Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
AIDS and Behavior
Published in: AIDS and Behavior 3/2019

01-03-2019 | Substantive Review

Self-Stigma Reduction Interventions for People Living with HIV/AIDS and Their Families: A Systematic Review

Authors: Polly H. X. Ma, Zenobia C. Y. Chan, Alice Yuen Loke

Published in: AIDS and Behavior | Issue 3/2019

Login to get access

Abstract

Stigma is a primary concern for people living with human immunodeficiency virus (HIV)/AIDS (PLWHA), and has great impact on their and their family members’ health. While previous reviews have largely focused on the public stigma, this systematic review aims to evaluate the impact of HIV/acquired immunodeficiency syndrome (AIDS)-related self-stigma reduction interventions among PLWHA and their families. A literature search using eight databases found 23 studies meeting the inclusion criteria. Five types of intervention approaches were identified: (1) psycho-educational intervention, (2) supportive intervention for treatment adherence (antiretroviral therapy), (3) psychotherapy intervention, (4) narrative intervention, and (5) community participation intervention. Overall, the reviewed articles suggested a general trend of promising effectiveness of these interventions for PLWHA and their family members. Psycho-educational interventions were the main approach. The results highlighted the need for more interventions targeting family members of PLWHA, and mixed-methods intervention studies.
Appendix
Available only for authorised users
Literature
1.
Erving G. In: Jenkins JH, Carpenter E, editors. Stigma: notes on a spoiled identity. Englewood Cliffs: Prentice-Hall; 1963.
2.
Mathiti V. Street life and the construction of social problems. In: Ratele K, Duncan N, editors. Social psychology: identities and relationships. Cape Town: UTC Press; 2003. p. 336–52.
3.
4.
5.
Drew N, Funk M, Tang S, Lamichhane J, Chávez E, Katontoka S, et al. Human rights violations of people with mental and psychosocial disabilities: an unresolved global crisis. Lancet. 2011;378(9803):1664–75.PubMedCrossRef
6.
Feldman DB, Crandall CS. Dimensions of mental illness stigma: what about mental illness causes social rejection? J Soc Clin Psychol. 2007;26(2):137–54.CrossRef
7.
Ehrenkranz N, Rubini J, Gunn R, Horsburgh C, Collins T, Hasiba U, et al. Pneumocystis carinii pneumonia among persons with hemophilia A. Morb Mortal Wkly Rep. 1982;31(2):365–7.
8.
Masoudnia E. Public perceptions about HIV/AIDS and discriminatory attitudes toward people living with acquired immunodeficiency syndrome in Iran. SAHARA J Soc Asp HIV/AIDS Res Alliance. 2015;12(1):116–22.CrossRef
9.
Jin H, Earnshaw VA, Wickersham JA, Kamarulzaman A, Desai MM, John J, et al. An assessment of health-care students’ attitudes toward patients with or at high risk for HIV: implications for education and cultural competency. AIDS Care. 2014;26(10):1223–8.PubMedPubMedCentralCrossRef
10.
Chen J, Choe M, Chen S, Zhang S. The effects of individual- and community-level knowledge, beliefs, and fear on stigmatization of people living with HIV/AIDS in China. AIDS Care. 2007;19(5):666–73.PubMedCrossRef
11.
Sudha R, Vijay D, Lakshmi V. Awareness, attitudes, and beliefs of the general public towards HIV/AIDS in Hyderabad, a capital city from South India. Indian J Med Sci. 2005;59(7):307.PubMedCrossRef
12.
