Skip to main content
Mijn bibliotheek
Shop
Nieuws Boeken Tijdschriften E-learning Web-tv Video Audio
Tips voor Mijn BSL
UITGEBREID ZOEKEN
Inloggen
Top
Child Psychiatry & Human Development
Gepubliceerd in: Child Psychiatry & Human Development 6/2023

07-06-2022 | Original Article

HIV-Related Shame, Stigma and the Mental Health Functioning of Adolescents Living with HIV: Findings from a Pilot Study in Uganda

Auteurs: Proscovia Nabunya, Flavia Namuwonge

Gepubliceerd in: Child Psychiatry & Human Development | Uitgave 6/2023

Log in om toegang te krijgen
share
DELEN

Deel dit onderdeel of sectie (kopieer de link)

  • Optie A:
    Klik op de rechtermuisknop op de link en selecteer de optie “linkadres kopiëren”
  • Optie B:
    Deel de link per e-mail
    Link delen
publish
Publiceer nu

Abstract

This study examined the relationship between HIV-related shame, stigma and the mental health of adolescents (10–14 years) living with HIV in Uganda. Cross sectional data from a 2-year pilot study for adolescents living with HIV (N = 89) were analyzed. Multiple linear regression analyses were conducted to determine the relation between HIV-related shame, as measured by the Shame Questionnaire, stigma, and adolescents’ mental health functioning, including depressive symptoms, hopelessness, PTSD symptoms, loneliness and self-concept. The average age was 12.2 years, and 56% of participants were female. HIV-related shame was associated with higher levels of depressive symptoms (p < 0.05), hopelessness (p < 0.001), PTSD symptoms (p < 0.001), loneliness (p < 0.01), and low levels of self-concept (p < 0.01). HIV stigma was not associated with any of the outcomes. Findings support the need for the development of strategies to help adolescents overcome the shame of living with HIV and mitigate the effects of shame on adolescents’ mental health and treatment outcomes.
vorige artikel A Short-Form Measure of Loneliness to Predict Depression Symptoms Among Adolescents
volgende artikel Parent Stress and Trauma, Autonomic Responses, and Negative Child Behaviors
Literatuur
1.
Dickerson SS, Gruenewald TL, Kemeny ME (2004) When the social self is threatened: shame, physiology, and health. J Pers 72:1191–1216PubMedCrossRef
2.
Wilson JP, Drozdek B, Turkovic S (2006) Posttraumatic shame and guilt. Trauma Violence Abuse 7:122–141PubMedCrossRef
3.
Pantelic M, Boyes M, Cluver L, Meinck F (2017) HIV, violence, blame and shame: pathways of risk to internalized HIV stigma among South African adolescents living with HIV. J Int AIDS Soc 20:21771PubMedPubMedCentralCrossRef
4.
Bennett DS, Traub K, Mace L, Juarascio A, O’Hayer CV (2016) Shame among people living with HIV: a literature review. AIDS Care 28:87–91PubMedCrossRef
5.
Neufeld SA, Sikkema KJ, Lee RS, Kochman A, Hansen NB (2012) The development and psychometric properties of the HIV and Abuse Related Shame Inventory (HARSI). AIDS Behav 16:1063–1074PubMedPubMedCentralCrossRef
6.
Bennett DS, Hersh J, Herres J, Foster J (2016) HIV-related stigma, shame, and avoidant coping: risk factors for internalizing symptoms among youth living with HIV? Child Psychiatry Hum Dev 47:657–664PubMedCrossRef
7.
Katz IT, Ryu AE, Onuegbu AG, Psaros C, Weiser SD, Bangsberg DR, Tsai AC (2013) Impact of HIV-related stigma on treatment adherence: systematic review and meta‐synthesis. J Int AIDS Soc 16(3 Suppl 2):18640PubMedPubMedCentralCrossRef
