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Park EH, Lee SM. Effects of a Brief Video Intervention on Attitudes Toward Counseling Services. Psychol Rep 2023; 126:967-983. [PMID: 34961383 DOI: 10.1177/00332941211051994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study investigated the effects of a brief video intervention on attitudes toward counseling services. Two hundred and seventy-seven participants were divided into four groups (anxious-preoccupied, dismissive-avoidant, fearful-avoidant, and secure) by their attachment scores. Then, the participants of each group were randomly assigned to three conditions (stigma-reducing, utility-enhancing, and control). A split-plot factorial design was performed to examine the intervention effects. The results indicate that the stigma-reducing video intervention was more effective for the anxious-preoccupied group, whereas the utility-enhancing video intervention was more effective for the dismissive-avoidant group than other groups. These results suggest the importance of implementing strategies tailored to each attachment group.
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Affiliation(s)
- Eun Hye Park
- Department of Education, 34973Korea University, Seoul, South Korea
| | - Sang Min Lee
- Department of Education, 34973Korea University, Seoul, South Korea
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Wanjala SW, Too EK, Luchters S, Abubakar A. Psychometric Properties of the Berger HIV Stigma Scale: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:13074. [PMID: 34948690 PMCID: PMC8701211 DOI: 10.3390/ijerph182413074] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/07/2021] [Accepted: 12/08/2021] [Indexed: 11/17/2022]
Abstract
Addressing HIV-related stigma requires the use of psychometrically sound measures. However, despite the Berger HIV stigma scale (HSS) being among the most widely used measures for assessing HIV-related stigma, no study has systematically summarised its psychometric properties. This review investigated the psychometric properties of the HSS. A systematic review of articles published between 2001 and August 2021 was undertaken (CRD42020220305) following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Additionally, we searched the grey literature and screened the reference lists of the included studies. Of the total 1241 studies that were screened, 166 were included in the review, of which 24 were development and/or validation studies. The rest were observational or experimental studies. All the studies except two reported some aspect of the scale's reliability. The reported internal consistency ranged from acceptable to excellent (Cronbach's alpha ≥ 0.70) in 93.2% of the studies. Only eight studies reported test-retest reliability, and the reported reliability was adequate, except for one study. Only 36 studies assessed and established the HSS's validity. The HSS appears to be a reliable and valid measure of HIV-related stigma. However, the validity evidence came from only 36 studies, most of which were conducted in North America and Europe. Consequently, more validation work is necessary for more precise insights.
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Affiliation(s)
- Stanley W. Wanjala
- Department of Public Health and Primary Care, Campus UZ-Ghent, Ghent University, 9000 Ghent, Belgium
- Department of Social Sciences, Pwani University, Kilifi P.O. Box 195-80108, Kenya
| | - Ezra K. Too
- Institute for Human Development, Aga Khan University, Nairobi P.O. Box 30270-00100, Kenya; (E.K.T.); (A.A.)
| | - Stanley Luchters
- Department of Public Health and Primary Care, Campus UZ-Ghent, Ghent University, 9000 Ghent, Belgium
- Institute for Human Development, Aga Khan University, Nairobi P.O. Box 30270-00100, Kenya; (E.K.T.); (A.A.)
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Amina Abubakar
- Institute for Human Development, Aga Khan University, Nairobi P.O. Box 30270-00100, Kenya; (E.K.T.); (A.A.)
- Department of Public Health, Pwani University, Kilifi P.O. Box 195-80108, Kenya
- Department of Psychiatry, University of Oxford, Oxford OX3 7JX, UK
- Neuroassessment Group, KEMRI/Wellcome Trust Research Programme, Centre for Geographic Medicine Research (Coast), Kilifi P.O. Box 230-80108, Kenya
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Davis K, Dawson-Rose C, Cuca YP, Shumway M, Machtinger E. Ending intimate partner violence among women living with HIV: How attachment and HIV stigma inform understanding and intervention. SOCIAL WORK IN HEALTH CARE 2021; 60:543-560. [PMID: 34396939 DOI: 10.1080/00981389.2021.1963026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 06/30/2021] [Accepted: 07/26/2021] [Indexed: 06/13/2023]
Abstract
This mixed-methods, exploratory study examined why women living with HIV (WLHIV) stay in intimate partner violence (IPV) relationships and what helps end IPV in their lives. WLHIV (n = 108) who experienced IPV and were patients at two HIV primary care clinics in San Francisco completed quantitative surveys; 15 participants also completed a qualitative interview. Qualitative data showed HIV stigma was the most cited reason for staying in an IPV relationship, followed by substance use, and then by themes of attachment insecurity. Quantitative data indicated that most participants accessed HIV services and rated them as more helpful than other community resources to end IPV in their lives. Enduring attachment relationships with HIV medical and social service providers and their attachment-enhancing actions and attributes were critical to participants addressing IPV and coping with HIV stigma. This study highlights the important role that HIV providers and clinics can play in addressing IPV among WLHIV.
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Affiliation(s)
- Katy Davis
- Department of Community Health Systems, School of Nursing, University of California, UCSF School of Nursing, San Francisco, California, USA
| | - Carol Dawson-Rose
- Department of Community Health Systems, School of Nursing, University of California, UCSF School of Nursing, San Francisco, California, USA
| | - Yvette P Cuca
- Department of Community Health Systems, School of Nursing, University of California, UCSF School of Nursing, San Francisco, California, USA
| | - Martha Shumway
- Department of Psychiatry, University of California, UCSF Department of Psychiatry, San Francisco, California, USA
| | - Edward Machtinger
- UCSF Division of Internal Medicine, Department of Medicine, Center to Advance Trauma-informed Care, UCSF School of Medicine, San Francisco, California, USA
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Shrout MR, Weigel DJ. A two-wave study on the health and relationship consequences of experienced stigma among individuals with concealable chronic health conditions. J Health Psychol 2019; 26:860-869. [PMID: 31106588 DOI: 10.1177/1359105319849637] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Applying and extending the concealable stigmatized identity outcomes model, this two-wave study examined the psychological, behavioral, physical, and relational health consequences of experienced stigma among a sample of 124 individuals with concealable chronic health conditions. Path analyses revealed that chronic health condition-related experienced stigma was associated with greater chronic health condition-related stress, which in turn was linked to more physical health problems and, ultimately, poorer relational health 4 months later. These findings demonstrate that chronic health condition-related experienced stigma not only creates psychological, behavioral, and physical health consequences but also contributes to poor relational health over time among individuals with chronic health conditions.
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Fazeli PL, Turan B. Experience Sampling Method Versus Questionnaire Measurement of HIV Stigma: Psychosocial Predictors of Response Discrepancies and Associations With HIV Outcomes. STIGMA AND HEALTH 2019; 4:487-494. [PMID: 31768417 DOI: 10.1037/sah0000170] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Accurate measurement of HIV-related stigma is key in understanding and reducing stigma for people living with HIV (PLWH). Experience sampling method (ESM) measures "state"-level phenomena and may improve understanding of daily stigma experiences of PLWH. In 109 men living with HIV, we examined: 1) associations between questionnaire (Q) and ESM internalized and enacted stigma measures; 2) psychosocial predictors (e.g., coping style, perceived HIV community stigma, helplessness) of discrepancies between Q and ESM internalized and enacted stigma; 3) whether Q or ESM measures better predict HIV outcomes. Hierarchical Linear Modeling showed moderate associations between ESM and Q measures of both internalized and enacted stigma. A majority of the psychosocial measures were associated with larger differences between both Q- and ESM-internalized stigma and enacted stigma, respectively. ESM measures were stronger predictors of visit adherence than Q measures. ESM may be advantageous in understanding moment-to-moment changes in stigma and associated processes in PLWH, particularly those with maladaptive psychological traits.
