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HIV-Related Stigma John B. Pryor, Ph.D. Illinois State University Presentation at the 17 th  Texas HIV/STD Conferences May 25 2010
Outline of Today’s Talk ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Goffman (1963) defined stigma as “an undesired  differentness  from what we had anticipated.” “ By definition, we believe the person with a stigma is not quite human.” “ We construct a stigma-theory, an ideology to explain his inferiority and account for the danger he represents, sometimes rationalizing an animosity based upon other differences, such as those of social class (p. 5).”
Four Manifestations of Stigma ,[object Object],[object Object],[object Object],[object Object]
A Dynamic Model of the Four Manifestations of Stigma Stigma-by- Association Public  Stigma Self- Stigma Institutional Stigma
Applying the Stigma Model to HIV
Public Stigma ,[object Object],[object Object],[object Object],US THEM
Tri-Part Conceptual Model of Public Stigma Cognitive Component Behavioral Component Affective Component
Cognitive components of reactions to perceived HIV-related stigma ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Affective (emotional) components of reactions to perceived HIV-related Stigma ,[object Object],[object Object]
Behavioral components of reactions to perceived HIV-related stigma ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
What is  self-  stigma?
Self-stigma  – derived from enacted (actual) or perceived (anticipated) social experiences   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Stigma-by-Association  Goffman called this  courtesy stigma ,[object Object],[object Object],[object Object],[object Object],[object Object]
Institutional stigma ,[object Object],[object Object],[object Object],[object Object],[object Object],Source:  Lambda Legal Report  , 2007
Institutional stigma ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
HIV African Americans MSM IV Drug Users Stigmas related to HIV in the US
HIV African Americans MSM IV Drug Users Societal responses to related stigmas  in the US Sexual Prejudice Racism Criminalization of drug addiction
Related Institutional Stigma in the United States ,[object Object],[object Object],[object Object]
 
Research focusing upon one link in the model of stigma Stigma-by- Association Public  Stigma Self- Stigma Institutional Stigma
 
Types of Stigmatizing Behavior Experienced
 
Stigmatizing experiences  that uniquely predict psychological distress among 601 Dutch  PLWHA Psychological Distress  Told to  Conceal  Exaggerated Kindness  Avoidance  Awkward  Social Interaction From Family From Health Care Sector Source: Stutterheim, Pryor, Bos,  Hoogendijk,  Muris, & Schaalma (in press, 2009)         Controlling for partner, educational & health status
Relationship of Endorsing Public Stigma to Manifestation of Self-Stigma Stigma-by- Association Public  Stigma Self- Stigma Institutional Stigma
Relationships between Endorsing Public  Stigma and HIV Testing  Source: Kalichman &  Simbayi (2003)
 
Evaluation Research of an Intervention Design to Reduce Public Stigma Stigma-by- Association Public  Stigma Self- Stigma Institutional Stigma
Salud Es Cultura ¡Protégete! (Health is Culture, Protect Yourself)  To reduce HIV/AIDS-related stigma within Latino communities through a portable  promotores (peer education) program designed to provide accurate and culturally appropriate HIV prevention and outreach information.
Overview of  peer education ( promotores ) intervention components  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Organization The National Council of La Raza Anti-Stigma Focus Public stigma Target Audience Selected Latino communities in California and Texas (N = 574) Method Peer education ( promotores ) programs Evaluation Quantitative: Pre/post assessment of public stigma in peer education sessions ( charlas ) Results Improvements in knowledge, communication intentions, testing comfort, & comfort with PLWHA
Stigma-by- Association Public  Stigma Self- Stigma Institutional Stigma Evaluation Research of an Intervention Design to Reduce Self-Stigma
THRIVE! Weekend A program developed by  the  AIDS SURVIVAL PROJECT To reduce HIV/AIDS-related stigma among PLWHA as a barrier to prevention, care, and treatment in two rural areas of Georgia using a   volunteer-based training run by and for those affected by and/or living with HIV/AIDS.
Topics covered in THRIVE! Weekend workshops ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Organization The AIDS Survival Project  Anti-Stigma Focus Self-stigma Target Audience PLWHA in rural & urban Georgia Method Weekend workshops led by teams of PWLHA, experts, and healthcare & social service providers Evaluation Quantitative: Pre/post assessment of self-stigma Results PLWHA felt less blame & shame following weekend workshops
Some Common Sense steps in Conducting a Stigma Reduction Intervention ,[object Object],[object Object],[object Object],[object Object],[object Object]
Components of Effective Interventions
Take Home Messages of Today’s Talk ,[object Object],[object Object],[object Object]
 

