HIV-Related Stigma: A Concept Analysis

Thursday, 15 July 2010

Aubrey L. Florom-Smith, BSN, RN
School of Nursing and Health Studies, University of Miami, Coral Gables, FL

Learning Objective 1: identify three categories conceptualized as HIV-related stigma: external HIV-related stigma, internal HIV-related stigma and linked stigma.

Learning Objective 2: describe three attributes of each type of HIV-related stigma.

Purpose: The purpose of this concept analysis is to understand HIV-related stigma as experienced by individuals affected by HIV/AIDS. An experience-encompassing understanding of HIV-related stigma will increase the opportunity for nurses to implement interventions leading to further stigma research and healthier outcomes.Methods: Schwartz-Barcott and Kim’s Hybrid Model is utilized for the concept analysis of HIV-related stigma. The theoretical phase of this method is an extensive review of professional literature.
Results: A working definition of HIV-related stigma is the collection of adverse attitudes, beliefs and actions of others against people living with HIV/AIDS and the deleterious beliefs within or actions taken by persons living with HIV/AIDS. Three categories of HIV-related stigma are delineated. External HIV-related stigma consists of attitudes or actions expressed towards people living with HIV, and includes issues such as rejection, avoidance, intolerance, stereotyping, discrimination, and physical violence. Internal HIV-related stigma is the feelings, beliefs or actions within or instigated by the person living with HIV/AIDS, and includes issues such as shame, self-blame, secrecy related to fear of disclosure, self-isolation, internalized homophobia, despair, and great concern over the thoughts and attitudes of others. Linked HIV-related stigma is experienced through an association with people living with HIV/AIDS, and may include components of external or internal HIV-related stigma, such as a loss of social status or fear of embarrassment. Conclusion: Research regarding HIV-related stigma is useful. Nurses can identify under-researched psychosocial and health components of stigma and promote an interdisciplinary approach to intervention design. Nurses can rectify a lack of knowledge of HIV transmission by identifying teaching opportunities, and comprehensive HIV/AIDS education can begin in nursing school to desensitize nursing students and other healthcare providers to HIV as a stigmatizing disease.