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Internalized Stigma Among People Living with HIV-AIDS

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Abstract

HIV is recognized as a highly stigmatized disease; however, there has been a lack of research on the internalization of this stigma by seropositive people. This study examined internalized stigma among HIV-positive men and women (N = 268) in Milwaukee and Madison, Wisconsin, and New York City. The majority of the sample experienced internalized stigma related to their HIV status. Individuals who experienced high internalized HIV stigma (IHS) had been diagnosed with HIV more recently, their families were less accepting of their illness, they were less likely to ever have attended an HIV support group, and they knew fewer people with HIV. Individuals with high IHS also worried more about spreading their infection to others. Heterosexuals and participants from Wisconsin experienced higher levels of IHS. Hierarchical regression analyses showed that IHS contributed significantly to levels of depression, anxiety, and hopelessness after controlling for the effects of key behavioral and psychosocial variables.

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REFERENCES

  • Adam, B. D., and Sears, A. (1994). Negotiating sexual relationships after testing HIV-positive. Medical Anthropology, 16, 63–77.

    Google Scholar 

  • Antoni, M. H., Goldstein, D., Ironson, G., LaPerriere, A., Fletcher, M. A., and Schneiderman, N. (1995). Coping responses to HIV-1 serostatus notification predict concurrent and prospective immunologic status. Clinical Psychology and Psychotherapy, 2, 234–248.

    Google Scholar 

  • Beck, A. T., and Steer, R. A. (1993). BDI: Beck Depression Inventory manual, New York: Psychological Corporation.

    Google Scholar 

  • Cella, D. F., McCain, N. L., Peterman, A. H., Mo, F., and Wolen, D. (1996). Development and validation of the Functional Assessment of Human Immunodeficiency Virus Infection (FAHI) quality of life instrument. Quality of Life Research, 5, 450–463.

    Google Scholar 

  • Centers for Disease Control and Prevention. (2000). HIV-related knowledge and stigma-United States, 2000. Morbidity and Mortality Weekly Report, 49, 1062–1064.

    Google Scholar 

  • Chesney, M. A., and Smith, A. W. (1999). Critical delays in HIV testing and care: The potential role of stigma. American Behavioral Scientist, 42, 1162–1174.

    Google Scholar 

  • Cohen, S., Mermelstein, R., Karmarck, T., and Hoberman, H. (1985). Measuring the functional components of social support. In I. Sarason and B. Sarason (Eds.), Social support: Theory, research and applications. Dordrecht, Netherlands: Martinus Nijhoff.

    Google Scholar 

  • Crandall, C. S., and Coleman, R. (1992). AIDS-related stigmatization and the disruption of social relationships. Journal of Social and Personal Relationships, 9, 163–177.

    Google Scholar 

  • Crawford, A. M. (1996). Stigma associated with AIDS: A meta-analysis. Journal of Applied Social Psychology, 26, {pp398-416}.

    Google Scholar 

  • Davison, K. P., Pennebaker, J. W., and Dickerson, S. S. (2000). Who talks? The social psychology of illness support groups. American Psychologist, 55, 205–217.

    Google Scholar 

  • DeRosa, C. J., and Marks, G. (1998). Preventive counseling of HIV positive men and self-disclosure of serostatus to sex partners: Newopportunities for prevention. Health Psychology, 17, 224–231.

    Google Scholar 

  • Fleishman, J. A., and Fogel, B. (1994). Coping and depressive symptoms among young people with AIDS. Health Psychology, 13, 156–169.

    Google Scholar 

  • Folkman, S., Chesney, M., Collette, L., Boccellari, A., and Cooke, M. (1996). Postbereavement depressive mood and its prebereavement predictors in HIV+ and HIV-gay men. Journal of Personality and Social Psychology, 70, 336–348.

    Google Scholar 

  • Goffman, E. (1963). Stigma: Notes on the management of a spoiled identity. Englewood Cliffs, NJ: Prentice-Hall.

    Google Scholar 

  • Herek, G. M. (1990). Illness, stigma, and AIDS. In P. T. Costa, Jr., and G. R. VandenBos (Eds.), Psychological aspects of serious illness: Chronic conditions, fatal diseases, and clinical care (pp. 103-150). Washington, DC: American Psychological Association.

    Google Scholar 

  • Herek, G. M. (1996). Heterosexism and homophobia. In R. P. Cabaj and T. S. Stein (Eds.), Textbook of homesexuality and mental health (pp. 101-113). Washington, DC: American Psychiatric Press.

    Google Scholar 

  • Herek, G. M. (1999). AIDS and stigma. American Behavioral Scientist, 42, 1106–1116.

    Google Scholar 

  • Herek, G. M., and Capitanio, J. P. (1993). Public reactions to AIDS in the United States: A second decade of stigma. American Journal of Public Health, 83, 574–577.

    Google Scholar 

  • Herek, G. M., and Capitanio, J. P. (1998, July). AIDS stigma and HIV-related beliefs in the United States: Results from a national telephone survey. Paper presented at XII International Conference on AIDS, Geneva.

  • Herek, G. M., and Capitanio, J. P. (1999). AIDS stigma and sexual prejudice. American Behavioral Scientist, 42, 1126–1143.

    Google Scholar 

  • Herek, G. M., Mitnick, L., Burris, S., Chesney, M., Devine, P., Fullilove, M. T., Fullilove, R., Gunther, H. C., Levi, J., Michaels, S., Novick, A., Pryor, J., Snyder, M., and Sweeney, T. (1998). Workshop report: AIDS and stigma: A conceptual framework and research agenda. AIDS and Public Policy Journal, 13, 36–47.