8.
Lowther K, Selman L, Harding R, Higginson IJ (2014) Experience of persistent psychological symptoms and perceived stigma among people with HIV on antiretroviral therapy (ART): a systematic review. Int J Nurs Stud 51:1171–1189PubMedCrossRef
9.
Persons E, Kershaw T, Sikkema KJ, Hansen NB (2010) The impact of shame on health-related quality of life among HIV-positive adults with a history of childhood sexual abuse. AIDS Patient Care STDS 24:571–580PubMedPubMedCentralCrossRef
10.
Dahl RE (2004) Adolescent brain development: a period of vulnerabilities and opportunities. Keynote address. Ann N Y Acad Sci 1021:1–22PubMedCrossRef
11.
Rankin JL, Lane DJ, Gibbons FX, Gerrard M (2004) Adolescent self-consciousness: longitudinal age changes and gender differences in two cohorts. J Res Adolesc 14:1–21CrossRef
12.
Westenberg PM, Drewes MJ, Goedhart AW, Siebelink BM, Treffers PD (2004) A developmental analysis of self-reported fears in late childhood through mid-adolescence: social-evaluative fears on the rise? J Child Psychol Psychiatry 45:481–495PubMedCrossRef
13.
Somerville LH, Jones RM, Ruberry EJ, Dyke JP, Glover G, Casey BJ (2013) The medial prefrontal cortex and the emergence of self-conscious emotion in adolescence. Psychol Sci 24:1554–1562PubMedCrossRef
14.
Cunha M, Matos M, Faria D, Zagalo S (2012) Shame memories and psychopathology in adolescence: the mediator effect of shame. Int J psychol psychol ther 12:203–218
15.
Hutchinson P, Dhairyawan R (2018) Shame and HIV: strategies for addressing the negative impact shame has on public health and diagnosis and treatment of HIV. Bioethics 32:68–76PubMedCrossRef
16.
Dolezal LU (2021) Shame, stigma and HIV: considering affective climates and the phenomenlogy of shame anxiety. Lambda Nordica 27:2–3CrossRef
17.
Kohler PK, Ondenge K, Mills LA et al (2014) Shame, guilt, and stress: community perceptions of barriers to engaging in prevention of mother to child transmission (PMTCT) programs in western Kenya. AIDS Patient Care STDS 28:643–651PubMedPubMedCentralCrossRef
18.
Kyaddondo D, Wanyenze RK, Kinsman J, Hardon A (2013) Disclosure of HIV status between parents and children in Uganda in the context of greater access to treatment. SAHARA J 10(Suppl 1):S37–S45PubMedCrossRef
19.
Herek GM, Saha S, Burack J (2013) Stigma and psychological distress in people with HIV/AIDS. Basic Appl Soc Psychol 35:41–54CrossRef
20.
Kim S, Thibodeau R, Jorgensen RS (2011) Shame, guilt, and depressive symptoms: a meta-analytic review. Psychol Bull 137:68–96PubMedCrossRef
21.
Andrews B, Brewin CR, Rose S, Kirk M (2000) Predicting PTSD symptoms in victims of violent crime: the role of shame, anger, and childhood abuse. J Abnorm Psychol 109:69–73PubMedCrossRef
22.
Lee DA, Scragg P, Turner S (2001) The role of shame and guilt in traumatic events: a clinical model of shame-based and guilt-based PTSD. Br J Med Psychol 74:451–466PubMedCrossRef
23.
24.
Konkle-Parker DJ, Erlen JA, Dubbert PM (2008) Barriers and facilitators to medication adherence in a southern minority population with HIV disease. J Assoc Nurses AIDS Care 19:98–104PubMedPubMedCentralCrossRef
25.
Zúñiga ML, Blanco E, Martínez P, Strathdee SA, Gifford AL (2007) Perceptions of barriers and facilitators to participation in clinical trials in HIV-positive Latinas: a pilot study. J Womens Health (Larchmt) 16:1322–1330PubMedCrossRef