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Affiliation(s)
- Pariya L Fazeli
- Department of Family, The School of Nursing, Community and Health Systems, University of Alabama at Birmingham, Birmingham, AL
| | - Bulent Turan
- Department of Psychology, The University of Alabama at Birmingham, Birmingham, AL.,Pariya L. Fazeli and Bulent Turan contributed equally to this manuscript
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Bradstreet S, Dodd A, Jones S. Internalised stigma in mental health: An investigation of the role of attachment style. Psychiatry Res 2018; 270:1001-1009. [PMID: 29609988 DOI: 10.1016/j.psychres.2018.03.047] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Revised: 03/15/2018] [Accepted: 03/20/2018] [Indexed: 11/25/2022]
Abstract
Internalised stigma is associated with a range of negative outcomes, yet little is known about what determines the internalisation of stigma. In this study we examined the potential role of adult attachment style in the internalisation process in a transdiagnostic sample of adults with experience of recent mental health service use (n = 122), using an online survey. Associations between internalised stigma and perceived public stigma were tested. We also examined whether anxious and avoidant (insecure) attachment styles were positively associated with a significant amount of variance in internalised stigma when controlling for other variables, and whether the relationship between perceived public stigma and internalised stigma was moderated by anxious and avoidant attachment. We found that internalised stigma, perceived public stigma and insecure attachment were commonly reported and that internalised stigma was positively associated with perceived public stigma. However, neither anxious or avoidant attachment were associated with a significant amount of variance in internalised stigma and we found no moderating effect on the relationship between perceived public stigma and internalised stigma for insecure attachment. Despite mixed results, the strength of association between anxious attachment and internalised stigma suggests further research, which addresses some limitations of the current study, is warranted.
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Affiliation(s)
- Simon Bradstreet
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
| | - Alyson Dodd
- Department of Psychology, Northumbria University, Newcastle, UK
| | - Steven Jones
- Division of Health Research, Lancaster University, Lancaster, UK
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Farias ODO, Alexandre HDO, Lima ICVD, Galvão MTG, Hanley-Dafoe R, Santos VDF. Attachment styles of People Living with HIV/AIDS. CIENCIA & SAUDE COLETIVA 2018; 25:495-504. [PMID: 32022190 DOI: 10.1590/1413-81232020252.11852018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 06/14/2018] [Indexed: 11/22/2022] Open
Abstract
Factors that involve the dynamics in interpersonal relationships and may have consequences in health are still little explored in people living with HIV/AIDS. The aim was to identify the evidences of literature regarding adult attachment style and HIV. It is an Integrative literature review. Seven databases were explored, using the combination of key words and Boolean connectors: "Attachment Style OR Object Attachment AND HIV". A reasonable number of articles addressed attachment among people with HIV as a mediator to post-traumatic stress disorder, depression and stress. The prevalence of insecure attachment in this group was high. Evidence was also found in relation to the attachment as an important factor to adaptation to the diagnosis of HIV, attachment and behavior in interpersonal relationships, and emphasize the possibility of changing the attachment style.
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Affiliation(s)
- Odaleia de Oliveira Farias
- Departamento de Enfermagem, Universidade Federal do Ceará. R. Alexandre Baraúna 1115, Rodolfo Teófilo. 60430-160, Fortaleza, CE, Brasil.
| | - Herta de Oliveira Alexandre
- Departamento de Enfermagem, Universidade Federal do Ceará. R. Alexandre Baraúna 1115, Rodolfo Teófilo. 60430-160, Fortaleza, CE, Brasil.
| | | | - Marli Teresinha Gimeniz Galvão
- Departamento de Enfermagem, Universidade Federal do Ceará. R. Alexandre Baraúna 1115, Rodolfo Teófilo. 60430-160, Fortaleza, CE, Brasil.
| | | | - Vanessa da Frota Santos
- Departamento de Enfermagem, Universidade Federal do Ceará. R. Alexandre Baraúna 1115, Rodolfo Teófilo. 60430-160, Fortaleza, CE, Brasil.
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Reinius M, Rao D, Manhart LE, Wiklander M, Svedhem V, Pryor J, Mayer R, Gaddist B, Kumar S, Mohanraj R, Jeyaseelan L, Wettergren L, Eriksson LE. Differential item functioning for items in Berger's HIV Stigma Scale: an analysis of cohorts from the Indian, Swedish, and US contexts. Qual Life Res 2018; 27:1647-1659. [PMID: 29574526 PMCID: PMC5951887 DOI: 10.1007/s11136-018-1841-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2018] [Indexed: 12/26/2022]
Abstract
PURPOSE To examine whether items in Berger's HIV Stigma Scale function differently with persons of different age, gender, and cultural backgrounds. METHODS Secondary data from cohorts, collected in South India (n = 250), Sweden (n = 193), and the US (n = 603) were reanalyzed to evaluate DIF within, between, and across these cohorts. All participants had answered the revised version of the HIV stigma scale consisting of 32 items forming the subscales Personalized stigma, Disclosure concerns, Concerns about public attitudes, and Negative self-image. Differential Item Functioning (DIF) for these items was assessed using hybrid ordinal regression-IRT technique. When DIF was detected, the cumulative impact of DIF on individual subscale scores was evaluated. RESULTS DIF was detected for 9 items within, between, or across cohorts, but the DIF was negligible in general. Detected DIF between the Swedish and Indian cohorts had a cumulative salient impact on individual scores for the subscale Disclosure Concerns; Disclosure concerns were overestimated in the Swedish cohort and both over- and underestimated in the Indian cohort. CONCLUSIONS The items in the 32-item version of the HIV stigma scale did not seem to be particularly prone to present DIF. The DIF between the Indian and Swedish cohort for items in the subscale Disclosure Concerns could, however, result in both type I and type II errors if scores should be compared between the Indian and Swedish cohort.
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Affiliation(s)
- Maria Reinius
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, SE-171 77, Solna, Sweden.
