Thursday, October 11, 2012

Meta-analysis of health and demographic correlates of stigma towards people living with HIV.

Meta-analysis of health and demographic correlates of stigma towards people living with HIV.


HIV-related stigma may negatively impact the health, quality of life, social support and well-being of people living with HIV (PLHIV). Previous studies have used diverse samples and a multitude of measurement instruments to examine demographic and health correlates of HIV-related stigma, highlighting the importance of synthesizing findings across different studies to gain a better understanding of these associations. This study examined the relationships between HIV-related stigma and a range of demographic, social, physical and health characteristics. A meta-analysis was conducted to assess the overall strength and direction of these relationships. Twenty-four studies of PLHIV, conducted in North America and published in peer-reviewed journals between January of 2000 and November of 2007, were examined and their findings integrated. The heterogeneity of reported results was also assessed and examined. Logie etal’s review revealed substantial variability in the ways researchers measure participants' HIV-related stigma as well as their physical, emotional and mental health. In spite of this variability, high stigma level was consistently and significantly associated with low social support (r = -0.369, p<0.0005), r =" -0.324," r =" -0.402,">. These correlations were of a medium size, which would be recognized by the individual in daily life. Health and mental health professionals working with individuals and families affected by HIV could benefit from an enhanced understanding of correlates of HIV-related stigma, which will inform assessments, interventions, and treatment plans. The association between HIV-related stigma and physical health has potential implications for treatment, care and support for people at different stages of HIV infection. AIDS Service Organizations are also encouraged to integrate findings into HIV stigma interventions and social support programs. Additionally, HIV-related stigma scales should be developed and validated, so that future studies using them are able to report findings that are operationally and conceptually consistent.

Drawing on data from 5600 individuals in 24 studies, this literature synthesis is the first to quantify the associations between HIV-related stigma and characteristics of people living with HIV. Five key variables were found to be significantly associated with high stigma levels: lack of social support, poor physical health, poor mental health, low income, and younger age. Effective interventions to address stigma operate on multiple levels and engage populations as diverse as policy makers, practitioners, communities, and people living with HIV. On a parallel track, it is high time to measure and better understand individual and collective strengths such as the resilience, resistance, solidarity, and empowerment that both help cope with stigma and reduce its prevalence.

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