    Google Scholar 

  • Ironson, G., Friedman, A., Klimas, N., Antoni, M., Fletcher, M. A., LaPerriere, A., Simoneau, J., and Schneiderman, N. (1994). Distress, denial, and low adherence to behavioral interventions predict faster disease progression in gay men infected with human immunodeficiency virus. International Journal of Behavioral Medicine, 1, 90–105.

    Google Scholar 

  • Lennon, M. C., Martin, J. L., and Dean, L. (1990). The influence of social support on AIDS-related grief reaction among gay men. Social Science and Medicine, 31, 477–484.

    Google Scholar 

  • Leserman, J., Jackson, E. D., Petitto, J. M., Golden, R. N., Silva, S. G., Perkins, D. O., Cai, J., Folds, J. D., and Evans, D. L. (1999). Progression to AIDS: The effects of stress, depressive symptoms, and social support. Psychosomatic Medicine, 61, 397–406.

    Google Scholar 

  • Leserman, J., Petitto, J. M., Golden, R., Gaynes, B., Gu, H., Perkins, D. O., Silva, S. G., Folds, J. D., and Evans, D. L. (2000). Impact of stressful life events, depression, social support, coping, and cortisol on progression to AIDS. American Journal of Psychiatry, 157, 1221–1228.

    Google Scholar 

  • Lewis, M. (1998). Shame and stigma. In P. Gilbert and B. Andrews (Eds.), Shame: Interpersonal behavior, psychopathology, and culture (pp. 126-140). New York: Oxford University Press.

    Google Scholar 

  • Lutgendorf, S. K., Antoni, M. H., Ironson, G., Starr, K., Costello, N., Zuckerman, M., Klimas, N., Fletcher, M., and Schneiderman, N. (1998). Changes in cognitive coping skills and social support during cognitive behavioral stress management intervention and distress outcomes in symptomatic human immunodeficiency virus (HIV)-gay men. Psychosomatic Medicine, 60, 204–214.

    Google Scholar 

  • Martin, J. L., and Dean, L. (1993). Effects of AIDS-related bereavement and HIV-related illness on psychological distress among gay men: A 7-year longitudinal study, 1985-1991. Journal of Consulting and Clinical Psychology, 61, 94–103.

    Google Scholar 

  • Mulder, C. L., Antoni, M. H., Duivenvoorden, H. J., Kauffman, R. H., and Goodkin, K. (1995). Active confrontational coping predicts decreased clinical progression over a one-year period in HIV-infected homosexual men. Journal of Psychosomatic Research, 39, 957–965.

    Google Scholar 

  • Namir, S., Wolcott, D. L., Fawzy, F. I., and Alumbaugh, M. J. (1987). Coping with AIDS: Psychological and health implications. Journal of Applied Social Psychology, 17, 309–328.

    Google Scholar 

  • Novick, A. (1997). Stigma and AIDS: Three layers of damage. Journal of the Gay and Lesbian Medical Association, 1, 53–60.

    Google Scholar 

  • Page-Shafer, K., Delorenze, G. N., Satariano,W., and Winkelstein, Jr., W. (1996). Comorbidity and survival in HIV-infected men in the San Francisco Men's Health Survey. Annals of Epidemiology, 6, 420–430.

    Google Scholar 

  • Peters, L., den Boer, D. J., Kok, G., and Schaalma, H. P. (1994). Public reactions towards people with AIDS: An attributional analysis. Patient Education and Counseling, 24, 323–335.

    Google Scholar 

  • Pomeroy, E.C., Rubin, A., and Walker, R. J. (1995). Effectiveness of a psycho-educational and task-centered group intervention for family members of people with AIDS. Social Work Research, 19, 142–152.

    Google Scholar 

  • Ross, M.W., and Rosser, B. R. (1996). Measurement and correlates of internalized homophobia: A factor analytic study. Journal of Clinical Psychology, 52, 15–21.

    Google Scholar 

  • Siegel, K., Karus, D., and Raveis, V. H. (1997). Correlates of change in depressive symptomatology among gay men with AIDS. Health Psychology, 16, {pp230-238}.

    Google Scholar 

  • Sikkema, K. J., Kalichman, S. C., Hoffmann, R., Koob, J. J., Kelly, J. A., and Heckman, T. G. (2000). Coping strategies and emotional well-being among HIV-infected men and women experiencing AIDS-related bereavement. AIDS Care, 12, 613–624.

    Google Scholar 

  • Snyder, M., Omoto, A., and Crain, L. (1999). Punished for their good deeds: Stigmatization of AIDS volunteers. American Behavioral Scientist, 42, 1175–1192.

    Google Scholar 

  • Wenger, N. S., Kusseling, F. S., Beck, K., and Shapiro, M. F. (1994). Sexual behavior of individuals infected with the human immunodeficiency virus. Archives of Internal Medicine, 154, 1849–1854.

    Google Scholar 

  • Williams, J. B. W. (1988). Structured interview guide for the Hamilton anxiety and depression rating scales (SIGH-AD). New York: New York State Psychiatric Institute.

    Google Scholar 

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Lee, R.S., Kochman, A. & Sikkema, K.J. Internalized Stigma Among People Living with HIV-AIDS. AIDS Behav 6, 309–319 (2002). https://doi.org/10.1023/A:1021144511957

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