| | - Deepa Rao
- Department of Global Health and Department of Psychiatry and Behavioral Sciences, Harborview Medical Center, University of Washington, 325 9th Ave, UW Campus Mailbox Number 359931, Seattle, WA, 98104, USA
| | - Lisa E Manhart
- Department of Epidemiology, Harborview Medical Center, University of Washington, 325 9th Ave, UW Campus Mailbox Number 35993, Seattle, WA, 98104, USA
| | - Maria Wiklander
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, SE-141 83, Huddinge, Sweden
| | - Veronica Svedhem
- Department of Infectious Diseases, Karolinska University Hospital, SE-141 86, Huddinge, Sweden
- Department of Medicine, Huddinge, Unit of Infectious Diseases, Karolinska Institutet, 141 86, Huddinge, Sweden
| | - John Pryor
- Department of Psychology, Illinois State University, Normal, IL, USA
| | - Randall Mayer
- Iowa Department of Public Health, 321 E. 12th St, Des Moines, IA, 50319-0075, USA
| | - Bambi Gaddist
- Joseph H. Neal Wellness Center Dba SC HIV Council, 1813 Laurel Street, Columbia, SC, 29201, USA
| | - Shuba Kumar
- Department of Social Sciences, Samarth, Chennai, India
| | - Rani Mohanraj
- Department of Social Sciences, Samarth, Chennai, India
| | | | - Lena Wettergren
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, SE-141 83, Huddinge, Sweden
- Department of Women's and Children's Health, Karolinska Institutet, SE-171 77, Stockholm, Sweden
| | - Lars E Eriksson
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, SE-171 77, Solna, Sweden
- Department of Infectious Diseases, Karolinska University Hospital, SE-141 86, Huddinge, Sweden
- School of Health Sciences, City, University of London, London, EC1V 0HB, UK
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Rising CJ, Bol N, Burke-Garcia A, Rains S, Wright KB. Perceived Stress in Online Prostate Cancer Community Participants: Examining Relationships with Stigmatization, Social Support Network Preference, and Social Support Seeking. JOURNAL OF HEALTH COMMUNICATION 2017; 22:469-476. [PMID: 28414570 DOI: 10.1080/10810730.2017.1304471] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Men with prostate cancer often need social support to help them cope with illness-related physiological and psychosocial challenges. Whether those needs are met depends on receiving support optimally matched to their needs. This study examined relationships between perceived stress, prostate cancer-related stigma, weak-tie support preference, and online community use for social support in a survey of online prostate cancer community participants (n = 149). Findings revealed a positive relationship between stigma and perceived stress. This relationship, however, was moderated by weak-tie support preference and online community use for social support. Specifically, stigma was positively related to perceived stress when weak-tie support was preferred. Analyses also showed a positive relationship between stigma and perceived stress in those who used their online community for advice or emotional support. Health communication scholars should work collaboratively with diagnosed men, clinicians, and online community administrators to develop online interventions that optimally match social support needs.
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Affiliation(s)
- Camella J Rising
- a Department of Communication , College of Humanities and Social Sciences, George Mason University , Fairfax , Virginia , USA
| | - Nadine Bol
- b Amsterdam School of Communication Research (ASCoR) , University of Amsterdam , Amsterdam , The Netherlands
| | - Amelia Burke-Garcia
- a Department of Communication , College of Humanities and Social Sciences, George Mason University , Fairfax , Virginia , USA
| | - Stephen Rains
- c Department of Communication , College of Social and Behavioral Sciences, University of Arizona , Tucson , Arizona , USA
| | - Kevin B Wright
- a Department of Communication , College of Humanities and Social Sciences, George Mason University , Fairfax , Virginia , USA
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Bradshaw M, Kent BV. Prayer, Attachment to God, and Changes in Psychological Well-Being in Later Life. J Aging Health 2017; 30:667-691. [PMID: 28553805 DOI: 10.1177/0898264316688116] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the effects of prayer and attachment to God on psychological well-being (PWB) in later life. METHOD Using data from two waves of the nationwide Religion, Aging, and Health Survey, we estimate the associations between frequency of prayer and attachment to God at baseline with cross-wave changes in three measures of PWB: self-esteem, optimism, and life satisfaction. RESULTS Prayer does not have a main effect on PWB. Secure attachment to God is associated with improvements in optimism but not self-esteem or life satisfaction. The relationship between prayer and PWB is moderated by attachment to God; prayer is associated with improvements in PWB among securely attached individuals but not those who are insecurely attached to God. DISCUSSION These findings shed light on the complex relationship between prayer and PWB by showing that the effects of prayer are contingent upon one's perceived relationship with God.
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Préau M, Laguette V, March L, Rabaud C, Hardel L, Protopopescu C, Granier P, Pierret J, Leport C, Raffi F. Discussing HIV Status: Is It Easier After 10 Years of Antiretroviral Treatment? The ANRS CO8 APROCO-COPILOTE Cohort. AIDS Behav 2017; 21:118-128. [PMID: 26910336 DOI: 10.1007/s10461-016-1328-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study's objective was to explore the factors associated with the belief (or not) by people living with HIV that it is easier to talk about their seropositivity 10 years after initiating a protease inhibitor-containing ART. All patients in the ANRS CO8 APROCO-COPILOTE cohort who completed a self-administered questionnaire at 10 years of follow-up were included in this study. Forty-four percent of patients declared that discussing their seropositivity with their family was easier 10 years later, while 28 % declared this was true for discussing their status with a new sexual partner. Having a low socioeconomic status, not receiving social support from a steady partner and declaring a low number of discomforting symptoms 12 months after PI initiation were all independently associated with less difficulty in discussing seropositivity. This study highlights the difficulties in disclosing HIV 10 years after PI initiation, and the important influence of psychosocial factors and patients' daily-life experience on disclosure.
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Quinn K, Voisin DR, Bouris A, Jaffe K, Kuhns L, Eavou R, Schneider J. Multiple Dimensions of Stigma and Health Related Factors Among Young Black Men Who Have Sex with Men. AIDS Behav 2017; 21:207-216. [PMID: 27233249 PMCID: PMC5124546 DOI: 10.1007/s10461-016-1439-1] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This study is among the first to examine the association between multiple domains of HIV-related stigma and health-related correlates including viral load and medication adherence among young Black men who have sex with men (N = 92). Individual logistic regressions were done to examine the hypothesized relationships between HIV-related stigma and various health and psychosocial outcomes. In addition to examining total stigma, we also examined four domains of HIV stigma. Findings revealed the various domains of stigma had differential effects on health-related outcomes. Individuals who reported higher levels of total stigma and personalized stigma were less likely to be virally suppressed (OR 0.96, 95 % CI 0.91-1.00 and OR 0.50, 95 % CI 0.25-1.02, respectively). Concerns about public attitudes toward HIV were positively related to medication adherence (OR 2.18, 95 % CI 1.20-3.94) and psychological distress (OR 5.02, 95 % CI 1.54-16.34). The various domains of HIV stigma differentially affected health and psychosocial outcomes, and our findings suggest that some forms of HIV stigma may significantly affect viral load and medication adherence among this population. Stigma-informed approaches to care and treatment are needed, along with incorporated psychological and social supports.
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Affiliation(s)
- Katherine Quinn
- Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, 2071 N. Summit, Milwaukee, WI, 53202, USA.
| | - Dexter R Voisin
- School of Social Service Administration, University of Chicago, Chicago, IL, USA
- STI/HIV Intervention Network, University of Chicago, Chicago, IL, USA
| | - Alida Bouris
- School of Social Service Administration, University of Chicago, Chicago, IL, USA
- STI/HIV Intervention Network, University of Chicago, Chicago, IL, USA
| | - Kate Jaffe
- STI/HIV Intervention Network, University of Chicago, Chicago, IL, USA
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Lisa Kuhns
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Rebecca Eavou
- STI/HIV Intervention Network, University of Chicago, Chicago, IL, USA
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | - John Schneider
- STI/HIV Intervention Network, University of Chicago, Chicago, IL, USA
- Department of Medicine, University of Chicago, Chicago, IL, USA
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
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Fazeli PL, Turan JM, Budhwani H, Smith W, Raper JL, Mugavero MJ, Turan B. Moment-to-moment within-person associations between acts of discrimination and internalized stigma in people living with HIV: An experience sampling study. STIGMA AND HEALTH 2016; 2:216-228. [PMID: 28966982 DOI: 10.1037/sah0000051] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Internalized stigma related to HIV is associated with poorer outcomes for people living with HIV (PLWH). However, little is known about the association between experiences of daily acts of discrimination by others and the activation of internalized stigma, including factors that may moderate this association. One hundred nine men living with HIV responded to experience sampling method (ESM) questions 3 times a day for 7 days via smart-phones. ESM questions included experiences of recent acts of discrimination, internalized HIV stigma, avoidance coping with HIV, and recent social support. We also administered several traditional questionnaire measures assessing psychosocial constructs. In Hierarchical Linear Modeling analyses controlling for age, race, socioeconomic status, and time on antiretroviral therapy, experiencing discrimination predicted internalized stigma within-persons. Individuals higher on attachment-related avoidance, attachment-related anxiety, avoidance coping, perceived community stigma, and helplessness, and individuals lower on social support, had stronger associations between discrimination and current internalized stigma. Similarly, results from two state moderator variables supported our trait analyses: State-level (ESM) social support and avoidance coping were significant moderators. Thus, when PLWH experience incidents of discrimination due to HIV, this may lead to increased feelings of internalized stigma. We extend the literature by demonstrating that the associations between experienced and internalized stigma are not just at the generalized trait level, but also occur at the state-level, accounting for within person variability. Results provide implications for interventions aiming to modify maladaptive interpersonal traits as well as interventions to increase social support to reduce the impact of discrimination on PLWH.
