks of people within these venues, how they relate to one another, share information, and influence each other. The articles also examine the experiences of people living with HIV, again collecting data from multiple levels and sources, and revealing the ongoing power of stigma to shape these lives. Taken together, the articles demonstrate the critical role of social contexts in shaping behaviors and meanings, which are linked to heterosexual transmission of HIV/STI, and which must be taken into account for the development of appropriate and effective public health interventions.
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Affiliation(s)
- Gail Henderson
- Department of Social Medicine, University of North Carolina School of Medicine, 333 South Columbia St., 347 MacNider, Chapel Hill, NC, 27599-7240, USA,
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Yingying H, Abler L, Suiming P, Henderson GE, Xin W, Xingliang Y, Parish WL. Population-based sexual behavior surveys in China: Liuzhou compared with other prefectural cities. AIDS Behav 2014; 18 Suppl 2:S118-25. [PMID: 24174289 PMCID: PMC3943943 DOI: 10.1007/s10461-013-0645-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Sexual behaviors in China are rapidly changing; simultaneously, sexually transmitted infections (STI)/HIV prevalence is increasing in the general population. To investigate these major shifts, we examined sexual behaviors and self-reported STI in one prefectural city in southern China, Liuzhou, and compared it to other prefectural cities throughout China. We used adults age 18-39 from two sets of population-based surveys that paralleled each other in both content and method. The first set was the Liuzhou survey conducted in 2008 (n = 398). The second set consisted of two national surveys collected in 2006 and 2010 (n = 2,186). Liuzhou respondents reported more active social and sexual behaviors than their national counterparts, including more socializing, dancing, drinking excessively, sexual activity among never married men and women, purchasing commercial sex among men, one-night stands among men, multiple sexual partnerships and self-reported STI among both men and women. Women in Liuzhou reported greater sexual risk behavior than their national counterparts, although overall they reported less than their male counterparts; they were also more likely to have had an abortion than women in other prefectural cities. Our findings provide a comprehensive overview of the sexual context of Liuzhou among the general population, which may help explain the greater STI/HIV prevalence in Liuzhou.
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Affiliation(s)
- Huang Yingying
- Department of Sociology, Institute of Sexuality and Gender, Renmin University of China, Beijing, China
| | - Laurie Abler
- Duke Global Health Institute, Duke University, Durham, NC
| | - Pan Suiming
- Department of Sociology, Institute of Sexuality and Gender, Renmin University of China, Beijing, China
| | - Gail E. Henderson
- Department of Social Medicine, UNC School of Medicine, Chapel Hill, NC
| | - Wang Xin
- School of Philosophy and Social Development, Shandong University, Shandong, China
| | - Yao Xingliang
- Harbin Engineering University, Harbin, Heilongjiang, China
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Muessig KE, Smith MK, Maman S, Huang Y, Chen XS. Advancing the prevention agenda for HIV and other sexually transmitted infections in south China: social science research to inform effective public health interventions. AIDS Behav 2014; 18 Suppl 2:S222-31. [PMID: 24443101 PMCID: PMC3982310 DOI: 10.1007/s10461-014-0695-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Despite widespread biomedical advances in treatment and prevention, HIV and other sexually transmitted infections (STI) continue to affect a large portion of the world's population. The profoundly social nature of behaviorally driven epidemics and disparities across socioeconomic divides in the distribution of HIV/STI and care outcomes emphasize the need for innovative, multilevel interventions. Interdisciplinary approaches to HIV/STI control are needed to combine insights from the social and biological sciences and public health fields. In this concluding essay to a Special Issue on HIV/STI in south China, we describe the evolution of the region's HIV/STI epidemics and the government response, then synthesize findings from the 11 studies presented in this issue to extend seven recommendations for future HIV/STI prevention and care research in China. We discuss lessons learned from forging international collaborations between the social and biological sciences and public health to inform a shared research agenda to better meet the needs of those most affected by HIV and other STI.
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Affiliation(s)
- Kathryn E. Muessig
- Department of Health Behavior, 306 Rosenau Hall, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599-7440 USA. Phone: 1-443-320-3152
| | - M. Kumi Smith
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Suzanne Maman
- Department of Health Behavior, 306 Rosenau Hall, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599-7440 USA. Phone: 1-443-320-3152
| | - Yingying Huang
- Department of Sociology, Renmin University, Beijing, China
| | - Xiang-sheng Chen
- National Center for STD Control and Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, 12 Jiangwangmiao Street, Nanjing, Jiangsu 210042, China (Tel: 86-25-845478901. Fax: 86-25-85424903)
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23
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Zhang YX, Golin CE, Bu J, Emrick CB, Zhang N, Li MQ. Coping strategies for HIV-related stigma in Liuzhou, China. AIDS Behav 2014; 18 Suppl 2:S212-20. [PMID: 24337724 PMCID: PMC4096624 DOI: 10.1007/s10461-013-0662-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This study explores the feelings, experiences, and coping strategies of people living with HIV (PLHIV) in Liuzhou, China. In a southwestern Chinese city with high HIV prevalence, we conducted semi-structured in-depth interviews with 47 PLHIV selected to represent individuals who had acquired HIV via different acquisition routes. Many participants felt severely stigmatized; they commonly reported having very low self-esteem and feelings of despair. Based on style of coping and whether it occurred at the interpersonal or intrapersonal level, four types of coping that participants used to deal with HIV-associated stigma were identified: (1) Compassion (Passive/Avoidant-Interpersonal); (2) Hiding HIV status (Passive/Avoidant-Intrapersonal); (3) Social support (Active/Problem-focused-Interpersonal; and (4) Self-care (Active/Problem-focused-Intrapersonal). Educational and stigma-reduction interventions targeting potential social support networks for PLHIV (e.g., family, close friends, and peers) could strengthen active interpersonal PLHIV coping strategies. Interventions teaching self-care to PLHIV would encourage active intrapersonal coping, both of which may enhance PLHIV quality of life in Liuzhou, China.
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Affiliation(s)
- Ying-Xia Zhang
- Liuzhou Center for Disease Prevention and Control, Liuzhou, China
| | - Carol E. Golin
- Division of General Medicine and Epidemiology, University of North Carolina at Chapel Hill
- Department of Health Behavior, University of North Carolina at Chapel Hill
- Center For AIDS Research (CFAR), University of North Carolina at Chapel Hill
| | - Jin Bu
- Editorial Department, Journal of Nanjing Medical University, Nanjing, China
| | | | - Nan Zhang
- Department of Sociology and Institute of Sexuality and Gender, Renmin University of China, Beijing
| | - Ming-Qiang Li
- Liuzhou Center for Disease Prevention and Control, Liuzhou, China
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