Houtsonen J, Kylmä J, Korhonen T, Välimäki M, Suominen T. University students’ perception of people living with HIV/AIDS: discomfort, fear, knowledge and a willingness to care. Coll Stud J. 2014;48(3):534–47.
13.
14.
Holzemer WL, Uys L, Makoae L, Stewart A, Phetlhu R, Dlamini PS, et al. A conceptual model of HIV/AIDS stigma from five African countries. J Adv Nurs. 2007;58(6):541–51.PubMedCrossRef
15.
Mhode M, Nyamhanga T. Experiences and impact of stigma and discrimination among people on antiretroviral therapy in Dar es Salaam: a qualitative perspective. AIDS Res Treat. 2016;2016:1–12.CrossRef
16.
Liu Y, Canada K, Shi K, Corrigan P. HIV-related stigma acting as predictors of unemployment of people living with HIV/AIDS. AIDS Care. 2012;24(1):129–35.PubMedCrossRef
17.
Dlamini PS, Kohi TW, Uys LR, Phetlhu RD, Chirwa ML, Naidoo JR, et al. Verbal and physical abuse and neglect as manifestations of HIV/AIDS stigma in five African countries. Public Health Nurs. 2007;24(5):389–99.PubMedCrossRef
18.
Emlet CA. “You’re awfully old to have this disease”: experiences of stigma and ageism in adults 50 years and older living with HIV/AIDS. Gerontologist. 2006;46(6):781–90.PubMedCrossRef
19.
Nyblade LC. Measuring HIV stigma: existing knowledge and gaps. Psychol Health Med. 2006;11(3):335–45.PubMedCrossRef
20.
Van Brakel WH. Measuring health-related stigma—a literature review. Psychol Health Med. 2006;11(3):307–34.PubMedCrossRef
21.
Turan JM, Nyblade L. HIV-related stigma as a barrier to achievement of global PMTCT and maternal health goals: a review of the evidence. AIDS Behav. 2013;17(7):2528–39.PubMedCrossRef
22.
Musheke M, Ntalasha H, Gari S, Mckenzie O, Bond V, Martin-Hilber A, et al. A systematic review of qualitative findings on factors enabling and deterring uptake of HIV testing in Sub-Saharan Africa. BMC Public Health. 2013;13(1):220.PubMedPubMedCentralCrossRef
23.
Darlington CK, Hutson SP. Understanding HIV-related stigma among women in the Southern United States: a literature review. AIDS Behav. 2017;21(1):12–26.PubMedCrossRef
24.
Rueda S, Mitra S, Chen S, Gogolishvili D, Globerman J, Chambers L, et al. Examining the associations between HIV-related stigma and health outcomes in people living with HIV/AIDS: a series of meta-analyses. BMJ Open. 2016;6(7):e011453.PubMedPubMedCentralCrossRef
25.
Katz IT, Ryu AE, Onuegbu AG, Psaros C, Weiser SD, Bangsberg DR, et al. Impact of HIV-related stigma on treatment adherence: systematic review and meta-synthesis. J Int AIDS Soc. 2013;16:18640.PubMedPubMedCentralCrossRef
26.
Lee RS, Kochman A, Sikkema KJ. Internalized stigma among people living with HIV-AIDS. AIDS Behav. 2002;6(4):309–19.CrossRef
27.
Simbayi LC, Kalichman S, Strebel A, Cloete A, Henda N, Mqeketo A. Internalized stigma, discrimination, and depression among men and women living with HIV/AIDS in Cape Town, South Africa. Soc Sci Med. 2007;64(9):1823–31.PubMedPubMedCentralCrossRef
28.
Turan B, Budhwani H, Fazeli PL, Browning WR, Raper JL, Mugavero MJ, et al. How does stigma affect people living with HIV? The mediating roles of internalized and anticipated HIV stigma in the effects of perceived community stigma on health and psychosocial outcomes. AIDS Behav. 2017;21(1):283–91.PubMedPubMedCentralCrossRef
29.
SeyedAlinaghi S, Paydary K, Kazerooni PA, Hosseini M, Sedaghat A, Emamzadeh-Fard S, et al. Evaluation of stigma index among people living with HIV/AIDS (PLWHA) in six cities in Iran. Thrita. 2013;2(4):69–75.CrossRef
