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      Patient Preference and Adherence (submit here)

      This international, peer-reviewed Open Access journal by Dove Medical Press focuses on the growing importance of patient preference and adherence throughout the therapeutic process. Sign up for email alerts here.

      34,896 Monthly downloads/views I 2.314 Impact Factor I 3.8 CiteScore I 1.14 Source Normalized Impact per Paper (SNIP) I 0.629 Scimago Journal & Country Rank (SJR)

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      Development of internalized and personal stigma among patients with and without HIV infection and occupational stigma among health care providers in Southern China

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          Abstract

          Background

          HIV/AIDS-related stigma is a major barrier of access to care for those infected with HIV. The aim of this study was to examine, validate, and adapt measuring scales of internalized, personal, and occupational stigma developed in Africa into a Chinese context.

          Methods

          A cross-sectional study was conducted from January to September 2015 in Kunming, People’s Republic of China. Various scales were constructed on the basis of the previous studies with modifications by experts using exploratory and confirmatory factor analyses (EFA + CFA). Validation of the new scales was done using multiple linear regression models and hypothesis testing of the factorial structure invariance.

          Results

          The numbers of subjects recruited for the development/validation samples were 696/667 HIV-positive patients, 699/667 non-HIV patients, and 157/155 health care providers. EFA revealed a two-factor solution for internalized and personal stigma scales (guilt/blaming and being refused/refusing service), which were confirmed by CFA with reliability coefficients ( r) of 0.869 and 0.853, respectively. The occupational stigma scale was found to have a three-factor structure (blaming, professionalism, and egalitarianism) with a reliability coefficient ( r) of 0.839. Higher correlations of factors in the HIV patients ( r=0.537) and non-HIV patients ( r=0.703) were observed in contrast to low-level correlations ( r=0.231, 0.286, and 0.266) among factors from health care providers.

          Conclusion

          The new stigma scales are valid and should be used to monitor HIV/AIDS stigma in different groups of Chinese people in health care settings.

          Most cited references43

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          From conceptualizing to measuring HIV stigma: a review of HIV stigma mechanism measures.

          Valerie Earnshaw, Stephenie Chaudoir (2009)
          Recent analyses suggest that lack of clarity in the conceptualization and measurement of HIV stigma at an individual level is a significant barrier to HIV prevention and treatment efforts. In order to address this concern, we articulate a new framework designed to aid in clarifying the conceptualization and measurement of HIV stigma among individuals. The HIV Stigma Framework explores how the stigma of HIV elicits a series of stigma mechanisms, which in turn lead to deleterious outcomes for HIV uninfected and infected people. We then apply this framework to review measures developed to gauge the effect of HIV stigma since the beginning of the epidemic. Finally, we emphasize the utility of using three questions to guide future HIV stigma research: who is affected by, how are they affected by, and what are the outcomes of HIV stigma?
          Article 0 comments Cited 344 times – based on 0 reviews     Review now
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            HIV and AIDS-related stigma and discrimination: a conceptual framework and implications for action.

            Richard Parker, Peter Aggleton (2003)
            Internationally, there has been a recent resurgence of interest in HIV and AIDS-related stigma and discrimination, triggered at least in part by growing recognition that negative social responses to the epidemic remain pervasive even in seriously affected communities. Yet, rarely are existing notions of stigma and discrimination interrogated for their conceptual adequacy and their usefulness in leading to the design of effective programmes and interventions. Taking as its starting point, the classic formulation of stigma as a 'significantly discrediting' attribute, but moving beyond this to conceptualize stigma and stigmatization as intimately linked to the reproduction of social difference, this paper offers a new framework by which to understand HIV and AIDS-related stigma and its effects. It so doing, it highlights the manner in which stigma feeds upon, strengthens and reproduces existing inequalities of class, race, gender and sexuality. It highlights the limitations of individualistic modes of stigma alleviation and calls instead for new programmatic approaches in which the resistance of stigmatized individuals and communities is utilized as a resource for social change.
            Article 0 comments Cited 298 times – based on 0 reviews     Review now
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              Combating HIV stigma in health care settings: what works?

              Laura Nyblade, Anne Stangl, Ellen Weiss … (2009)
              The purpose of this review paper is to provide information and guidance to those in the health care setting about why it is important to combat HIV-related stigma and how to successfully address its causes and consequences within health facilities. Research shows that stigma and discrimination in the health care setting and elsewhere contributes to keeping people, including health workers, from accessing HIV prevention, care and treatment services and adopting key preventive behaviours. Studies from different parts of the world reveal that there are three main immediately actionable causes of HIV-related stigma in health facilities: lack of awareness among health workers of what stigma looks like and why it is damaging; fear of casual contact stemming from incomplete knowledge about HIV transmission; and the association of HIV with improper or immoral behaviour. To combat stigma in health facilities, interventions must focus on the individual, environmental and policy levels. The paper argues that reducing stigma by working at all three levels is feasible and will likely result in long-lasting benefits for both health workers and HIV-positive patients. The existence of tested stigma-reduction tools and approaches has moved the field forward. What is needed now is the political will and resources to support and scale up stigma-reduction activities throughout health care settings globally.
              Article 0 comments Cited 166 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Patient Prefer Adherence
                Journal ID (iso-abbrev): Patient Prefer Adherence
                Journal ID (publisher-id): Patient Preference and Adherence
                Title: Patient preference and adherence
                Publisher: Dove Medical Press
                ISSN (Electronic): 1177-889X
                Publication date Collection: 2016
                Publication date (Electronic): 08 November 2016
                Volume: 10
                Pages: 2309-2320
                Affiliations
                [1 ]Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
                [2 ]School of Public Health, Kunming Medical University
                [3 ]Yunnan Center for Disease Prevention and Control
                [4 ]Infectious Diseases Department, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, People’s Republic of China
                Author notes
                Correspondence: Lin Lu, Yunnan Center for Disease Prevention and Control, 158 Dongsi Street, Xishan District, Kunming 650022, Yunnan Province, People’s Republic of China, Email lulin@ 123456yncdc.cn
                [*]

                These authors contributed equally to this work

                Article
                Publisher ID: ppa-10-2309
                DOI: 10.2147/PPA.S112771
                PMC ID: 5108600
                PubMed ID: 27877022
                SO-VID: cd5e0e5c-77dc-42ae-8a5e-516196c3e49a
                Copyright © © 2016 Li et al. This work is published and licensed by Dove Medical Press Limited
                License:

                The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

                History
                Categories
                Subject: Original Research

                ScienceOpen disciplines: Medicine
                Keywords: hiv/aids-related stigma,exploratory factor analysis,confirmatory factor analysis,guilt,blaming,being refused,refusing service
                Data availability:
                ScienceOpen disciplines: Medicine
                Keywords: hiv/aids-related stigma, exploratory factor analysis, confirmatory factor analysis, guilt, blaming, being refused, refusing service

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