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Affiliation(s)
- Pariya L Fazeli
- Department of Family, Community and Health Systems, School of Nursing, University of Alabama at Birmingham, Birmingham, AL
| | - Janet M Turan
- Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL
| | - Henna Budhwani
- Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL
| | - Whitney Smith
- Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL
| | - James L Raper
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Michael J Mugavero
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Bulent Turan
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL
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Smith M, Williamson AE, Walsh D, McCartney G. Is there a link between childhood adversity, attachment style and Scotland's excess mortality? Evidence, challenges and potential research. BMC Public Health 2016; 16:655. [PMID: 27465498 PMCID: PMC4964073 DOI: 10.1186/s12889-016-3201-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2015] [Accepted: 06/08/2016] [Indexed: 01/08/2023] Open
Abstract
Background Scotland has a persistently high mortality rate that is not solely due to the effects of socio-economic deprivation. This “excess” mortality is observed across the entire country, but is greatest in and around the post-industrial conurbation of West Central Scotland. Despite systematic investigation, the causes of the excess mortality remain the subject of ongoing debate. Discussion Attachment processes are a fundamental part of human development, and have a profound influence on adult personality and behaviour, especially in response to stressors. Many studies have also shown that childhood adversity is correlated with adult morbidity and mortality. The interplay between childhood adversity and attachment is complex and not fully elucidated, but will include socio-economic, intergenerational and psychological factors. Importantly, some adverse health outcomes for parents (such as problem substance use or suicide) will simultaneously act as risk factors for their children. Data show that some forms of “household dysfunction” relating to childhood adversity are more prevalent in Scotland: such problems include parental problem substance use, rates of imprisonment, rates of suicide and rates of children being taken into care. However other measures of childhood or family wellbeing have not been found to be substantially different in Scotland compared to England. Summary We suggest in this paper that the role of childhood adversity and attachment experience merits further investigation as a plausible mechanism influencing health in Scotland. A model is proposed which sets out some of the interactions between the factors of interest, and we propose parameters for the types of study which would be required to evaluate the validity of the model.
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Affiliation(s)
- M Smith
- NHS Greater Glasgow and Clyde, Commonwealth House, 32 Albion Street, Glasgow, G1 1LH, UK.
| | - A E Williamson
- General Practice and Primary Care, School of Medicine, University of Glasgow, 1 Horselethill Road, Glasgow, G12 9LX, UK
| | - D Walsh
- Glasgow Centre for Population Health, Olympia Building, 2-16 Orr Street, Bridgeton Cross, Glasgow, G40 2QH, UK
| | - G McCartney
- NHS Health Scotland, Meridian Court, 5 Cadogan Street, Glasgow, G2 6QE, UK
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15
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Zarei N, Joulaei H, Fararouei M. Perceived Stigma and Quality of Life Among Women Living with HIV/AIDS. WOMEN’S HEALTH BULLETIN 2016. [DOI: 10.17795/whb-34535] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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16
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Turan N, Kocalevent RD, Quintana SM, Erdur-Baker Ö, Diestelmann J. Attachment Orientations: Predicting Psychological Distress in German and Turkish Samples. JOURNAL OF COUNSELING AND DEVELOPMENT 2016. [DOI: 10.1002/jcad.12065] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Numan Turan
- Department of Counseling Psychology; University of Wisconsin-Madison
| | - Rüya-Daniela Kocalevent
- Department of Medical Psychology; University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Özgür Erdur-Baker
- Department of Educational Sciences; Middle East Technical University, Ankara, Turkey
| | - Jacob Diestelmann
- Department of Counseling Psychology; University of Wisconsin-Madison
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17
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Préau M, Beaulieu-Prévost D, Henry E, Bernier A, Veillette-Bourbeau L, Otis J. HIV serostatus disclosure: development and validation of indicators considering target and modality. Results from a community-based research in 5 countries. Soc Sci Med 2015; 146:137-46. [PMID: 26513123 DOI: 10.1016/j.socscimed.2015.10.034] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Revised: 09/14/2015] [Accepted: 10/15/2015] [Indexed: 10/22/2022]
Abstract
RATIONALE HIV serostatus disclosure is a complex challenge for persons living with HIV (PLHIV). Despite its beneficial effects, it can also lead to stigmatization and rejection. The current lack of multi-dimensional measurement tools impede an in-depth understanding of the dynamic of disclosure. OBJECTIVE To develop and validate complex measures of serostatus disclosure. METHODS This international community based research study was performed by joint research teams (researchers/community based organizations (CBO)) in five countries (Democratic Republic of the Congo, Ecuador, Mali, Morocco and Romania). A convenience sample of 1500 people living with HIV (PLHIV) in contact with local CBO were recruited in 2011 (300 in each country). Face-to-face interviews were performed using a 125-item questionnaire covering HIV status disclosure to 23 potential disclosure targets and related issues (including personal history with HIV, people's reaction to disclosure, sexuality). A principal component analysis and a hierarchical cluster analysis were performed, in order to identify the main components of HIV disclosure, create measures and classify participants into profiles. RESULTS Patterns of disclosure were summarized using two main measures: direct and indirect disclosure. Disclosure to sexual partners, whether steady or not, was different from patterns of disclosure to other targets. Among the participants, three profiles emerged - labelled Restricted disclosure, Mainly indirect disclosure and Mainly direct disclosure, respectively representing 61%, 13% and 26% of the total sample. The profiles were associated with different aspects of PLHIV's lives, including self-efficacy, functional limitations and social exclusion. Patterns varied across the five studied countries. CONCLUSION Results suggest that multi-dimensional constructs should be used to measure disclosure in order to improve understanding of the disclosure process.
