Skip to main content
SpringerLink
Log in

Stigma and Prejudice in Patients with HIV/AIDS

  • Chapter
  • First Online:
Stigma and Prejudice

Part of the book series: Current Clinical Psychiatry ((CCPSY))

Abstract

An abundance of advances related to pharmacology, diagnostics, patient education, management, and biomedical research over the past three decades has resulted in a dramatic decrease in the morbidity and mortality from HIV/AIDS. However, suffering remains high among those who are affected with HIV and their families as a result of negative mental health and quality of life consequences due to stigma. HIV stigma exists worldwide; its common drivers are recognized across different settings [1]. Stigma continues to be one of the greatest challenges in the fight against HIV/AIDS [2]. The goal of this chapter is to highlight stigma and prejudice as it pertains to patients with HIV/AIDS. We will set the stage with regard to stigma and HIV in this chapter by giving a historic overview of the HIV/AIDS epidemic from the 1980s; summarize the biology of HIV, transmission of the virus, course of illness and how they impact stigma; and discuss the implications of HIV detection and diagnosis on stigma.

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

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Thomas BE, Rehman F, Suryanarayanan D, Josephine K, Dilip M, Dorairaj VS, Swaminathan S. How stigmatizing is stigma in the life of people living with HIV: a study on HIV positive individuals from Chennai, South India. AIDS Care. 2005;17(7):795–801.

    Article  CAS  PubMed  Google Scholar 

  2. Wolfe WR, Weiser SD, Leiter K, Steward WT, Percy-de Korte F, Phaladze N, Iacopino V, Heisler M. The impact of universal access to antiretroviral therapy on HIV stigma in Botswana. Am J Public Health. 2008;98(10):1865–71.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Greene WC. A history of AIDS: looking back to see ahead. Eur J Immunol. 2007;37 Suppl 1:S94–102.

    Article  CAS  PubMed  Google Scholar 

  4. Altman LK. New homosexual disorder worries health officials. The New York Times. May 11 1982.

    Google Scholar 

  5. Broder S, Gallo RC. A pathogenic retrovirus (HTLV-III) linked to AIDS. N Engl J Med. 1984;311(20):1292–7.

    Article  CAS  PubMed  Google Scholar 

  6. Laurence J, Brun-Vezinet F, Schutzer SE, Rouzioux C, Klatzmann D, Barre-Sinoussi F, Chermann JC, Montagnier L. Lymphadenopathy-associated viral antibody in AIDS. Immune correlations and definition of a carrier state. N Engl J Med. 1984;311(20):1269–73.

    Article  CAS  PubMed  Google Scholar 

  7. Kwitny J. Bad medicine. American Journalism Review Features. 1993. http://ajrarchive.org/Article.asp?id=1411. Accessed 31 Aug 2015.

  8. Busch MP, Lee LL, Satten GA, Henrard DR, Farzadegan H, Nelson KE, Read S, Dodd RY, Petersen LR. Time course of detection of viral and serologic markers preceding human immunodeficiency virus type 1 seroconversion: implications for screening of blood and tissue donors. Transfusion. 1995;35(2):91–7.

    Article  CAS  PubMed  Google Scholar 

  9. Kahn JO, Walker BD. Acute human immunodeficiency virus type 1 infection. N Engl J Med. 1998;339(1):33–9.

    Article  CAS  PubMed  Google Scholar 

  10. Morison L. The global epidemiology of HIV/AIDS. Br Med Bull. 2001;58:7–18.

    Article  CAS  PubMed  Google Scholar 

  11. Fauci AS, Lane HC. Chapter 189: Human immunodeficiency virus disease: AIDS and related disorders. In: Longo DL, FA, Kasper DL, Hauser SL, Jameson J, Loscalzo J, editors. Harrison’s principles of internal medicine. 18th ed. New York: McGraw-Hill; 2012: http://accessmedicine.mhmedical.com.ezp-prod1.hul.harvard.edu/content.aspx?bookid=331&Sectionid=40726947. Accessed 3 Sep 2015.

  12. De Cock KM, Adjorlolo G, Ekpini E, Sibailly T, Kouadio J, Maran M, Brattegaard K, Vetter KM, Doorly R, Gayle HD. Epidemiology and transmission of HIV-2. Why there is no HIV-2 pandemic. JAMA. 1993;270(17):2083–6.

    Article  PubMed  Google Scholar 

  13. Bouvet E, De Vincenzi I, Ancelle R, Vachon F. Defloration as risk factor for heterosexual HIV transmission. Lancet. 1989;1(8638):615.

    Article  CAS  PubMed  Google Scholar 

  14. de Vincenzi I. A longitudinal study of human immunodeficiency virus transmission by heterosexual partners. European Study Group on Heterosexual Transmission of HIV. N Engl J Med. 1994;331(6):341–6.

