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Internalized stigma, discrimination, and depression among men and women living with HIV/AIDS in Cape Town, South Africa

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  • Simbayi, Leickness C.
  • Kalichman, Seth
  • Strebel, Anna
  • Cloete, Allanise
  • Henda, Nomvo
  • Mqeketo, Ayanda

Abstract

AIDS stigmas interfere with HIV prevention, diagnosis, and treatment and can become internalized by people living with HIV/AIDS. However, the effects of internalized AIDS stigmas have not been investigated in Africa, home to two-thirds of the more than 40 million people living with AIDS in the world. The current study examined the prevalence of discrimination experiences and internalized stigmas among 420 HIV-positive men and 643 HIV-positive women recruited from AIDS services in Cape Town, South Africa. The anonymous surveys found that 40% of persons with HIV/AIDS had experienced discrimination resulting from having HIV infection and one in five had lost a place to stay or a job because of their HIV status. More than one in three participants indicated feeling dirty, ashamed, or guilty because of their HIV status. A hierarchical regression model that included demographic characteristics, health and treatment status, social support, substance use, and internalized stigma significantly predicted cognitive-affective depression. Internalized stigma accounted for 4.8% of the variance in cognitive-affective depression scores over and above the other variables. These results indicate an urgent need for social reform to reduce AIDS stigmas and the design of interventions to assist people living with HIV/AIDS to adjust and adapt to the social conditions of AIDS in South Africa.