30.
Ogunmefun C, Gilbert L, Schatz E. Older female caregivers and HIV/AIDS-related secondary stigma in rural South Africa. J Cross Cult Gerontol. 2011;26(1):85–102.PubMedCrossRef
31.
Saengtienchai C, Knodel J. Parental caregiving to adult children with AIDS: a qualitative analysis of circumstances and consequences in Thailand. PSC research report; 2001.
32.
Wight RG, Aneshensel CS, Murphy DA, Miller-Martinez D, Beals KP. Perceived HIV stigma in AIDS caregiving dyads. Soc Sci Med. 2006;62(2):444–56.PubMedCrossRef
33.
Wight RG, Beals K, Miller-Martinez D, Murphy D, Aneshensel C. HIV-related traumatic stress symptoms in AIDS caregiving family dyads. AIDS Care. 2007;19(7):901–9.PubMedCrossRef
34.
Demmer C. Experiences of families caring for an HIV-infected child in KwaZulu-Natal, South Africa: an exploratory study. AIDS Care. 2011;23(7):873–9.PubMedPubMedCentralCrossRef
35.
36.
Haghdoost A, Karamouzian M. Zero new HIV infections, zero discrimination, and zero AIDS-related deaths: feasible goals or ambitious visions on the occasion of the world AIDS day? Int J Prev Med. 2012;3(12):819.PubMedPubMedCentralCrossRef
37.
Joint United Nations Programme on HIV/AIDS. UNAIDS Strategy 2016–2021; 2016.
38.
Brown L, Macintyre K, Trujillo L. Interventions to reduce HIV/AIDS stigma: what have we learned? AIDS Educ Prev. 2003;15(1):49–69.PubMedCrossRef
39.
40.
Stangl AL, Lloyd JK, Brady LM, Holland CE, Baral S. A systematic review of interventions to reduce HIV-related stigma and discrimination from 2002 to 2013: how far have we come? J Int AIDS Soc. 2013;16:18734.PubMedPubMedCentralCrossRef
41.
Mak WW, Mo PK, Ma GY, Lam MY. Meta-analysis and systematic review of studies on the effectiveness of HIV stigma reduction programs. Soc Sci Med. 2017;188:30–40.PubMedCrossRef
42.
Downs SH, Black N. The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. J Epidemiol Community Health. 1998;52(6):377–84.PubMedPubMedCentralCrossRef
43.
O’Connor SR, Tully MA, Ryan B, Bradley JM, Baxter GD, McDonough SM. Failure of a numerical quality assessment scale to identify potential risk of bias in a systematic review: a comparison study. BMC Res Notes. 2015;8(1):224.PubMedPubMedCentralCrossRef
44.
Morris SB. Estimating effect sizes from pretest–posttest-control group designs. Organ Res Methods. 2008;11(2):364–86.CrossRef
45.
Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale: Erlbaum; 1988.
46.
Skinta MD, Lezama M, Wells G, Dilley JW. Acceptance and compassion-based group therapy to reduce HIV stigma. Cogn Behav Pract. 2015;22(4):481–90.CrossRef
47.
Uys L, Chirwa M, Kohi T, Greeff M, Naidoo J, Makoae L, et al. Evaluation of a health setting-based stigma intervention in five African countries. AIDS Patient Care STDs. 2009;23(12):1059–66.PubMedPubMedCentralCrossRef
48.
Pomeroy EC, Rubin A, Laningham VL, Walker RJ. “Straight Talk”: the effectiveness of a psychoeducational group intervention for heterosexuals with HIV/AIDS. Res Soc Work Pract. 1997;7(2):149–64.CrossRef
49.
Abel E. Women with HIV and stigma. Fam Community Health J Health Promot Maint. 2007;30(1, Suppl):S104–6.
50.
Masquillier C, Wouters E, Mortelmans D, Roux Booysen F. The impact of community support initiatives on the stigma experienced by people living with HIV/AIDS in South Africa. AIDS Behav. 2015;19(2):214–26.PubMedCrossRef