    Article  PubMed  Google Scholar 

  15. Vernazza PL, Eron JJ, Fiscus SA, Cohen MS. Sexual transmission of HIV: infectiousness and prevention. AIDS. 1999;13(2):155–66.

    Article  CAS  PubMed  Google Scholar 

  16. Coffin J, Swanstrom R. HIV pathogenesis: dynamics and genetics of viral populations and infected cells. Cold Spring Harb Perspect Med. 2013;3(1):a012526.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Branson BM. State of the art for diagnosis of HIV infection. Clin Infect Dis. 2007;45 Suppl 4:S221–5.

    Article  PubMed  Google Scholar 

  18. Hutchinson AB, Branson BM, Kim A, Farnham PG. A meta-analysis of the effectiveness of alternative HIV counseling and testing methods to increase knowledge of HIV status. AIDS. 2006;20(12):1597–604.

    Article  PubMed  Google Scholar 

  19. Prevention CfDCa. State HIV testing laws: consent and counseling requirements. HIV/AIDS. 2015. http://www.cdc.gov/hiv/policies/law/states/testing.html. Accessed 31 Aug 2015.

  20. Goffman E. Stigma: notes on the management of spoiled identity. New York: Simon & Schuster Inc: 1986.

    Google Scholar 

  21. Alonzo AA, Reynolds NR. Stigma, HIV and AIDS: an exploration and elaboration of a stigma trajectory. Soc Sci Med. 1995;41(3):303–15.

    Article  CAS  PubMed  Google Scholar 

  22. Castro A, Farmer P. Understanding and addressing AIDS-related stigma: from anthropological theory to clinical practice in Haiti. Am J Public Health. 2005;95(1):53–9.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Courtwright A, Turner AN. Tuberculosis and stigmatization: pathways and interventions. Public Health Rep. 2010;125 Suppl 4:34–42.

    PubMed  PubMed Central  Google Scholar 

  24. Corrigan PW, Watson AC. Understanding the impact of stigma on people with mental illness. World Psychiatry. 2002;1(1):16–20.

    PubMed  PubMed Central  Google Scholar 

  25. Parker R, Aggleton P. HIV and AIDS-related stigma and discrimination: a conceptual framework and implications for action. Soc Sci Med. 2003;57(1):13–24.

    Article  PubMed  Google Scholar 

  26. Deacon H, Inez S, Sandra P. Understanding HIV/AIDS Stigma A theoretical and methodological analysis. Cape Town: Human Sciences Research. 2005.

    Google Scholar 

  27. Sengupta S, Banks B, Jonas D, Miles MS, Smith GC. HIV interventions to reduce HIV/AIDS stigma: a systematic review. AIDS Behav. 2011;15(6):1075–87.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Aggleton P. Barcelona 2002: law, ethics, and human rights. HIV/AIDS-related stigma and discrimination: a conceptual framework. Can HIV AIDS Policy Law Rev. 2002;7(2–3):115–6.

    PubMed  Google Scholar 

  29. Link BG, Phelan JC. Conceptulaizing stigma. Annu Rev Socio. 2001;27:363–85.

    Article  Google Scholar 

  30. Kleinman A, Wang WZ, Li SC, Cheng XM, Dai XY, Li KT, Kleinman J. The social course of epilepsy: chronic illness as social experience in interior China. Soc Sci Med. 1995;40(10):1319–30.

    Article  CAS  PubMed  Google Scholar 

  31. Whittaker AM. Living with HIV: resistance by positive people. Med Anthropol Q. 1992;6(4):385–90.

    Article  Google Scholar 

  32. Farmer P, Kleinman A. AIDS as human suffering. Daedalus. 1989;118(2):135–60.

    Google Scholar 

  33. Campbell C, Skovdal M, Mupambireyi Z, Madanhire C, Robertson L, Nyamukapa CA, Gregson S. Can AIDS stigma be reduced to poverty stigma? Exploring Zimbabwean children’s representations of poverty and AIDS. Child Care Health Dev. 2012;38(5):732–42.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Hontelez JA, de Vlas SJ, Baltussen R, Newell ML, Bakker R, Tanser F, Lurie M, Barnighausen T. The impact of antiretroviral treatment on the age composition of the HIV epidemic in sub-Saharan Africa. AIDS. 2012;26 Suppl 1:S19–30.

    Article  PubMed  Google Scholar 

  35. Reidpath DD, Chan KY, Gifford SM, Allotey P. ‘He hath the French pox’: stigma, social value and social exclusion. Sociol Health Illn. 2005;27(4):468–89.

    Article  PubMed  Google Scholar 

  36. Stangl AL, Brady L, Fritz K. Technical Brief: Measuring HIV stigma and discrimination, tackling the structural drivers of HIV. International Center for Research on Women, Washington DC. 2012.

