Skip to main content

Advertisement

Log in

Blocking the Benefit of Group-Based HIV-Prevention Efforts during Adolescence: The Problem of HIV-Related Stigma

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

HIV-related stigma has been shown to impede HIV-antibody testing and safer sexual practices in adults. Less is known about its effects on prevention programs among at-risk youth. This study examined the longitudinal relationships between HIV-stigma and HIV-knowledge following completion of a validated group-based intervention. Data were provided by 1,654 African-American adolescents who participated in a large multi-city prevention trial (Project iMPACCS). Participants were randomly assigned to an empirically-validated skill-based intervention or a general health promotion control group. Both stigma and knowledge were assessed at baseline and post-intervention. Results suggested that adolescents participating in the intervention showed improvements in knowledge and decreases in stigma when compared to controls. Improvements in stigma appeared to be partly driven by improvements in knowledge. Higher baseline stigma was shown to reduce gains in knowledge in both the treatment and control groups. Results suggest that HIV-stigma can interfere with how youth identify with and internalize messages from group-based prevention trials.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Fortenberry JD, McFarlane M, Bleakley A, Bull S, Fishbein M, Grimley DM, et al. Relationships of stigma and shame to gonorrhea and HIV screening. Am J Public Health. 2002;92(3):378–81.

    Article  PubMed  Google Scholar 

  2. Klein SJ, Karchner WD, O’Connell DA. Interventions to prevent HIV-related stigma and discrimination: findings and recommendations for public health practice. J Public Health Manag Pract. 2002;8(6):44–53.

    PubMed  Google Scholar 

  3. Mahajan AP, Sayles JN, Patel VA, Remien RH, Ortiz D, Szekeres G, et al. Stigma in the HIV/AIDS epidemic: a review of the literature and recommendations for the way forward. AIDS. 2008;22(Suppl 2):S67–79.

    Article  PubMed  Google Scholar 

  4. Valdiserri RO. HIV/AIDS stigma: an impediment to public health. Am J Public Health. 2002;92(3):341–2.

    Article  PubMed  Google Scholar 

  5. Earnshaw VA, Chaudoir SR. From conceptualizing to measuring HIV stigma: a review of HIV stigma mechanism measures. AIDS Behav. 2009;13(6):1160–77.

    Article  PubMed  Google Scholar 

  6. Link BG, Phelan JC. Conceptualizing stigma. Annu Rev Sociol. 2001;27(1):363–85.

    Article  Google Scholar 

  7. Bartlett JG, Branson BM, Fenton K, Hauschild BC, Miller V, Mayer KH. Opt-out testing for human immunodeficiency virus in the United States: progress and challenges. JAMA. 2008;300(8):945–51.

    Article  PubMed  CAS  Google Scholar 

  8. Darrow WW, Montanea JE, Gladwin H. AIDS-related stigma among Black and Hispanic young adults. AIDS Behav. 2009;13(6):1178–88.

    Article  PubMed  Google Scholar 

  9. Nyblade L. Measuring HIV stigma: existing knowledge and gaps. Psychol Health Med. 2006;11(3):335–45.

    Article  PubMed  Google Scholar 

  10. Moore S, Rosenthal D. Adolescent invulnerability and perceptions of AIDS risk. J Adolesc Res. 1991;6(2):164–80.

    Article  Google Scholar 

  11. Macintyre K, Rutenberg N, Brown L, Karim A. Understanding perceptions of HIV risk among adolescents in KwaZulu-Natal. AIDS Behav. 2004;8(3):237–50.

    Article  PubMed  Google Scholar 

  12. Heijnders M, Van Der Meij S. The fight against stigma: an overview of stigma-reduction strategies and interventions. Psychol Health Med. 2006;11(3):353.

    Article  PubMed  Google Scholar 

  13. Yang H, Li X, Stanton B, Fang X, Lin D, Naar-King S. HIV-related knowledge, stigma, and willingness to disclose: a mediation analysis. AIDS Care. 2006;18(7):717–24.

    Article  PubMed  CAS  Google Scholar 

  14. Kalichman S, Simbayi L, Cain D, Jooste S, Skinner D, Cherry C. Generalizing a model of health behaviour change and AIDS stigma for use with sexually transmitted infection clinic patients in Cape Town, South Africa. AIDS Care. 2006;18(3):178–82.

    Article  PubMed  Google Scholar 

  15. Brown L, Macintyre K, Trujillo L. Interventions to reduce HIV/AIDS stigma: what have we learned? AIDS Educ Prev. 2003;15(1):49–69.

