Academic journal article International Journal of Men's Health

Perceived Stigma and Life Satisfaction: Experiences of Urban African American Men Living with HIV/AIDS

Academic journal article International Journal of Men's Health

Perceived Stigma and Life Satisfaction: Experiences of Urban African American Men Living with HIV/AIDS

Article excerpt

The purpose of this study was to explore associations and relationships between the domains of perceived stigma and life satisfaction in a sample of HIV-infected African American men in an urban setting. A descriptive cross-sectional survey design method was used. Participants include a convenience sample (N = 55) of urban African American males who self-identified as having HIV/AIDS. Study participants completed a questionnaire that included sociodemographic indicators (age, education, length of time since diagnosis, subjective health status, clinical status) as well as instruments designed to measure perceived stigma (personalized stigma, negative self-image, disclosure concerns, and public attitudes) using the perceived stigma scale and life satisfaction scale. A majority of the men perceived being stigmatized along the domains of personalized stigma, negative self-image, disclosure concerns, and public attitudes, all of which were inversely associated with life satisfaction. A hierarchical regression analysis identified four stigma domains that accounted for 40.2% of variance in life satisfaction after adjusting for sociodemographic variables. Mediational analysis indicated that the domains of personalized stigma and public attitudes operated through negative self-image to influence life satisfaction. Findings from this study suggest that HIV-related stigma is a complex phenomenon experienced in both the personal and social realms. Reducing stigma through targeted interventions may aid individuals with HIV/AIDS to better adhere to treatment regimens and improve their life satisfaction.

Keywords: HIV/AIDS, African American males, perceived stigma, health system barriers, life satisfaction, quality of life

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There is overwhelming agreement among public health professionals that the HIV/AIDS epidemic is a critical health problem for African Americans. Of all males living with AIDS in the United States at the end of 2003, the Centers for Disease Control and Prevention (CDC) reports that more than one-third (37.2%) were African Americans (CDC, 2003a, 2003b). In 2003, based on confidential laboratory reporting in 31 states, the estimated incidence rate of AIDS among persons 14 years of age or older in the United States was nearly three times greater for males than for females (CDC, 2004). Non-Hispanic African American males were eight times more likely than non-Hispanic white males to be newly diagnosed with AIDS and three times as likely as Hispanic men. The CDC estimates that between 1999 and 2003, 59% of newly diagnosed AIDS cases were in men who had sexual contact with men (MSM) and 23% in men who injected illegal drugs. Most new AIDS cases for which MSM is the HIV exposure category are now among MSM of color. They face barriers to HIV counseling, testing, and care (CDC, 2002). African Americans have the least favorable long-term AIDS survival rate (CDC, 2004). The HIV/AIDS epidemic has differentially had an impact on the African American community, in particular African American males.

To reduce the HIV/AIDS disparity in the African American community, multiple strategies must be taken to increase the rate of voluntary HIV testing, to decrease the risk of transmission of HIV/AIDS, and to increase access to healthcare and social services as well as the use of life-extending treatment. Adherence to antiretroviral therapy has been shown to improve quality of life (Mannheimer et al., 2005). Although HIV/AIDS threatens both longevity and quality of life (Heckman, 2003), quality of life and factors that may affect it such as stigma have received limited attention in the literature to date.

STIGMA AS AN OBSTACLE TO PREVENTION, TREATMENT, AND CARE

HIV/AIDS is a disease that may be perceived by the afflicted person as highly stigmatizing when the stigma has been internalized (Lee, Kochman, & Sikkema, 2002). Moral stigma based on the modes of transmission of HIV/AIDS through male-to-male sexual contact, sex work, and the use of injected drugs may be imposed by others (Reidpath & Chan, 2005). …

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