    Google Scholar 

  37. Gray AJ. Stigma in psychiatry. J R Soc Med. 2002;95(2):72–6.

    Article  PubMed  PubMed Central  Google Scholar 

  38. 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  PubMed Central  Google Scholar 

  39. Jacoby A. Felt versus enacted stigma: a concept revisited. Evidence from a study of people with epilepsy in remission. Soc Sci Med. 1994;38(2):269–74.

    Article  CAS  PubMed  Google Scholar 

  40. Evans T. Retro indy: ryan white (1971–1990). IndyStar. April 8, 2010.

    Google Scholar 

  41. White R, Cunningham AM. Ryan white: my own story. New York: Signet; 1992.

    Google Scholar 

  42. Herek G. Beyond “Homophobia”: thinking about sexual prejudice and stigma in the twenty-first century. Sexual Res Soc Pol. 2004;1(2):6–24.

    Article  Google Scholar 

  43. Bharat SAP, Tyrer P. India, HIV and AIDS-related discrimination, stigmatization and denial. Geneva: UNAIDS; 2001.

    Google Scholar 

  44. Lim T, Zelaya C, Latkin C, Quan VM, Frangakis C, Ha TV, Minh NL, Go V. Individual-level socioeconomic status and community-level inequality as determinants of stigma towards persons living with HIV who inject drugs in Thai Nguyen, Vietnam. J Int AIDS Soc. 2013;16(3 Suppl 2):18637.

    PubMed  PubMed Central  Google Scholar 

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

    Article  PubMed  PubMed Central  Google Scholar 

  46. Edwards LV. Perceived social support and HIV/AIDS medication adherence among African American women. Qual Health Res. 2006;16(5):679–91.

    Article  PubMed  Google Scholar 

  47. Konkle-Parker DJ, Erlen JA, Dubbert PM. Barriers and facilitators to medication adherence in a southern minority population with HIV disease. J Assoc Nurses AIDS Care. 2008;19(2):98–104.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Anderson M, Elam G, Gerver S, Solarin I, Fenton K, Easterbrook P. HIV/AIDS-related stigma and discrimination: accounts of HIV-positive Caribbean people in the United Kingdom. Soc Sci Med. 2008;67(5):790–8.

    Article  PubMed  Google Scholar 

  49. Ramin B. Anthropology speaks to medicine: the case HIV/AIDS in Africa. Mcgill J Med. 2007;10(2):127–32.

    PubMed  PubMed Central  Google Scholar 

  50. Nyblade L, Stangl A, Weiss E, Ashburn K. Combating HIV stigma in health care settings: what works? J Int AIDS Soc. 2009;12:15.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Rutledge SE, Abell N, Padmore J, McCann TJ. AIDS stigma in health services in the Eastern Caribbean. Sociol Health Illn. 2009;31(1):17–34.

    Article  PubMed  Google Scholar 

  52. Grossman CI, Stangl AL. Editorial: global action to reduce HIV stigma and discrimination. J Int AIDS Soc. 2013;16(3 Suppl 2):18881.

    PubMed  PubMed Central  Google Scholar 

  53. Obermeyer CM, Osborn M. The utilization of testing and counseling for HIV: a review of the social and behavioral evidence. Am J Public Health. 2007;97(10):1762–74.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Dixon S, McDonald S, Roberts J. The impact of HIV and AIDS on Africa’s economic development. BMJ. 2002;324(7331):232–4.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Barnighausen T, Bloom DE, Humair S. Human resources for treating HIV/AIDS: needs, capacities, and gaps. AIDS Patient Care STDS. 2007;21(11):799–812.

    Article  PubMed  Google Scholar 

  56. 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 

  57. Hong Y, Li X. HIV/AIDS behavioral interventions in China: a literature review and recommendation for future research. AIDS Behav. 2009;13(3):603–13.

    Article  PubMed  PubMed Central  Google Scholar 

  58. Jain A, Nuankaew R, Mongkholwiboolphol N, Banpabuth A, Tuvinun R, Oranop NA Ayuthaya P, Richter K. Community-based interventions that work to reduce HIV stigma and discrimination: results of an evaluation study in Thailand. J Int AIDS Soc. 2013;16(3 Suppl 2):18711.

    PubMed  PubMed Central  Google Scholar 

  59. Bernal G, Jiménez-Chafey MI, Domenech Rodríguez MM. Cultural adaptation of treatments: a resource for considering culture in evidence-based practice. Prof Psychol Res Pract. 2009;40(4):361–8.

    Article  Google Scholar 

  60. Gearing RE, Schwalbe CS, MacKenzie MJ, Brewer KB, Ibrahim RW, Olimat HS, Al-Makhamreh SS, Mian I, Al-Krenawi A. Adaptation and translation of mental health interventions in Middle Eastern Arab countries: a systematic review of barriers to and strategies for effective treatment implementation. Int J Soc Psychiatry. 2013;59(7):671–81.