Suggested Citation

  • Simbayi, Leickness C. & Kalichman, Seth & Strebel, Anna & Cloete, Allanise & Henda, Nomvo & Mqeketo, Ayanda, 2007. "Internalized stigma, discrimination, and depression among men and women living with HIV/AIDS in Cape Town, South Africa," Social Science & Medicine, Elsevier, vol. 64(9), pages 1823-1831, May.
    • Handle: RePEc:eee:socmed:v:64:y:2007:i:9:p:1823-1831
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    2. Wight, Richard G., 2000. "Precursive depression among HIV infected AIDS caregivers over time," Social Science & Medicine, Elsevier, vol. 51(5), pages 759-770, September.
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    1. Horwood, Christiane & Voce, Anna & Vermaak, Kerry & Rollins, Nigel & Qazi, Shamim, 2010. "Routine checks for HIV in children attending primary health care facilities in South Africa: Attitudes of nurses and child caregivers," Social Science & Medicine, Elsevier, vol. 70(2), pages 313-320, January.
    2. Burke, Sara E. & Calabrese, Sarah K. & Dovidio, John F. & Levina, Olga S. & Uusküla, Anneli & Niccolai, Linda M. & Abel-Ollo, Katri & Heimer, Robert, 2015. "A tale of two cities: Stigma and health outcomes among people with HIV who inject drugs in St. Petersburg, Russia and Kohtla-Järve, Estonia," Social Science & Medicine, Elsevier, vol. 130(C), pages 154-161.
    3. Dallas Swendeman & Anne E Fehrenbacher & Soma Roy & Rishi Das & Protim Ray & Stephanie Sumstine & Toorjo Ghose & Smarajit Jana, 2018. "Gender disparities in depression severity and coping among people living with HIV/AIDS in Kolkata, India," PLOS ONE, Public Library of Science, vol. 13(11), pages 1-20, November.
    4. Salmen, Charles R. & Hickey, Matthew D. & Fiorella, Kathryn J. & Omollo, Dan & Ouma, Gor & Zoughbie, Daniel & Salmen, Marcus R. & Magerenge, Richard & Tessler, Robert & Campbell, Harold & Geng, Elvin , 2015. "“Wan Kanyakla” (We are together): Community transformations in Kenya following a social network intervention for HIV care," Social Science & Medicine, Elsevier, vol. 147(C), pages 332-340.
    5. Gaeul Kim & Jinmok Kim & Su-Kyoung Lee & Juho Sim & Yangwook Kim & Byung-Yoon Yun & Jin-Ha Yoon, 2020. "Multidimensional gender discrimination in workplace and depressive symptoms," PLOS ONE, Public Library of Science, vol. 15(7), pages 1-13, July.
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    8. Nella Otoobea Anakwa & Enoch Teye-Kwadjo & Irene A. Kretchy, 2021. "Effect of HIV-Related Stigma and HIV-Related Stress on HIV Disclosure Concerns: a Study of HIV-Positive Persons on Antiretroviral Therapy at Two Urban Hospitals in Ghana," Applied Research in Quality of Life, Springer;International Society for Quality-of-Life Studies, vol. 16(3), pages 1249-1264, June.
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    10. Tsai, Alexander C. & Bangsberg, David R. & Emenyonu, Nneka & Senkungu, Jude K. & Martin, Jeffrey N. & Weiser, Sheri D., 2011. "The social context of food insecurity among persons living with HIV/AIDS in rural Uganda," Social Science & Medicine, Elsevier, vol. 73(12), pages 1717-1724.
    11. Arimoto, Yutaka & Hori, Narumi & Ito, Seiro & Kudo, Yuya & Tsukada, Kazunari, 2016. "Impacts of an HIV counseling and testing initiative -- results from an experimental intervention in a large firm in South Africa," IDE Discussion Papers 597, Institute of Developing Economies, Japan External Trade Organization(JETRO).
    12. Betancourt, Theresa Stichick & Meyers-Ohki, Sarah & Stulac, Sara N. & Elizabeth Barrera, Amy & Mushashi, Christina & Beardslee, William R., 2011. "Nothing can defeat combined hands (Abashize hamwe ntakibananira): Protective processes and resilience in Rwandan children and families affected by HIV/AIDS," Social Science & Medicine, Elsevier, vol. 73(5), pages 693-701, September.
    13. Ning Hsieh, 2013. "Perceived risk of HIV infection and mental health in rural Malawi," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 28(13), pages 373-408.
    14. Liamputtong, Pranee & Haritavorn, Niphattra & Kiatying-Angsulee, Niyada, 2009. "HIV and AIDS, stigma and AIDS support groups: Perspectives from women living with HIV and AIDS in central Thailand," Social Science & Medicine, Elsevier, vol. 69(6), pages 862-868, September.
    15. Tsai, Alexander C. & Bangsberg, David R. & Frongillo, Edward A. & Hunt, Peter W. & Muzoora, Conrad & Martin, Jeffrey N. & Weiser, Sheri D., 2012. "Food insecurity, depression and the modifying role of social support among people living with HIV/AIDS in rural Uganda," Social Science & Medicine, Elsevier, vol. 74(12), pages 2012-2019.
    16. Mbokazi, Nonzuzo & van Pinxteren, Myrna & Murphy, Katherine & Mair, Frances S. & May, Carl R. & Levitt, Naomi S., 2023. "Ubuntu as a mediator in coping with multimorbidity treatment burden in a disadvantaged rural and urban setting in South Africa," Social Science & Medicine, Elsevier, vol. 334(C).
    17. Charlotte Bernard & François Dabis & Nathalie de Rekeneire, 2017. "Prevalence and factors associated with depression in people living with HIV in sub-Saharan Africa: A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 12(8), pages 1-22, August.
    18. Tsai, Alexander C. & Venkataramani, Atheendar S., 2015. "The causal effect of education on HIV stigma in Uganda: Evidence from a natural experiment," Social Science & Medicine, Elsevier, vol. 142(C), pages 37-46.
    19. Hejoaka, Fabienne, 2009. "Care and secrecy: Being a mother of children living with HIV in Burkina Faso," Social Science & Medicine, Elsevier, vol. 69(6), pages 869-876, September.
    20. Steward, Wayne T. & Herek, Gregory M. & Ramakrishna, Jayashree & Bharat, Shalini & Chandy, Sara & Wrubel, Judith & Ekstrand, Maria L., 2008. "HIV-related stigma: Adapting a theoretical framework for use in India," Social Science & Medicine, Elsevier, vol. 67(8), pages 1225-1235, October.
    21. Gausset, Quentin & Mogensen, Hanne Overgaard & Yameogo, Wambi Maurice Evariste & Berthé, Abdramane & Konaté, Blahima, 2012. "The ambivalence of stigma and the double-edged sword of HIV/AIDS intervention in Burkina Faso," Social Science & Medicine, Elsevier, vol. 74(7), pages 1037-1044.
    22. McPherson, A., 2009. "Health service delivery and other HIV/AIDS related interventions in the fisheries sector in Sub-Saharan Africa: a literature review," Monographs, The WorldFish Center, number 38688, April.

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