26.
Vincent W, Fang X, Calabrese SK, Heckman TG, Sikkema KJ, Hansen NB (2017) HIV-related shame and health-related quality of life among older, HIV-positive adults. J Behav Med 40:434–444PubMedCrossRef
27.
Barroso J, Burrage J, Carlson J, Carlson BW (2006) Salivary cortisol values in HIV-positive people. J Assoc Nurses AIDS Care 17:29–36PubMedCrossRef
28.
Gruenewald TL, Kemeny ME, Aziz N, Fahey JL (2004) Acute threat to the social self: shame, social self-esteem, and cortisol activity. Psychosom Med 66:915–924PubMedCrossRef
29.
Sikkema KJ, Hansen NB, Meade CS, Kochman A, Fox AM (2009) Psychosocial predictors of sexual HIV transmission risk behavior among HIV-positive adults with a sexual abuse history in childhood. Arch Sex Behav 38:121–134PubMedCrossRef
30.
Feiring C, Taska L, Lewis M (2002) Adjustment following sexual abuse discovery: the role of shame and attributional style. Dev Psychol 38:79–92PubMedCrossRef
31.
Stuewig J, McCloskey LA (2005) The relation of child maltreatment to shame and guilt among adolescents: psychological routes to depression and delinquency. Child Maltreat 10:324–336PubMedCrossRef
32.
Michalopoulos LM, Meinhart M, Barton SM, Kuhn J, Mukasa MN, Namuwonge F, Feiring C, Ssewamala FM (2019) Adaptation and validation of the shame questionnaire among Ugandan youth living with HIV. Child Indic Res 12(3):1023–1042PubMedCrossRef
33.
Abas M, Ali GC, Nakimuli-Mpungu E, Chibanda D (2014) Depression in people living with HIV in sub-Saharan Africa: time to act. Trop Med Int Health 19:1392–1396PubMedCrossRef
34.
Fekete EM, Williams SL, Skinta MD (2018) Internalised HIV-stigma, loneliness, depressive symptoms and sleep quality in people living with HIV. Psychol Health 33(3):398–415PubMedCrossRef
35.
Grov C, Golub SA, Parsons JT, Brennan M, Karpiak SE (2010) Loneliness and HIV-related stigma explain depression among older HIV-positive adults. AIDS Care 22:630–639PubMedPubMedCentralCrossRef
36.
Nachega JB, Morroni C, Zuniga JM et al (2012) HIV-related stigma, isolation, discrimination, and serostatus disclosure: a global survey of 2035 HIV-infected adults. J Int Assoc Physicians AIDS Care (Chic) 11:172–178PubMedCrossRef
37.
Lewis M (1995) Shame: the exposed self. Simon and Schuster, New York
38.
Fortenberry JD, McFarlane M, Bleakley A, Bull S, Fishbein M, Grimley DM, Malotte CK, Stoner BP (2002) Relationships of stigma and shame to gonorrhea and HIV screening. Am J Public Health 92(3):378–381PubMedPubMedCentralCrossRef
39.
40.
Nabunya P, Ssewamala FM, Bahar OS, Michalopoulos LTM, Mugisha J, Neilands TB, Trani JF, McKay MM (2022) Suubi4Stigma study protocol: a pilot cluster randomized controlled trial to address HIV-associated stigma among adolescents living with HIV in Uganda. Pilot Feasibility Stud 8(1):95PubMedPubMedCentralCrossRef
41.
Byansi W, Brathwaite R, Calvert M, Nabunya P, Sensoy Bahar O, Damulira C, Namuwonge F, McKay MM, Mellins CA, Ssewamala FM (2021) Relationship between mental health and HIV transmission knowledge and prevention attitudes among adolescents living with HIV: lessons from Suubi + adherence cluster randomized study in southern Uganda. AIDS Behav 25(11):3721–3733PubMedPubMedCentralCrossRef
42.
Nabunya P, Byansi W, Sensoy Bahar O, McKay M, Ssewamala FM, Damulira C (2020) Factors associated with HIV disclosure and HIV-related stigma among adolescents living with HIV in Southwestern Uganda. Front Psychiatry 11:772PubMedPubMedCentralCrossRef
