Gender Differences in Perceived Stigma and Coping Strategies Among People Living with HIV/AIDS at Jugal Hospital, Harar, Ethiopia

Background

HIV/AIDS is among the most devastating diseases, having multiple effects on the health and well-being of people living with HIV/AIDS (PLWHA). There is a paucity of studies that examined the gender differences in perceived stigma among PLWHA and the different coping strategies that they use in Ethiopia.

Objective

To assess the gender differences in perceived stigma and coping strategies among PLWHA.

Methods

A comparative cross-sectional study was conducted at Jugal Hospital, Harar, eastern Ethiopia from May 01 to July 30, 2018. A total of 412 (206 females and 206 males) PLWHA were included. Face-to-face interviewer-administered data were collected. Perceived HIV stigma was assessed using the Berger HIV stigma scale. Similarly, the coping strategies were assessed using the Brief Coping Orientation to Problems Experienced (Brief COPE) scale. The data were analyzed using STATA version 13.

Results

The mean Berger stigma scale score was 65.3±11.3. The overall perceived stigma mean score was not statistically different between males and females (64.8±10.8 vs 65.8±11.7, p=0.407). Among the four subscales, women reported a higher level of disclosure stigma than men (21.1±5.5 vs 20.3±5.5; p=0.006). Regarding maladaptive coping strategies, men often used substances compared to women (2.8±1.5 vs 2.1±0.4; p<0.001). However, women use behavioral disengagement (4.6±1.1 vs 4.2±1.1; p=0.002) and self-distraction (5.9±1.5 vs 5.5±1.7; p=0.019) more often than men. Females used a higher level of adaptive coping strategies compared to males (42.5±4.9 vs 40.9±6.3, p=0.005). Furthermore, females were found to use more emotional-focused coping than males (27.6±3.2 vs 26.4±4.0; p<0.001).

Conclusion

Women reported a higher level of disclosure stigma than men and the types of coping strategies used vary between male and female. Thus, interventions to support PLWHA must take into account the gender differences in terms of perceived stigma.

A preliminary validation of the Brief COPE instrument for assessing coping strategies among people living with HIV in China

BACKGROUND

The Brief COPE instrument has been utilized to conduct research on various populations, including people living with HIV (PLWH). However, the questionnaire constructs when applied to PLWH have not been subjected to thorough factor validation.

METHODS

A total of 258 PLWH were recruited from two provinces of China. They answered questions involving the scales of three instruments: the Brief COPE, the Perceived Social Support Scale, and the Perceived Discrimination Scale for PLWH. Confirmatory factor analysis (CFA) and exploratory factor analysis (EFA) were conducted.

RESULTS

The CFA found a poor goodness of fit to the data. The subsequent EFA identified six preliminary factors, forming subscales with Cronbach's alphas, which ranged from 0.61 to 0.80. Significant correlation coefficients between the subscales and measures of perceived social support and perceived discrimination were reported, giving preliminary support to the validity of the new empirical factor structure.

CONCLUSION

This study showed that the original factor structure of the Brief COPE instrument, when applied to PLWH in China, did not fit the data. Thus, the Brief COPE should be applied to various populations and cultures with caution. The new factor structure established by the EFA is only preliminary and requires further validation.

Effects of social support, stress, and level of illness on caregiving of children with AIDS

The purpose of this descriptive correlational study was to explore the relationship between social support, stressors, level of illness, and perceived caregiver burden in caregivers of children with HIV/AIDS. Instruments used were: (1) the Classification System for Human Immunodeficiency Virus (HIV) Infection in Children Under 13 Years of Age (1987), (2) the Daily Hassles Scale, (3) the Tilden Interpersonal Relationship Inventory (IPRI), (4) the Derogatis Stress Profile (DSP), and (5) the Caregiver Appraisal Scale. The sample was drawn from two medical centers in New Jersey. The 49 caregivers of children with perinatally acquired HIV were predominantly HIV-positive biological mothers of African American descent whose education ranged from 8th grade through college. One-half of the children were classified at the CDC P2 level. Descriptive statistics and stepwise multiple regression were used to analyze the data. The results of the DSP indicated subjects were slightly below the 70th percentile for anxiety, depression, hostility, and work stressors and that subjects' social support levels were in the upper end of the low support category. Stepwise regression indicated that depression and anxiety predicted 40% of the variance in caregiver burden (R2 = .399; F = 14,985; p = .000). Hostility and level of social support predicted 37% of the variance in caregiving impact (R2 = .37; F = 13.254; p = .000). Finally, social support predicted 17.5% of the variability in the caregivers' sense of caregiving competency (R2 = .175; F = 9.788; p = .003). The child's level of illness and HIV status of caregiver did not significantly predict variance in caregiving appraisal.