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Hiv Related Stigma Pryor Texas Hiv Std Conf

  • 1. HIV-Related Stigma John B. Pryor, Ph.D. Illinois State University Presentation at the 17 th Texas HIV/STD Conferences May 25 2010
  • 2.
  • 3. Goffman (1963) defined stigma as “an undesired differentness from what we had anticipated.” “ By definition, we believe the person with a stigma is not quite human.” “ We construct a stigma-theory, an ideology to explain his inferiority and account for the danger he represents, sometimes rationalizing an animosity based upon other differences, such as those of social class (p. 5).”
  • 4.
  • 5. A Dynamic Model of the Four Manifestations of Stigma Stigma-by- Association Public Stigma Self- Stigma Institutional Stigma
  • 6. Applying the Stigma Model to HIV
  • 7.
  • 8. Tri-Part Conceptual Model of Public Stigma Cognitive Component Behavioral Component Affective Component
  • 9.
  • 10.
  • 11.
  • 12. What is self- stigma?
  • 13.
  • 14.
  • 15.
  • 16.
  • 17. HIV African Americans MSM IV Drug Users Stigmas related to HIV in the US
  • 18. HIV African Americans MSM IV Drug Users Societal responses to related stigmas in the US Sexual Prejudice Racism Criminalization of drug addiction
  • 19.
  • 20.  
  • 21. Research focusing upon one link in the model of stigma Stigma-by- Association Public Stigma Self- Stigma Institutional Stigma
  • 22.  
  • 23. Types of Stigmatizing Behavior Experienced
  • 24.  
  • 25. Stigmatizing experiences that uniquely predict psychological distress among 601 Dutch PLWHA Psychological Distress Told to Conceal Exaggerated Kindness Avoidance Awkward Social Interaction From Family From Health Care Sector Source: Stutterheim, Pryor, Bos, Hoogendijk, Muris, & Schaalma (in press, 2009)         Controlling for partner, educational & health status
  • 26. Relationship of Endorsing Public Stigma to Manifestation of Self-Stigma Stigma-by- Association Public Stigma Self- Stigma Institutional Stigma
  • 27. Relationships between Endorsing Public Stigma and HIV Testing Source: Kalichman & Simbayi (2003)
  • 28.  
  • 29. Evaluation Research of an Intervention Design to Reduce Public Stigma Stigma-by- Association Public Stigma Self- Stigma Institutional Stigma
  • 30. Salud Es Cultura ¡Protégete! (Health is Culture, Protect Yourself) To reduce HIV/AIDS-related stigma within Latino communities through a portable promotores (peer education) program designed to provide accurate and culturally appropriate HIV prevention and outreach information.
  • 31.
  • 32. Organization The National Council of La Raza Anti-Stigma Focus Public stigma Target Audience Selected Latino communities in California and Texas (N = 574) Method Peer education ( promotores ) programs Evaluation Quantitative: Pre/post assessment of public stigma in peer education sessions ( charlas ) Results Improvements in knowledge, communication intentions, testing comfort, & comfort with PLWHA
  • 33. Stigma-by- Association Public Stigma Self- Stigma Institutional Stigma Evaluation Research of an Intervention Design to Reduce Self-Stigma
  • 34. THRIVE! Weekend A program developed by the AIDS SURVIVAL PROJECT To reduce HIV/AIDS-related stigma among PLWHA as a barrier to prevention, care, and treatment in two rural areas of Georgia using a volunteer-based training run by and for those affected by and/or living with HIV/AIDS.
  • 35.
  • 36. Organization The AIDS Survival Project Anti-Stigma Focus Self-stigma Target Audience PLWHA in rural & urban Georgia Method Weekend workshops led by teams of PWLHA, experts, and healthcare & social service providers Evaluation Quantitative: Pre/post assessment of self-stigma Results PLWHA felt less blame & shame following weekend workshops
  • 37.
  • 38. Components of Effective Interventions
  • 39.
  • 40.