    Article  PubMed  Google Scholar 

  61. Li L, Lin C, Guan J, Wu Z. Implementing a stigma reduction intervention in healthcare settings. J Int AIDS Soc. 2013;16(3 Suppl 2):18710.

    PubMed  PubMed Central  Google Scholar 

  62. Stangl AL, Lloyd JK, Brady LM, Holland CE, Baral S. A systematic review of interventions to reduce HIV-related stigma and discrimination from 2002 to 2013: how far have we come? J Int AIDS Soc. 2013;16(3 Suppl 2):18734.

    PubMed  PubMed Central  Google Scholar 

  63. Mburu G, Ram M, Skovdal M, Bitira D, Hodgson I, Mwai GW, Stegling C, Seeley J. Resisting and challenging stigma in Uganda: the role of support groups of people living with HIV. J Int AIDS Soc. 2013;16(3 Suppl 2):18636.

    PubMed  PubMed Central  Google Scholar 

  64. Roopnaraine T, Rawat R, Babirye F, Ochai R, Kadiyala S. “The group” in integrated HIV and livelihoods programming: opportunity or challenge? AIDS Care. 2012;24(5):649–57.

    Article  PubMed  Google Scholar 

  65. Pulerwitz J, Michaelis A, Weiss E, Brown L, Mahendra V. Reducing HIV-related stigma: lessons learned from horizons research and programs. Public Health Rep. 2010;125(2):272–81.

    PubMed  PubMed Central  Google Scholar 

  66. Specter M. How magic Johnson fought the AIDS epidemic. The New Yorker. 2014. http://www.newyorker.com/news/daily-comment/how-magic-johnson-fought-the-aids-epidemic.

  67. Seeley J, Russel S. Social rebirth and social transformation? Rebuilding social lives after ART in rural Uganda. AIDS Care. 2010;22 Suppl 1:44–50.

    Article  PubMed  Google Scholar 

  68. Tsai AC, Bangsberg DR, Weiser SD. Harnessing poverty alleviation to reduce the stigma of HIV in sub-Saharan Africa. PLoS Med. 2013;10(11):e1001557.

    Article  PubMed  PubMed Central  Google Scholar 

  69. Midtbø V, Shirima V, Skovdal M, Daniel M. How disclosure and antiretroviral therapy help HIV-infected adolescents in sub-Saharan Africa cope with stigma. Afr J AIDS Res. 2012;11(3):261–71.

    Article  PubMed  Google Scholar 

  70. Campbell C, Skovdal M, Madanhire C, Mugurungi O, Gregson S, Nyamukapa C. “We, the AIDS people…”: how antiretroviral therapy enables Zimbabweans living with HIV/AIDS to cope with stigma. Am J Public Health. 2011;101(6):1004–10.

    Article  PubMed  PubMed Central  Google Scholar 

  71. Logie C, Gadalla TM. Meta-analysis of health and demographic correlates of stigma towards people living with HIV. AIDS Care. 2009;21(6):742–53.

    Article  CAS  PubMed  Google Scholar 

  72. Vyas KJ, Patel GR, Shukla D, Mathews WC. A comparison in HIV-associated stigma among healthcare workers in urban and rural Gujarat. SAHARA J. 2010;7(2):71–5.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. MGH/McLean Adult Psychiatry Residency Training Program, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA

    Hermioni N. Lokko MD, MPP

  2. McLean Hospital, Belmont, MA, USA

    Hermioni N. Lokko MD, MPP

  3. Department of Medicine, Mount Auburn Hospital, Cambridge, MA, USA

    Valerie E. Stone MD, MPH (Charles S. Davidson Professor of Medicine)

  4. Harvard Medical School, Boston, MA, USA

    Valerie E. Stone MD, MPH (Charles S. Davidson Professor of Medicine)

Authors
  1. Hermioni N. Lokko MD, MPP
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Valerie E. Stone MD, MPH
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hermioni N. Lokko MD, MPP .

Editor information

Editors and Affiliations

  1. Massachusetts General Hospital, Boston, Massachusetts, USA

    Ranna Parekh

  2. Morehouse School of Medicine, Atlanta, Georgia, USA

    Ed W. Childs

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Lokko, H.N., Stone, V.E. (2016). Stigma and Prejudice in Patients with HIV/AIDS. In: Parekh, R., Childs, E. (eds) Stigma and Prejudice. Current Clinical Psychiatry. Humana Press, Cham. https://doi.org/10.1007/978-3-319-27580-2_10

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-27580-2_10

  • Published:

  • Publisher Name: Humana Press, Cham

  • Print ISBN: 978-3-319-27578-9

  • Online ISBN: 978-3-319-27580-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation