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HIV Stigmatization Among Healthcare Providers: Review of the Evidence and Implications for HIV Care

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Stigma, Discrimination and Living with HIV/AIDS

Abstract

HIV-related stigmatization is associated with a number of adverse consequences among HIV-positive individuals. Given the direct role healthcare providers play in promoting and maintaining the overall health of HIV-positive individuals, it is important to understand the extent to which stigmatization among healthcare providers exists and the potential effects that such negative attitudes and behavior may have on the well-being of HIV-positive patients. This chapter provides a review of the literature on stigmatization among healthcare providers, with a focus on studies that report information on stigmatizing healthcare experiences from the patient’s perspective. We describe the potential effects of stigmatization on the well-being of HIV-positive patients, offer a methodological critique of the existing literature, and provide directions for future research and training interventions. Overall, findings confirm that HIV-positive patients experience stigmatization within healthcare settings in the form of negative demeanor from providers, as well as more overt examples, including patient avoidance, lowered quality of care, and treatment refusal. Review findings also confirm that provider stigmatization remains a concern for HIV-positive patients and may exert negative effects on medical care. In reviewing the literature, we suggest directions for research that informs the development of interventions to assist healthcare providers and HIV-positive patients in creating more positive treatment experiences and health outcomes.

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References

  • Agne, R. R., Thompson, T. L., & Cusella, L. P. (2000). Stigma in the line of face: Self disclosure of patients’ HIV status to health care providers. Journal of Applied Communication Research, 28, 235–261.

    Article  Google Scholar 

  • Berger, B. E., Ferrans, C. E., & Lashley, F. R. (2001). Measuring stigma in people with HIV: Psychometric assessment of the HIV stigma scale. Research in Nursing and Health, 24, 518–529.

    Article  Google Scholar 

  • Blake, B. J., Jones Taylor, G. A., Reid, P., & Kosowski, M. (2008). Experiences of women in obtaining human immunodeficiency virus testing and healthcare services. Journal of the American Academy of Nurse Practitioners, 20, 40–46.

    Article  Google Scholar 

  • Bodenlos, J. S., Grothe, K. B., Whitehead, D., Konkle-Parker, D. J., Jones, G. N., & Brantley, P. J. (2007). Attitudes toward health care providers and appointment attendance in HIV/AIDS Patients. The Journal of the Association of Nurses in AIDS Care, 18, 65–73.

    Article  Google Scholar 

  • Brown, L., Macintyre, D., & Trujillo, L. (2003). Interventions to reduce HIV/AIDS stigma: What have we learned? AIDS Education and Prevention, 15, 49–69.

    Article  Google Scholar 

  • Buseh, A. G., & Stevens, P. E. (2006). Constrained but not determined by stigma: Resistance by African American women living with HIV. Women & Health, 44, 1–18.

    Article  Google Scholar 

  • Catz, S. L., Kelly, J. A., Bogart, L. M., Benotsch, E. G., & McAuliffe, T. (2000). Patterns, predictors, and barriers to medication adherence among persons prescribed new treatments for HIV disease. Health Psychology, 19, 124–133.

    Article  Google Scholar 

  • Chapman, E. (2002). Patient impact of negative representations of HIV. AIDS Patient Care and STDs, 16, 173–177.

    Article  Google Scholar 

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

    Article  Google Scholar 

  • Clark, H. J., Lindner, G., Armistead, L., & Austin, B. (2003). Stigma, disclosure, and psychological functioning among HIV-infected and non-infected African-American women. Women & Health, 38, 57–71.

    Article  Google Scholar 

  • Courtenay-Quick, C., Wolitski, R. J., Parsons, J. T., & Gomez, C. A. (2006). Is HIV/AIDS stigma dividing the gay community? Perceptions of HIV-positive men who have sex with men. AIDS Education and Prevention, 18, 56–67.

    Article  Google Scholar 

  • Crocker, J., Major, B., & Steele, C. (1998). Social stigma. In D. Gilbert, S. T. Fiske, & G. Lindzey (Eds.), The handbook of social psychology (4th ed., Vol. 2, pp. 504–553). New York: McGraw Hill.

    Google Scholar 

  • Eldridge, G. D., & St. Lawrence, J. S. (1995). The knowledge, attitudes and behaviour of health care professionals regarding HIV and AIDS: Current status of the research literature. In L. Bennett, D. Miller, & M. Ross (Eds.), Health workers and AIDS: Research, intervention and current issues in burnout and response (pp. 35–59). Amsterdam: Harwood Academic Publishers.

    Google Scholar 

  • Elford, J., Ibrahim, F., Bukutu, C., & Anderson, J. (2008). HIV-related discrimination reported by people living with HIV in London, UK. AIDS and Behavior, 12, 255–264.

    Article  Google Scholar 

  • Frable, D. E., Blackstone, T., & Scherbaum, C. (1990). Marginal and mindful: Deviants in social interactions. Journal of Personality and Social Psychology, 59, 140–149.

    Article  Google Scholar 

  • Gardezi, F., Calzavara, L., Husbands, W., Tharao, W., Lawson, E., Myers, T., et al. (2008). Experiences of and responses to HIV among African and Caribbean communities in Toronto, Canada. AIDS Care, 20, 718–725.

    Article  Google Scholar 

  • Heckman, B. D., Catz, S. L., Heckman, T. G., Miller, J. G., & Kalichman, S. C. (2004). Adherence to antiretroviral therapy in rural persons living with HIV disease in the United States. AIDS Care, 16, 219–230.

    Article  Google Scholar 

  • Herek, G. M., Capitanio, J. P., & Widaman, K. F. (2002). HIV-related stigma and knowledge in the United States: Prevalence and trends, 1991–1999. American Journal of Public Health, 92, 371–377.

    Article  Google Scholar 

  • Herek, G. M., Capitanio, J. P., & Widaman, K. F. (2003). Stigma, social risk, and health policy: Public attitudes toward HIV surveillance policies and the social construction of illness. Health Psychology, 22, 533–540.

    Google Scholar 

  • King, M. B. (1989). Prejudice and AIDS: The views and experiences of people with HIV infection. AIDS Care, 1, 137–143.

    Article  Google Scholar 

  • Kinsler, J. J., Wong, M. D., Sayles, J. N., Davis, C., & Cunningham, W. E. (2007). The effect of perceived stigma from a health care provider on access to care among a low-income HIV-­positive population. AIDS Patient Care and STDs, 21, 584–592.

    Article  Google Scholar 

  • Ladany, N., Stern, M., & Inman, A. P. (1998). Medical students’ perceptions of and willingness to treat patients who are HIV infected. Journal of Applied Social Psychology, 28, 1031–1050.

    Article  Google Scholar 

  • Lee, R. S., Kochman, A., & Sikkema, K. J. (2002). Internalized stigma among people living with HIV-AIDS. AIDS and Behavior, 6, 309–319.

    Article  Google Scholar 

  • Lindau, S. T., Jerome, J., Miller, K., Monk, E., Garcia, P., & Cohen, M. (2006). Mothers on the margins: Implications for eradicating perinatal HIV. Social Science & Medicine, 62, 59–69.

    Article  Google Scholar 

  • Mahajan, A. P., Sayles, J. N., Patel, V. A., Remien, R. H., Sawires, S. R., Ortiz, D. J., et al. (2008). Stigma in the HIV/AIDS epidemic: A review of the literature and recommendations for the way forward. AIDS, 22, S67–S79.

    Article  Google Scholar 

  • Mallinson, R. K., Rajabiun, S., & Coleman, S. (2007). The provider role in client engagement in HIV care. AIDS Patient Care and STDs, 21, S77–S84.

    Article  Google Scholar 

  • Marcenko, M. O., & Samost, L. (1999). Living with HIV/AIDS: The voices of HIV-positive mothers. Social Work, 44, 36–45.

    Article  Google Scholar 

  • Naughton, J., & Vanable, P. (2012). An experimental investigation of a dual process model of HIV-related stigma. Basic and Applied Social Psychology, 43, 8–19.

    Google Scholar 

  • Nyblade, L. C. (2006). Measuring HIV stigma: Existing knowledge and gaps. Psychology, Health & Medicine, 11, 335–345.

    Google Scholar 

  • Pryor, J., Reeder, G., & Landau, S. (1999). A social-psychological analysis of HIV-related stigma. The American Behavioral Scientist, 42, 1193–1211.

    Article  Google Scholar 

  • Pryor, J., Reeder, G., Yeadon, C., & Hesson-McInnis, M. (2004). A dual process model of reactions to perceived stigma. Journal of Personality and Social Psychology, 87, 436–452.

    Article  Google Scholar 

  • Rintamaki, L. S., Scott, A. M., Kosenko, K. A., & Jensen, R. E. (2007). Male patient perceptions of HIV stigma in health care contexts. AIDS Patient Care and STDs, 21, 956–969.

    Article  Google Scholar 

  • Rothenberg, K. H., Paskey, S. J., Reuland, M. M., Zimmerman, S. L., & North, R. L. (1995). Domestic violence and partner notification: Implications for treatment and counseling of women with HIV. Journal of the American Medical Women's Association, 50, 87–93.

    Google Scholar 

  • Schuster, M. A., Collins, R., Cunningham, W. E., Morton, S. C., Zierler, S., Wong, M., et al. (2005). Perceived discrimination in clinical care in a nationally representative sample of HIV-­infected adults receiving health care. Journal of General Internal Medicine, 20, 807–813.

    Article  Google Scholar 

  • Surlis, S., & Hyde, A. (2001). HIV-positive patients’ experiences of stigma during hospitalization. The Journal of the Association of Nurses in AIDS Care, 12, 68–77.

    Article  Google Scholar 

  • Thrasher, A. D., Earp, J. L., Golin, C. E., & Zimmer, C. R. (2008). Discrimination, distrust, and racial/ethnic disparities in antiretroviral therapy adherence among a national sample of HIV-­infected patients. Journal of Acquired Immune Deficiency Syndrome, 49, 84–93.

    Article  Google Scholar 

  • UNAIDS. (2007). AIDS epidemic update. Retrieved March 1, 2009, from http://www.unaids.org/en/KnowledgeCentre/HIVData/EpiUpdate/EpiUpdArchive/2007/default.asp

  • Vanable, P. A., Carey, M. P., Blair, D. C., & Littlewood, R. A. (2006). Impact of HIV-related stigma on health behaviors and psychological adjustment among HIV-positive men and women. AIDS and Behavior, 10, 473–482.

    Article  Google Scholar 

  • Vara-Diaz, N., Serrano-Garcia, I., & Toro-Alfonso, J. (2005). AIDS-related stigma and social Interaction: Puerto Ricans living with HIV/AIDS. Qualitative Health Research, 15, 169–187.

    Article  Google Scholar 

  • Weinberger, M., Conover, C. J., Samsa, G. P., & Greenberg, S. M. (1992). Physicians’ attitudes and practices regarding treatment of HIV infected patients. Southern Medical Journal, 85, 683–686.

    Article  Google Scholar 

  • Wingwood, G. M., Hardin, J. M., DiClemente, R. J., Peterson, S. H., Mikhail, I., Hook, E. W., et al. (2007). HIV discrimination and the health of women living with HIV. Women & Health, 46, 99–112.

    Article  Google Scholar 

  • Wood, E., Hogg, R. S., Yip, B., Harrigan, P. R., O’Shaughnessy, M. V., & Montaner, J. S. (2003). Effect of medication adherence on survival of HIV-infected adults who start highly active antiretroviral therapy when the CD4+ cell count is 0.200 to 0.350 × 10(9) cells/L. Annals of Internal Medicine, 139, 810–816.

    Article  Google Scholar 

  • World Health Organization. (2009). WHO and HIV/AIDS. Retrieved March 1, 2009, from http://www.who.int/hiv/en/

  • Zierler, S., Cunningham, W. E., Andersen, R., Shapiro, M. F., Bozzette, S. A., Nakazona, T., et al. (2000). Violence victimization after HIV infection in a US probability sample of adult patients in primary care. American Journal of Public Health, 90, 208–215.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Psychology, Syracuse University, Syracuse, NY, USA

    Jessie D. Naughton & Peter A. Vanable

Authors
  1. Jessie D. Naughton
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  2. Peter A. Vanable
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Correspondence to Jessie D. Naughton .

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Editors and Affiliations

  1. School of Public Health, La Trobe University, Bundoora, 3086, Victoria, Australia

    Pranee Liamputtong

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Naughton, J.D., Vanable, P.A. (2013). HIV Stigmatization Among Healthcare Providers: Review of the Evidence and Implications for HIV Care. In: Liamputtong, P. (eds) Stigma, Discrimination and Living with HIV/AIDS. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-6324-1_6

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