51.
Bhatta DN, Liabsuetrakul T. Efficacy of a social self-value empowerment intervention to improve quality of life of HIV infected people receiving antiretroviral treatment in Nepal: a randomized controlled trial. AIDS Behav. 2017;21(6):1620–31.PubMedCrossRef
52.
Hosek SG, Lemos D, Harper GW, Telander K. Evaluating the acceptability and feasibility of Project ACCEPT: an intervention for youth newly diagnosed with HIV. AIDS Educ Prev. 2011;23(2):128–44.PubMedPubMedCentralCrossRef
53.
Rao D, Desmond M, Andrasik M, Rasberry T, Lambert N, Cohn S, et al. Feasibility, acceptability and initial efficacy of the ‘Unity workshop’: an internalized stigma reduction intervention for African American women living with HIV. J Int AIDS Soc. 2012;15:172.
54.
Smith Fawzi MC, Eustache E, Oswald C, Louis E, Surkan PJ, Scanlan F, et al. Psychosocial support intervention for HIV-affected families in Haiti: implications for programs and policies for orphans and vulnerable children. Soc Sci Med. 2012;74(10):1494–503.PubMedCrossRef
55.
Tshabalala J, Visser M. Developing a cognitive behavioural therapy model to assist women to deal with HIV and stigma. S Afr J Psychol. 2011;41(1):17–28.CrossRef
56.
Miles MS, Holditch-Davis D, Eron J, Black BP, Pedersen C, Harris DA. An HIV self-care symptom management intervention for African American mothers. Nurs Res. 2003;52(6):350–60.PubMedCrossRef
57.
Nyamathi A, Ekstrand M, Salem BE, Sinha S, Ganguly KK, Leake B. Impact of Asha intervention on stigma among rural Indian women with AIDS. West J Nurs Res. 2013;35(7):867–83.PubMedPubMedCentralCrossRef
58.
Nambiar D, Ramakrishnan V, Kumar P, Varma R, Balaji N, Rajendran J, et al. Knowledge, stigma, and behavioral outcomes among antiretroviral therapy patients exposed to Nalamdana’s radio and theater program in Tamil Nadu, India. AIDS Educ Prev. 2011;23(4):351–66.PubMedCrossRef
59.
Rounds KA, Galinsky MJ, Despard MR. Evaluation of telephone support groups for persons with HIV disease. Res Soc Work Pract. 1995;5(4):442–59.CrossRef
60.
Barroso J, Relf MV, Williams MS, Arscott J, Moore ED, Caiola C, et al. A randomized controlled trial of the efficacy of a stigma reduction intervention for HIV-infected women in the Deep South. AIDS Patient Care STDs. 2014;28(9):489–98.PubMedPubMedCentralCrossRef
61.
Gordon VL. Effectiveness of a time-limited psychoeducational group for cohabitating sero-negative partners and spouses of persons with HIV disease (immune deficiency). 1998.
62.
Pomeroy EC, Rubin A, Walker RJ. Effectiveness of a psychoeducational and task-centered group intervention for family members of people with AIDS. Soc Work Res. 1995;19(3):142–52.PubMed
63.
Apinundecha C, Laohasiriwong W, Cameron MP, Lim S. A community participation intervention to reduce HIV/AIDS stigma, Nakhon Ratchasima Province, northeast Thailand. AIDS Care. 2007;19(9):1157–65.PubMedCrossRef
64.
Bhana A, Mellins CA, Petersen I, Alicea S, Myeza N, Holst H, et al. The VUKA family program: piloting a family-based psychosocial intervention to promote health and mental health among HIV infected early adolescents in South Africa. AIDS Care. 2014;26(1):1–11.PubMedCrossRef
65.
Echenique M, Illa L, Saint-Jean G, Avellaneda VB, Sanchez-Martinez M, Eisdorfer C. Impact of a secondary prevention intervention among HIV-positive older women. AIDS Care. 2013;25(4):443–6.PubMedCrossRef