43.
Cavazos-Rehg P, Byansi W, Xu C, Nabunya P, Sensoy Bahar O, Borodovsky J, Kasson E, Anako N, Mellins C, Damulira C, Neilands T, Ssewamala FM (2021) The impact of a family-based economic intervention on the mental health of HIV-infected adolescents in Uganda: results from Suubi + adherence. J Adolesc Health 68(4):742–749PubMedCrossRef
44.
Kovacs M (1992) Children’s depression inventory: manual. Multi-Health Systems, North Tonawanda
45.
Beck AT, Weissman A, Lester D, Trexler L (1974) The measurement of pessimism: the hopelessness scale. J Consult Clin Psychol 42:861–865PubMedCrossRef
46.
Russell D, Peplau LA, Ferguson ML (1978) Developing a measure of loneliness. J Pers Assess 42:290–294PubMedCrossRef
47.
Frederick C, Pynoos RS, Nader KO (1992) Childhood Post-Traumatic Stress Reaction Index (CPTS-RI). Two Suns Measures, Los Angeles
48.
Fitts WH, Warren WL (1996) Tennessee self-concept scale: TSCS-2. Western Psychological Services, Los Angeles
49.
Feiring C, Taska LS (2005) The persistence of shame following sexual abuse: a longitudinal look at risk and recovery. Child Maltreat 10:337–349PubMedCrossRef
50.
Berger BE, Ferrans CE, Lashley FR (2001) Measuring stigma in people with HIV: psychometric assessment of the HIV stigma scale. Res Nurs Health 24:518–529PubMedCrossRef
51.
52.
Dessauvagie AS, Jörns-Presentati A, Napp AK et al (2020) The prevalence of mental health problems in sub-Saharan adolescents living with HIV: a systematic review. Glob Ment Health (Camb) 7:e29PubMedCrossRef
53.
Bhana A, Abas MA, Kelly J, van Pinxteren M, Mudekunye LA, Pantelic M (2020) Mental health interventions for adolescents living with HIV or affected by HIV in low- and middle-income countries: systematic review. BJPsych Open 6:e104PubMedPubMedCentralCrossRef
54.
Lewis M (2008) Self-conscious emotions: embarrassment, pride, shame, and guilt. In: Lewis M, Haviland-Jones J, Feldman BL (eds) Handbook of emotions, 3rd edn. Guilford, New York, pp 742–756
55.
De Rubeis S, Hollenstein T (2009) Individual differences in shame and depressive symptoms during early adolescence. Pers Individ Dif 46:477–482CrossRef
56.
Breuer E, Myer L, Struthers H, Joska JA (2011) HIV/AIDS and mental health research in sub-Saharan Africa: a systematic review. Afr J AIDS Res 10(2):101–122PubMedCrossRef
57.
Rueda S, Mitra S, Chen S, Gogolishvili D, Globerman J, Chambers L, Wilson M, Logie CH, Shi Q, Morassaei S, Rourke SB (2016) Examining the associations between HIV-related stigma and health outcomes in people living with HIV/AIDS: a series of meta-analyses. BMJ Open 6(7):e011453PubMedPubMedCentralCrossRef
58.
59.
Lau AS, Guo S, Tsai W, Nguyen DJ, Nguyen HT, Ngo V, Weiss B (2016) Adolescents’ stigma attitudes toward internalizing and externalizing disorders: cultural influences and implications for distress manifestations. Clin Psychol Sci 4(4):704–717PubMedPubMedCentralCrossRef
60.
Mellins CA, Elkington KS, Leu CS, Santamaria EK, Dolezal C, Wiznia A, Bamji M, Mckay MM, Abrams EJ (2012) Prevalence and change in psychiatric disorders among perinatally HIV-infected and HIV-exposed youth. AIDS Care 24(8):953–962PubMedPubMedCentralCrossRef
61.