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Affiliation(s)
- Marie Préau
- Social Psychology Research Group, Institute of Psychology, University of Lyon 2, Bron, France; Institut National de la Santé et de la Recherche Médicale U912 (SESSTIM), Marseille, France
| | | | | | | | | | - Joanne Otis
- CReCES, Université du Québec à Montréal, Canada
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18
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Valle A, Treviño AC, Zambrano FF, Urriola KE, Sánchez LA, Elizondo JE. Perceived HIV-Associated Stigma among HIV-Seropositive Men: Psychometric Study of HIV Stigma Scale. Front Public Health 2015; 3:171. [PMID: 26191524 PMCID: PMC4490212 DOI: 10.3389/fpubh.2015.00171] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2015] [Accepted: 06/19/2015] [Indexed: 12/03/2022] Open
Abstract
Objectives To assess the internal consistency and factor structure of the abridged Spanish version of the Berger HIV Stigma Scale (HSS-21), to provide evidence for its convergent and discriminant validity, and to describe perceived stigma in an urban population from northeast Mexico. Methods Seventy-five HIV-positive men who have sex with men (MSM) were recruited. Participants answered the Spanish versions of three Likert-type scales: HSS-21, Robsenberg’s self-esteem scale, and the abbreviated version of the Zung’s Depression Scale. Results HSS-21 showed high reliability and validity; its factor structure included four components: concern with public attitudes; negative self-image; disclosure concerns; and enacted stigma. The level of stigma was high in 27 out of 75 (36%) participants; nevertheless, the score found in the component related to disclosure concerns indicated high level of stigma in 68% of participants. The score of HSS-21 was positively correlated with the score of depression and negatively correlated with the score of self-esteem. Conclusion Results demonstrated high reliability for the HSS-21; correlations with other scales supported its validity. This scale demonstrated to be a practical tool for assessing stigma among Mexican HIV-positive MSM. High level of stigma was found only in the factor related to disclosure concerns. Policy implications Identifying HIV-associated stigma through a short, reliable, and validated instrument will allow the development of interventions that cope and manage stigma in HIV-positive MSM. HSS-21 distinguishes between different dimensions of stigma and will contribute to a better understanding of this phenomenon.
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Affiliation(s)
- Adrian Valle
- Medical and Health Sciences Program, Department of Basic Sciences, Instituto Tecnológico de Monterrey , Monterrey , Mexico
| | - Ana Cecilia Treviño
- Medical and Surgical Dentist Program, Instituto Tecnológico de Monterrey , Monterrey , Mexico
| | | | | | - Luis Antonio Sánchez
- Clinical Microbiology and Infectious Diseases, Universidad de Monterrey , San Pedro Garza García , Mexico ; Secretaria de Salud de Nuevo León, Nuevo Leon State Council for AIDS Prevention (COESIDA NL) , Monterrey , Mexico
| | - Jesus Eduardo Elizondo
- Medical and Health Sciences Program, Department of Basic Sciences, Instituto Tecnológico de Monterrey , Monterrey , Mexico ; Doctoral Program in Biotechnology, Biopharmaceuticals and Biopharmaceutical Engineering, Instituto Tecnológico de Monterrey , Monterrey , Mexico ; Doctoral Program in Dentistry, Research in Dentistry, Universitat Internacional de Catalunya , Barcelona , Spain
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Polansky M, Teti M, Chengappa R, Aaron E. Risk and Protective Factors for HIV Self-disclosure among Poor African-American Women Living with HIV/AIDS. Issues Ment Health Nurs 2015; 36:171-81. [PMID: 25897863 DOI: 10.3109/01612840.2014.963209] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
African-American women with HIV are among the fastest growing populations with HIV. The psychosocial factors and beliefs/attitudes associated with disclosure and other un-safe sex practices are not fully understood in this population. A total of 158 HIV-positive women receiving primary care in an HIV clinic in Philadelphia who enrolled in a safe-sex intervention, completed a baseline questionnaire on their sexual activities with male partners and psychosocial factors that were potential protective/risk factors for unsafe sex. Women who were emotionally close and monogamous with their partner were most likely to disclose their HIV status and least likely to worry they had infected their partner. Women who were non-monogamous and who did not have an emotional connection to any of their partners were least likely to self-disclose. Partners were more likely to know each other's status when the woman felt she had a responsibility to talk about the importance of staying HIV-negative.
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Affiliation(s)
- Marcia Polansky
- Drexel University, School of Public Health , Philadelphia, Pennsylvania , USA
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20
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Blais M, Fernet M, Proulx-Boucher K, Lebouché B, Rodrigue C, Lapointe N, Otis J, Samson J. Barriers to health-care and psychological distress among mothers living with HIV in Quebec (Canada). AIDS Care 2015; 27:731-8. [PMID: 25587793 DOI: 10.1080/09540121.2014.997661] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Health-care providers play a major role in providing good quality care and in preventing psychological distress among mothers living with HIV (MLHIV). The objectives of this study are to explore the impact of health-care services and satisfaction with care providers on psychological distress in MLHIV. One hundred MLHIV were recruited from community and clinical settings in the province of Quebec (Canada). Prevalence estimation of clinical psychological distress and univariate and multivariable logistic regression models were performed to predict clinical psychological distress. Forty-five percent of the participants reported clinical psychological distress. In the multivariable regression, the following variables were significantly associated with psychological distress while controlling for sociodemographic variables: resilience, quality of communication with the care providers, resources, and HIV disclosure concerns. The multivariate results support the key role of personal, structural, and medical resources in understanding psychological distress among MLHIV. Interventions that can support the psychological health of MLHIV are discussed.
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Affiliation(s)
- Martin Blais
- a Department of Sexology , Université du Québec à Montréal , Montreal , QC , Canada
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21
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Ringer JM, Buchanan EE, Olesek K, Lysaker PH. Anxious and avoidant attachment styles and indicators of recovery in schizophrenia: associations with self-esteem and hope. Psychol Psychother 2014; 87:209-21. [PMID: 23913519 DOI: 10.1111/papt.12012] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2012] [Revised: 06/26/2013] [Indexed: 01/30/2023]
Abstract
OBJECTIVES Having an insecure attachment style in schizophrenia has been linked to treatment response and symptom severity in schizophrenia. This study sought to further examine whether attachment style is related to subjective indicators of recovery including hope and self-esteem, independent of symptom level and secondly, whether attachment style in schizophrenia differs from attachment style of persons facing adversity in the form of a prolonged non-psychiatric medical illness. DESIGN Participants were 52 men with schizophrenia, and 26 with HIV/AIDS who had no history of experiencing severe mental illness. These groups were compared in terms of their endorsement of attachment style. METHODS All participants were administered the Experiences in Close Relationships measure of adult attachment style. The schizophrenia group was also given the Rosenberg Self-Esteem Scale to assess self-esteem, the Beck Hopelessness Scale as a measure of hope, and the Positive and Negative Syndrome Scale, as an assessment of symptoms. RESULTS Avoidant attachment in the schizophrenia group was linked with higher levels of hopelessness while anxious attachment was linked to lower levels of self-esteem. The association between anxious attachment and self-esteem persisted after controlling for severity of positive, negative, and depressive symptoms in a stepwise multiple regression analyses. Compared to the HIV/AIDS group, participants with schizophrenia had significantly higher levels of anxious attachment but not avoidant attachment style. CONCLUSIONS Attachment style may impact attainment of key subjective domains of recovery in schizophrenia such as self-esteem, independent of symptom severity. PRACTITIONER POINTS If self-esteem and/or hopelessness are identified as a focus of treatment, focusing on attachment style may be an important treatment component. Therapist understanding of patients' attachment style may allow for a better understanding of resistance in the therapeutic relationship. Helping persons with schizophrenia to recognize and change how they tend to relate to others may promote gains in subjective elements of recovery.