66.
Kaai S, Bullock S, Sarna A, Chersich M, Luchters S, Geibel S, et al. Perceived stigma among patients receiving antiretroviral treatment: a prospective randomised trial comparing an m-DOT strategy with standard-of-care in Kenya. SAHARA J J Soc Asp HIV/AIDS Res Alliance. 2010;7(2):62–70.CrossRef
67.
Muñoz M, Finnegan K, Zeladita J, Caldas A, Sanchez E, Callacna M, et al. Community-based DOT-HAART accompaniment in an urban resource-poor setting. AIDS Behav. 2010;14(3):721–30.PubMedCrossRef
68.
Abel E, Rew L, Gortner EM, Delville CL. Cognitive reorganization and stigmatization among persons with HIV. J Adv Nurs. 2004;47(5):510–25.PubMedCrossRef
69.
Mittal D, Sullivan G, Chekuri L, Allee E, Corrigan PW. Empirical studies of self-stigma reduction strategies: a critical review of the literature. Psychiatr Serv. 2012;63(10):974–81.PubMedCrossRef
70.
Livingston JD, Milne T, Fang ML, Amari E. The effectiveness of interventions for reducing stigma related to substance use disorders: a systematic review. Addiction. 2012;107(1):39–50.PubMedPubMedCentralCrossRef
71.
UNAIDS. Development of a tool to measure stigma and discrimination experienced by people living with HIV 2008.
72.
Loutfy MR, Logan Kennedy V, Mohammed S, Wu W, Muchenje M, Masinde K, et al. Recruitment of HIV-positive women in research: discussing barriers, facilitators, and research personnel’s knowledge. Open AIDS J. 2014;8:58.PubMedPubMedCentralCrossRef
73.
Zweben A, Fucito LM, O’Malley SS. Effective strategies for maintaining research participation in clinical trials. Drug Inf J. 2009;43(4):459–67.CrossRef
74.
75.
Stahl ST, Rodakowski J, Saghafi EM, Park M, Reynolds CF, Dew MA. Systematic review of dyadic and family-oriented interventions for late-life depression. Int J Geriatr Psychiatry. 2016;31(9):963–73.PubMedPubMedCentralCrossRef
76.
77.
Hattie J. Visible learning for teachers: maximizing impact on learning. London: Routledge; 2012.CrossRef
Metadata
Title
Self-Stigma Reduction Interventions for People Living with HIV/AIDS and Their Families: A Systematic Review
Authors
Polly H. X. Ma
Zenobia C. Y. Chan
Alice Yuen Loke
Publication date
01-03-2019
Publisher
Springer US
Published in
AIDS and Behavior / Issue 3/2019
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-018-2304-1

Other articles of this Issue 3/2019

AIDS and Behavior 3/2019 Go to the issue

Original Paper

Randomized Control Trial of Culturally Adapted Cognitive Processing Therapy for PTSD Substance Misuse and HIV Sexual Risk Behavior for Native American Women

Original Paper

Depressive Symptoms at HIV Testing and Two-Year All-Cause Mortality Among Men Who Inject Drugs in Vietnam

Original Paper

HIV and Sexuality Stigma Reduction Through Engagement in Online Forums: Results from the HealthMPowerment Intervention

Original Paper

Feasibility and Acceptability of an Online Positive Affect Intervention for Those Living with Comorbid HIV Depression

Original Paper

Physical Activity Intensity is Associated with Symptom Distress in the CNICS Cohort

Original Paper

Multilevel Factors Associated with a Lack of Viral Suppression Among Persons Living with HIV in a Federally Funded Housing Program

ACC 2024 Congress Coverage

Heart Failure Video

Year in Review: Heart failure and cardiomyopathies

Watch now

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits