The actual number of HIV/AIDS cases in Turkey is higher than the number of cases reported, and People Living with HIV (PLWHIV) may refrain from acknowledging their sickness or seeking help because of the stigma associated with HIV and fear of discrimination from their close friends, workmates, and even their families. In this paper we aim to explore HIV-positive people's relationships with significant others such as family members, friends, sexual partners, employers and health professionals in order to present the patients' perceptions about stigma and attitudes that lead to pro-social or anti-social behavior towards them. We carried out a qualitative study based on in-depth interviews with 16 PLWHIV in order to understand the conditions of people living with HIV/AIDS in Turkey. Our results revealed that except for family relations, the fear of contagion is the main obstacle for HIV-positive people's relations with others. HIV-positive people are severely afflicted with discrimination due to the overlapping "instrumental" and "symbolic" stigmas that directly affect their relations. The attribute of responsibility is related to gender and socio-economic status of PLWHIV living in Turkey. Key Words: HIV/AIDS, Stigma, Social Relations, Attributions, Turkey, Grounded Theory.
The prevalence of HIV/AIDS in Turkey is considered to be low (Altan, 2008). Eastern European countries have one of the fastest-growing HIV epidemics in the world, and Central Asia also has a high incidence of HIV/AIDS. Turkey's position is between these two regions (Altan, 2008). In Eastern Europe, there were 250,000 new cases in 2001 (www.unaids.org). It can be said that HIV/AIDS is accepted as an emerging disease in Turkey.
According to the Country Report prepared by Altan (2008) for UNGASS, a total of 1,922 HIV cases were reported in Turkey from 1985 to 2004. It was also reported that 551 of the infected individuals had developed AIDS, of whom 63 had died in 2004. The total cases of HIV infection were 2,711 by the end of June 2007, whereas by the end of 2008, the number of HIV cases increased to 3,307. The most common mode of transmission was heterosexual contact; 75 percent of the transmissions were attributed to heterosexual practice, and approximately seven percent were infected through intravenous drug use (Altan, 2008).
The actual number of HIV/AIDS cases in Turkey is unknown, and certainly the actual number of HIV/AIDS cases is higher than the number of cases reported (Ay & Karabey, 2006). The main reason involves the recording system for illnesses in Turkey and a long asymptomatic period of HIV (Duyan & Yildirim, 2003). The number of women contracting HIV has been rising due to the lack of education about AIDS and infections. Most of the victims remain silent about their HIV status because of the fear of being exposed to stigmatization and discrimination (Greef et al., 2008).
In his famous work on stigma, Goffman (1963), defines stigma as "an attribute that is deeply discrediting" (p. 3). According to Goffman, stigma is a process by which the reaction of others spoils normal identity. This is because an individual with an attribute that is highly discrediting in a society faces rejection. Therefore, to understand how stigma is constructed in a society, it is crucial to focus on attributions on a sociological level.
Goffman (1963) identified "three grossly different types of stigma: abominations of the body, blemishes of individual character, and tribal stigma" (p. 4). The first one includes the negative attributes attached to physical deformities; the second type includes the negative attributes attached to personal character. And the last type includes the negative attributes attached to a community with a specific nationality, religion, race, etc.
On the other hand, Herek (1999) based on his studies about HIV/AIDS, divided HIV-related stigma into two types: "instrumental" …