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Affiliation(s)
- Jamie M Ringer
- Roudebush VA Medical Center, Indianapolis, Indiana, USA; Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA
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22
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Fuster-Ruizdeapodaca MJ, Molero F, Holgado FP, Mayordomo S. Enacted and internalized stigma and quality of life among people with HIV: the role of group identity. Qual Life Res 2014; 23:1967-75. [PMID: 24585185 DOI: 10.1007/s11136-014-0653-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE This study analyzes the mediating role of social identity in the relationship between enacted stigma and internalized stigma and quality of life of people with HIV. METHODS A total of 557 people with HIV participated in this study. Participants were recruited from hospitals and non-governmental organizations. Questionnaires measuring perceived stigma (Berger's HIV Stigma Scale), social identity (Cameron's three factor identity scale), and quality of life (Ruiz and Baca's Quality of Life Questionnaire) were administered. The instruments were adapted for use with the Spanish population. Structural equation modeling (SEM) was used to test the mediation model, and multigroup SEM was conducted to evaluate its invariance. RESULTS Both enacted stigma and internalized stigma had a negative influence on the quality of life of people with HIV, but this influence occurred in different ways. Enacted stigma had a direct negative influence on quality of life. No dimension of group identity protected people with HIV from its negative influence. However, the negative influence of internalized stigma was totally mediated by some dimensions of group identification, mainly through in-group affect. CONCLUSIONS Group identification not only did not protect people with HIV from the negative effects of stigmatization, but it may even be detrimental in the case of internalized stigma. This suggests that in highly stigmatized groups, the salience of identity is negative and worsens the members' opinion of their own group. This argues for different kinds of intervention to improve the quality of life of people with HIV.
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Affiliation(s)
- Maria J Fuster-Ruizdeapodaca
- Department of Social and Organizational Psychology, Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
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Aarts F, Hinnen C, Gerdes VEA, Acherman Y, Brandjes DPM. Psychologists’ Evaluation of Bariatric Surgery Candidates Influenced by Patients’ Attachment Representations and Symptoms of Depression and Anxiety. J Clin Psychol Med Settings 2014; 21:116-23. [DOI: 10.1007/s10880-014-9385-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Starks TJ, Parsons JT. Adult attachment among partnered gay men: patterns and associations with sexual relationship quality. ARCHIVES OF SEXUAL BEHAVIOR 2014; 43:107-17. [PMID: 24297659 DOI: 10.1007/s10508-013-0224-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Previous research has found secure adult attachment to be associated positively with dimensions of main partner relationship quality and negatively with sexual risk taking and sex with casual partners among heterosexuals in primary relationships. Potential associations between adult attachment and aspects of relationship functioning have received limited attention among gay men. Data were collected from both members of 344 gay male couples as part of a community survey (M age = 38.6, SD = 9.4). Participants completed a shortened version of the Adult Attachment Inventory (Collins & Read, 1990) and the Dyadic Sexual Communication Scale (Catania, 1998). They reported the frequency of sex with main partners and the number of casual male unprotected sex partners. Data were analyzed using the Actor-Partner Interdependence Model. Securely attached individuals reported the highest levels of sexual communication and men with securely attached partners were the most likely to report having sex with their partners as least once per week. Avoidantly attached men reported significantly more casual unprotected anal intercourse (UAI) partners compared to other attachment styles. Having an avoidantly attached partner was also associated with an increase in the number of UAI partners reported. Attachment style is relevant to the sexual relationship quality and sexual safety of partnered gay men. Cognitive-interpersonal intervention approaches developed to target attachment-related cognitions and behaviors may be relevant to HIV prevention efforts in this population.
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Affiliation(s)
- Tyrel J Starks
- Center for HIV/AIDS Educational Studies and Training (CHEST), New York, NY, USA
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25
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Earnshaw VA, Smith LR, Cunningham CO, Copenhaver MM. Intersectionality of internalized HIV stigma and internalized substance use stigma: Implications for depressive symptoms. J Health Psychol 2013; 20:1083-9. [PMID: 24170015 DOI: 10.1177/1359105313507964] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
We adopted an intersectionality framework and examined whether the relationship between internalized HIV stigma and depressive symptoms is moderated by internalized substance use stigma. A total of 85 people living with HIV with a history of substance use in the Bronx, New York, completed a survey. Results revealed evidence of moderation: Participants who internalized HIV stigma experienced greater depressive symptoms only if they also internalized substance use stigma. Researchers should examine stigma associated with multiple socially devalued characteristics to best understand how stigma impacts mental health among people living with HIV. Healthcare providers should address stigma associated with the full range of socially devalued characteristics with which people living with HIV live.
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26
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Su X, Lau JTF, Mak WWS, Choi KC, Chen L, Song J, Zhang Y, Zhao G, Feng T, Chen X, Liu C, Liu J, Liu D, Cheng J. Prevalence and associated factors of depression among people living with HIV in two cities in China. J Affect Disord 2013; 149:108-15. [PMID: 23452645 DOI: 10.1016/j.jad.2013.01.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2012] [Revised: 12/31/2012] [Accepted: 01/02/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Depression has significant effects on morbidity and mortality in people living with HIV (PLWH). Current study estimated the rate of depressive disorder and identified the correlates of depressive disorder among PLWH in China. METHODS 258 PLWH in China were recruited and interviewed with a structured questionnaire including measurements testing perceived stress, social support, perceived discrimination, and depression. Mediating effect of perceived stress between perceived discrimination and depression and moderating effect of social support on effect of perceived discrimination and perceived stress to depression were tested. Multivariate regression was used to examine the determinants of depression. RESULTS The prevalence of mild to severe depression is 71.9%. The relationship between the perceived discrimination and depression is fully mediated by perceived stress (perceived discrimination that was statistically significant (β=0.153) to depression became non-significant after adding perceived stress in the regression model). Interaction term between social support and perceived stress has negative effects (β=-0.117) and explained a significant amount of variance (R(2)=0.018) in depression. Lower income, and higher perceived stress predicted more depressive symptoms. LIMITATIONS Cross-sectional study and self-report bias are major limitations of this study. CONCLUSION Depression among PLWH is a severe problem in China. Primary health care workers need to be trained in recognition and treatment in depression. Stress management skills and social support for PLWH are warranted.
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Affiliation(s)
- Xiaoyou Su
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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Hinnen C, Schreuder I, Jong E, van Duijn M, Dahmen R, van Gorp ECM. The contribution of adult attachment and perceived social support to depressive symptoms in patients with HIV. AIDS Care 2012; 24:1535-42. [PMID: 22530817 DOI: 10.1080/09540121.2012.672714] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The present study investigated the relationship between adult attachment style and depressive symptomatology in patients with HIV. Moreover, perceived social support was investigated as a potential mediator between adult attachment and depressive symptoms. A sample of 233 HIV-infected patients (90% male) completed questionnaires assessing adult attachment style (Relationship Questionnaire), depressive symptoms (Beck Depression Inventory), and perceived social support (Medical Outcomes Study Social Support Survey). After controlling for demographic and medical variables, an insecure adult attachment style was found to be strongly related with depressive symptoms. Half of the insecurely attached patients reported clinically elevated levels of distress, while one in nine securely attached patients reported elevated levels of distress (χ(2)=32.25, p=0.001). Moreover, the association between attachment style and depressive symptomatology was found to be partly mediated through perceived social support. This study strongly supports the notion that an insecure attachment style is a vulnerability factor for developing depressive symptoms that would warrant clinical attention when confronted with a chronic illness such as HIV. The clinical implications of these findings are discussed.
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Affiliation(s)
- Chris Hinnen
- Department of Psychology, Slotervaart Hospital, Amsterdam, The Netherlands.