Gadow KD, Angelidou K, Chernoff M, Williams PL, Heston J, Hodge J et al (2012) Longitudinal study of emerging mental health concerns in youth perinatally infected with HIV and peer comparisons. J Dev Behav Pediatr 33:456PubMedPubMedCentralCrossRef
62.
Mellins CA, Malee KM (2013) Understanding the mental health of youth living with perinatal HIV infection: lessons learned and current challenges. J Int AIDS Soc 16:18593PubMedPubMedCentralCrossRef
63.
Machtinger EL, Wilson TC, Haberer JE, Weiss DS (2012) Psychological trauma and PTSD in HIV-positive women: a meta-analysis. AIDS Behav 16:2091–2100PubMedCrossRef
64.
Orza L, Bewley S, Logie CH, Crone ET, Moroz S, Strachan S, Vazquez M, Welbourn A (2015) How does living with HIV impact on women’s mental health? Voices from a global survey. J Int AIDS Soc 18(Suppl 5):20289PubMedPubMedCentralCrossRef
65.
Machtinger EL, Wilson TC, Haberer JE, Weiss DS (2012) Psychological trauma and PTSD in HIV-positive women: a meta-analysis. AIDS Behav 16:2091–2100PubMedCrossRef
66.
Nakimuli-Mpungu E, Bass JK, Alexandre P, Mills EJ, Musisi S, Ram M, Katabira E, Nachega JB (2012) Depression, alcohol use and adherence to antiretroviral therapy in sub-Saharan Africa: a systematic review. AIDS Behav 16(8):2101–2118PubMedCrossRef
67.
Antelman G, Kaaya S, Wei R, Mbwambo J, Msamanga GI, Fawzi WW, Fawzi MC (2007) Depressive symptoms increase risk of HIV disease progression and mortality among women in Tanzania. J Acquir Immune Defic Syndr 44(4):470–477PubMedPubMedCentralCrossRef
68.
Goffnett J, Liechty JM, Kidder E (2020) Interventions to reduce shame: a systematic review. J Behav Cogn Therapy 30(2):141–160CrossRef
69.
Stynes G, Leão CS, McHugh L (2022) Exploring the effectiveness of mindfulness-based and third wave interventions in addressing self-stigma, shame and their impacts on psychosocial functioning: a systematic review. J Context Behav Sci 23:174–189CrossRef
70.
Luoma JB, Kohlenberg BS, Hayes SC, Fletcher L (2012) Slow and steady wins the race: a randomized clinical trial of acceptance and commitment therapy targeting shame in substance use disorders. J Consult Clin Psychol 80:43–53PubMedCrossRef
71.
Metagegevens
Titel
HIV-Related Shame, Stigma and the Mental Health Functioning of Adolescents Living with HIV: Findings from a Pilot Study in Uganda
Auteurs
Proscovia Nabunya
Flavia Namuwonge
Publicatiedatum
07-06-2022
Uitgeverij
Springer US
Gepubliceerd in
Child Psychiatry & Human Development / Uitgave 6/2023
Print ISSN: 0009-398X
Elektronisch ISSN: 1573-3327
DOI
https://doi.org/10.1007/s10578-022-01374-z

Andere artikelen Uitgave 6/2023

Child Psychiatry & Human Development 6/2023 Naar de uitgave

Article

The Impact of Callous-Unemotional Traits on Achievement, Behaviors, and Relationships in School: A Systematic Review

Original Article

Child’s Play: Examining the Association Between Time Spent Playing and Child Mental Health

Original Article

Associations between Parental Factors and Children’s Screen Time During the COVID-19 Pandemic in South Korea

Original Article

The Role of Maternal Anxiety in Treatment Response for Youth with ASD and Co-occurring Anxiety

Original Article

Evidence for Protective Effects of Peer Play in the Early Years: Better Peer Play Ability at Age 3 Years Predicts Lower Risks of Externalising and Internalising Problems at Age 7 Years in a Longitudinal Cohort Analysis

Original Article

A Short-Form Measure of Loneliness to Predict Depression Symptoms Among Adolescents