    Article  PubMed  Google Scholar 

  16. Sengupta S, Banks B, Jonas D, Miles MS, Smith GC. HIV interventions to reduce HIV/AIDS stigma: a systematic review. AIDS Behav. 2011;15:1075–87.

    Article  PubMed  Google Scholar 

  17. Klepp KI, Ndeki SS, Leshabari MT, Hannan PJ, Lyimo BA. AIDS education in Tanzania: promoting risk reduction among primary school children. Am J Public Health. 1997;87(12):1931–6.

    Article  PubMed  CAS  Google Scholar 

  18. Markham C, Baumler E, Richesson R, et al. Impact of HIV-positive speakers in a multicomponent, school-based HIV/STD prevention program for inner-city adolescents. AIDS Educ Prev. 2000;12(5):442–54.

    PubMed  CAS  Google Scholar 

  19. Fawole IO, Asuzu MC, Oduntan SO, Brieger WR. A school-based AIDS education programme for secondary school students in Nigeria: a review of effectiveness. Health Educ Res. 1999;14(5):675–83.

    Article  PubMed  CAS  Google Scholar 

  20. Stanton BF, Li X, Ricardo I, Galbraith J, Feigelman S, Kaljee L. A randomized, controlled effectiveness trial of an AIDS prevention program for low-income African-American youths. Arch Pediatr Adolesc Med. 1996;150(4):363–72.

    Article  PubMed  CAS  Google Scholar 

  21. Romer D, Sznitman S, DiClemente R, Salazar LF, Vanable PA, et al. Mass media as an HIV-prevention strategy: using culturally-sensitive messages to reduce HIV-associated sexual behavior of at-risk African-American youth. Am J Public Health. 2009;99(12):2150–9.

    Article  PubMed  Google Scholar 

  22. Vanable PA, Carey MP, Brown JL, et al. Test-retest reliability of self-reported HIV/STD-related measures among African-American adolescents in four U.S. cities. J Adolesc Health. 2009;44(3):214–21.

    Article  PubMed  Google Scholar 

  23. Carey MP, Schroder KEE. Development and psychometric evaluation of the brief HIV knowledge questionnaire. AIDS Educ Prev. 2002;14(2):172–82.

    Article  PubMed  Google Scholar 

  24. Kalichman SC, Simbayi LC, Jooste S, Toefy Y, Cain D, Cherry C, et al. Development of a brief scale to measure AIDS-related stigma in South Africa. AIDS Behav. 2005;9(2):135–43.

    Article  PubMed  Google Scholar 

  25. MacKinnon DP, Lockwood CM, Williams J. Confidence limits for the indirect effect: distribution of the product and resampling methods. Multivar Behav Res. 2004;39(1):99–128.

    Article  Google Scholar 

  26. Muthén L, Muthén B. Mplus user’s guide. 5th ed. Los Angeles: Muthén & Muthén; 1998.

    Google Scholar 

  27. Donovan B, Ross MW. Preventing HIV: determinants of sexual behaviour. Lancet. 2000;355(9218):1897–901.

    Article  PubMed  CAS  Google Scholar 

  28. Swenson R, Rizzo CJ, Brown LK, Vanable P, Carey M, Valois RF, et al. HIV knowledge and its contributions to sexual health behaviors of low-income African American adolescents. J Natl Med Assoc. 2010;102(12):1173–82.

    PubMed  Google Scholar 

  29. Albarracín D, Gillette JC, Earl AN, Glasman LR, Durantini MR, Ho M. A test of major assumptions about behavior change: a comprehensive look at the effects of passive and active HIV-prevention interventions since the beginning of the epidemic. Psychol Bull. 2005;131(6):856–97.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This research was supported by National Institutes of Health grant UO1 MH066785, a collaborative project awarded to participating sites: Rhode Island Hospital, Emory University, Syracuse University, University of South Carolina, and University of Pennsylvania and by a National Institutes of Mental Health Program in Child/Adolescent Biobehavioral HIV Research Training at Rhode Island Hospital/Brown University (T32-MH-07878, PI: L. Brown).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to David H. Barker.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Barker, D.H., Swenson, R.R., Brown, L.K. et al. Blocking the Benefit of Group-Based HIV-Prevention Efforts during Adolescence: The Problem of HIV-Related Stigma. AIDS Behav 16, 571–577 (2012). https://doi.org/10.1007/s10461-011-0101-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-011-0101-1

Keywords

Navigation