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28
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Lehman KA, Burns MN, Gagen EC, Mohr DC. Development of the brief inventory of perceived stress. J Clin Psychol 2012; 68:631-44. [PMID: 22467381 DOI: 10.1002/jclp.21843] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES To provide a measure of perceived stress that is psychometrically superior to existing instruments and novel in dimensionality. DESIGN At 4-week intervals over 48 weeks, patients with multiple sclerosis (N = 138) completed 26 items from the Perceived Stress Scale (PSS) and the Perceived Stress Questionnaire (PSQ). RESULTS Extant factor analytic models of the PSS fit poorly. A new measure using nine PSS and PSQ items, the Brief Inventory of Perceived Stress (BIPS), demonstrated good fit, construct validity, and stability with 3 factors: Lack of Control, Pushed, and Conflict and Imposition. CONCLUSIONS Items commonly used to measure perceived stress may have a more sophisticated underlying structure than previously thought. The BIPS's multidimensionality and longitudinal stability offer potential benefits in conceptualization and outcome prediction.
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Hult JR, Wrubel J, Bränström R, Acree M, Moskowitz JT. Disclosure and nondisclosure among people newly diagnosed with HIV: an analysis from a stress and coping perspective. AIDS Patient Care STDS 2012; 26:181-90. [PMID: 22256856 DOI: 10.1089/apc.2011.0282] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Disclosing HIV status to friends, family, and sex partners is often stressful. However, HIV disclosure has been associated with improved physical health, psychological well-being, and improved health behaviors. The aim of this study was to address some of the gaps in the literature regarding the disclosure process by conducting a mixed-methods study of disclosure in people newly diagnosed with HIV and the relationship of disclosure to stigma and social support. The CHAI (Coping, HIV, and Affect Interview) Study was a longitudinal cohort study that followed individuals who were newly diagnosed with HIV. The study took place from October 2004 to June 2008 in the San Francisco Bay Area. This sample includes data from 50 participants who were interviewed 1, 3, and 9 months following diagnosis with HIV. We identified four main approaches to HIV disclosure that revealed distinct differences in how participants appraised disclosure, whether disclosure was experienced as stressful, and whether disclosure or nondisclosure functioned as a way of coping with an HIV diagnosis. Implications of these findings for disclosure counseling are discussed.
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Affiliation(s)
- Jen R. Hult
- Osher Center for Integrative Medicine, University of California San Francisco
| | - Judith Wrubel
- Osher Center for Integrative Medicine, University of California San Francisco
| | | | - Michael Acree
- Osher Center for Integrative Medicine, University of California San Francisco
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Gore-Felton C, Ginzburg K, Chartier M, Gardner W, Agnew-Blais J, McGarvey E, Weiss E, Koopman C. Attachment style and coping in relation to posttraumatic stress disorder symptoms among adults living with HIV/AIDS. J Behav Med 2012; 36:51-60. [DOI: 10.1007/s10865-012-9400-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2010] [Accepted: 01/23/2012] [Indexed: 10/14/2022]
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Martin LA, Vosvick M, Riggs SA. Attachment, forgiveness, and physical health quality of life in HIV + adults. AIDS Care 2012; 24:1333-40. [DOI: 10.1080/09540121.2011.648598] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Luci A. Martin
- a Department of Psychology , University of La Verne , La Verne , CA , USA
| | - Mark Vosvick
- b Department of Psychology , University of North Texas , Denton , TX , USA
| | - Shelley A. Riggs
- b Department of Psychology , University of North Texas , Denton , TX , USA
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Davis KB. Understanding and addressing stigma and attachment insecurity in HIV-positive women who experience intimate partner violence: a model of medical and psychosocial care. SOCIAL WORK IN HEALTH CARE 2012; 51:213-231. [PMID: 22443402 DOI: 10.1080/00981389.2011.614835] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Low-income women of color who are HIV positive and living in violent relationships are at significant risk for stigma and problems with attachment security. This article explores the ways in which these women may experience internalized stigma from incorporating society's negative views of HIV and domestic violence. It also addresses the ways in which insecure attachment may develop or intensify in this population through violence in their adult intimate relationships and/or living with a life threatening illness. A model of medical and psychosocial care utilized at the Women's HIV Program at the University of California San Francisco is offered as an intervention to reduce stigma and enhance healthy attachment. Clinical examples demonstrate how this system of medical and psychosocial care can help women in this situation establish stability and improve their lives despite the intense challenges they face.
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Affiliation(s)
- Katy B Davis
- Smith College School for Social Work, Northampton, Massachusetts 01063, USA.
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Stutterheim SE, Shiripinda I, Bos AE, Pryor JB, de Bruin M, Nellen JF, Kok G, Prins JM, Schaalma HP. HIV status disclosure among HIV-positive African and Afro-Caribbean people in the Netherlands. AIDS Care 2011; 23:195-205. [DOI: 10.1080/09540121.2010.498873] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Sarah E. Stutterheim
- a Department of Work and Social Psychology, Faculty of Psychology and Neuroscience , Maastricht University , PO Box 616, 6200 , MD , Maastricht , the Netherlands
| | | | - Arjan E.R. Bos
- a Department of Work and Social Psychology, Faculty of Psychology and Neuroscience , Maastricht University , PO Box 616, 6200 , MD , Maastricht , the Netherlands
| | - John B. Pryor
- c Department of Psychology , Illinois State University , Normal , IL , USA
| | - Marijn de Bruin
- d Communication Science , Wageningen University , Wageningen , the Netherlands
| | - Jeannine F.J.B. Nellen
- e Department of Internal Medicine, Division of Infectious Diseases, Tropical Medicine and AIDS, and Centre for Infection and Immunity Amsterdam (CINIMA), Academic Medical Centre , University of Amsterdam , Amsterdam , the Netherlands
| | - Gerjo Kok
- a Department of Work and Social Psychology, Faculty of Psychology and Neuroscience , Maastricht University , PO Box 616, 6200 , MD , Maastricht , the Netherlands
| | - Jan M. Prins
- e Department of Internal Medicine, Division of Infectious Diseases, Tropical Medicine and AIDS, and Centre for Infection and Immunity Amsterdam (CINIMA), Academic Medical Centre , University of Amsterdam , Amsterdam , the Netherlands
| | - Herman P. Schaalma
- a Department of Work and Social Psychology, Faculty of Psychology and Neuroscience , Maastricht University , PO Box 616, 6200 , MD , Maastricht , the Netherlands
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Abstract
People living with HIV/AIDS (PLHA) are stigmatised socially. They are devalued and considered like outcasts by having lesser opportunities for education, treatment and housing, and in an organisational context they get reduced opportunities of selection, promotion and income. The phenomena have been extensively researched in developed countries but limited literature addresses the situation in underdeveloped countries like Pakistan, which is also facing spread of the HIV/AIDS epidemic. There are a number of groups who are carrying the disease but the problems being faced by PLHA employed in different organisations have rarely been analysed. Stigma at the workplace can generate a number of negative outcomes. The present study considers two such outcomes among stigmatised PLHA. These outcomes are organisational cynicism and breach of psychological contract. A questionnaire was used to collect data from a sample of 174 PLHA, having a work experience after identification of the epidemic, working in different organisations across Pakistan. These PLHA were identified and recruited through a scattered record available with some government/non-government organisations operating in Pakistan to control HIV/AIDS. Findings of the study extend the knowledge about HIV/AIDS stigma indicating that PLHA are subjected to stigma, which is significantly associated with a breach of psychological contract and organisational cynicism. There is a need at governmental and organisational level as well to increase awareness about the disease and formulate policies to reduce stigma against PLHA working in different organisations.
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Affiliation(s)
- Sajid Bashir
- Human Resource Management, Mohammad Ali Jinnah University, Islamabad, Pakistan.
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35
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Bresnahan M, Jie Zhuang. Exploration and validation of the dimensions of stigma. J Health Psychol 2010; 16:421-9. [PMID: 21041292 DOI: 10.1177/1359105310382583] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Stigma research is hampered by lack of consensus about the number of dimensions making up the stigma construct and what these dimensions measure. Two studies were conducted testing the dimensionality of stigma. Using 105 items proposed to measure stigma in previous research, the first study (N = 307) conducted an exploratory factor analysis using the maximum likelihood method of factor extraction. Results supported five factors that were designated as labeling, negative attribution, separation, status loss, and controllability. Using these factors, a second study (N = 263) demonstrated support for the goodness of fit of the proposed 5-dimensional stigma model.
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Teixeira ME, Budd GM. Obesity stigma: a newly recognized barrier to comprehensive and effective type 2 diabetes management. ACTA ACUST UNITED AC 2010; 22:527-33. [PMID: 21040086 DOI: 10.1111/j.1745-7599.2010.00551.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
PURPOSE The purpose of this article is to increase awareness regarding the social problem of obesity stigma and its effects on persons with type 2 diabetes mellitus (T2DM). In addition, practical strategies to dispel stigma and improve diabetes care that nurse practitioners (NPs) can integrate into practice will be introduced. DATA SOURCES Thorough review of the literature was conducted including MEDLINE, PsycINFO and CINAHL, spanning the years 1994-2008. CONCLUSIONS Obesity and diabetes are both epidemics that demand immediate attention; however, obesity stigma can act as a barrier to ongoing management of both conditions. Obese patients with T2DM may feel responsible not only for their weight but also their diabetes. Therefore, NPs can employ specific counseling strategies that may be beneficial with T2DM obese patients to improve continuity of care while decreasing weight-related stigmatization. IMPLICATIONS FOR PRACTICE Negative attitudes toward obesity by healthcare professionals can act as a barrier to diabetes management. Primary care providers including NPs must begin through self-reflection to recognize their own attitudes regarding weight-stigma and how these attitudes may affect their patients. By implementing effective strategies to reduce weight bias, an environment conducive to diabetes and lifestyle modification management may prevent patients from forgoing care.
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Affiliation(s)
- M Elizabeth Teixeira
- Drexel University College of Nursing and Health Professions, Philadelphia, Pennsylvania 19102, USA.
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Wagner AC, Hart TA, Mohammed S, Ivanova E, Wong J, Loutfy MR. Correlates of HIV stigma in HIV-positive women. Arch Womens Ment Health 2010; 13:207-14. [PMID: 20372948 DOI: 10.1007/s00737-010-0158-2] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2008] [Accepted: 02/06/2010] [Indexed: 12/01/2022]
Abstract
We examined the variables associated with HIV stigma in HIV-positive women currently living in Ontario, Canada. Based on previous literature, we predicted that variables of social marginalization (e.g., ethnicity, income, education), medical variables (e.g., higher CD4 count, lower viral load), and increased psychological distress would be associated with higher perceived HIV stigma among HIV-positive women. One hundred fifty-nine HIV-positive women between the ages of 18 and 52 in Ontario completed self-report measures of the aforementioned variables. Women were recruited through 28 AIDS service organizations, eight HIV clinics, and two community health centers. In multiple regression analyses, for women born in Canada, lower educational level and higher anxiety were associated with higher HIV stigma. For women born outside of Canada, having been judged by a physician in Canada for trying to become pregnant was associated with higher HIV stigma. For HIV-positive women born outside of Canada, negative judgment by a physician regarding intentions to become pregnant should be addressed to reduce perceived HIV stigma and vice versa. Health care providers should be trained in the provision of sensitive and effective health care for women living with HIV, especially when providing reproductive health care.
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Affiliation(s)
- Anne C Wagner
- Department of Psychology, Ryerson University, 105 Bond Street, Toronto, ON M5B 1Y3, Canada.
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Bradshaw M, Ellison CG, Marcum JP. Attachment to God, Images of God, and Psychological Distress in a Nationwide Sample of Presbyterians. THE INTERNATIONAL JOURNAL FOR THE PSYCHOLOGY OF RELIGION 2010; 20:130-147. [PMID: 23329878 PMCID: PMC3545685 DOI: 10.1080/10508611003608049] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Drawing broadly on insights from attachment theory, the present study outlines a series of theoretical arguments linking styles of attachment to God, perceptions of the nature of God (i.e., God imagery), and stressful life events with psychological distress. Main effects and potential stress-moderator effects are then evaluated using data from a nationwide sample of elders and rank-and-file members of the Presbyterian Church (U.S.A.). Key findings indicate that secure attachment to God is inversely associated with distress, whereas both anxious attachment to God and stressful life events are positively related to distress. Once variations in patterns of attachment to God are controlled, there are no net effects of God imagery on levels of distress. There is only modest support for the hypothesis that God images moderate the effects of stressful life events on psychological distress, but no stress-moderator effects were found for attachment to God. Study limitations are identified, and findings are discussed in terms of their implications for religion-health research, as well as recent extensions of attachment theory.
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HIV-related stigma and psychological distress: the harmful effects of specific stigma manifestations in various social settings. AIDS 2009; 23:2353-7. [PMID: 19741478 DOI: 10.1097/qad.0b013e3283320dce] [Citation(s) in RCA: 100] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Recent research has shown that experiences of stigmatization have an adverse impact on the psychological well being of people living with HIV/AIDS (PLWHA). Most studies investigating this relationship employ an aggregate measure of stigma. Although this approach provides useful information about the psychological implications of HIV-related stigma in general, it neglects to acknowledge the possibility that some manifestations in specific settings may be psychologically more detrimental than others. The present study examines which specific stigma experiences are most strongly related to psychological distress across a number of social settings. METHODS A cross-sectional survey was administered to 667 PLWHA in the Netherlands. We examined participants' experiences of 11 manifestations of HIV-related stigma in six social settings. Linear regression analyses were conducted to determine which setting-specific manifestations best predict psychological distress after controlling for marital status, education and health status. RESULTS Three manifestations in family settings, namely receiving advice to conceal one's status, being avoided and being treated with exaggerated kindness, and one manifestation in healthcare settings, namely awkward social interaction, best predicted psychological distress in PLWHA. CONCLUSION Manifestations of HIV-related stigma vary according to setting. Certain manifestations in specific social settings impact the psychological well being of PLWHA more than others. In this study, certain experiences of stigmatization with PLWHA's families and in healthcare settings were more strongly related to psychological distress than experiences occurring in other social settings. These findings suggest that stigma reduction interventions focusing on these influential settings may benefit the psychological well being of PLWHA.
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Logie C, Gadalla T. Meta-analysis of health and demographic correlates of stigma towards people living with HIV. AIDS Care 2009; 21:742-53. [DOI: 10.1080/09540120802511877] [Citation(s) in RCA: 284] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- C. Logie
- a Factor-Inwentash Faculty of Social Work , University of Toronto , Toronto , ON , Canada
| | - T.M. Gadalla
- a Factor-Inwentash Faculty of Social Work , University of Toronto , Toronto , ON , Canada
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Hinchliff S. Ageing and sexual health in the UK: how should health psychology respond to the challenges? J Health Psychol 2009; 14:355-60. [PMID: 19293296 DOI: 10.1177/1359105308101673] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The UK has an increasing ageing population and, like other western societies, has undergone several significant shifts over the last 50 years, including attitudes towards sexual activity, relationships and growing older. Drawing on evidence from a range of sources and a number of disciplines, this editorial examines the potential sexual and reproductive health implications for current and future cohorts of ;older' people, and considers the role of health psychology in responding to the challenges of growing older in a rapidly changing (sexualized, digitalized and medicalized) world.
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