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Namisi CP, Munene JC, Wanyenze RK, Katahoire AR, Parkes-Ratanshi RM, Kentutsi S, Nannyonga MM, Ssentongo RN, Ogola MK, Nabaggala MS, Amanya G, Kiragga AN, Batamwita R, Tumwesigye NM. Stigma mastery in people living with HIV: gender similarities and theory. Z Gesundh Wiss 2022; 30:2883-2897. [PMID: 36567981 PMCID: PMC9788541 DOI: 10.1007/s10389-021-01480-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Accepted: 01/26/2021] [Indexed: 12/30/2022]
Abstract
Aims This study aimed to determine the prevalence of, factors associated with, and to build a theoretical framework for understanding Internalsed HIV-related Stigma Mastery (IHSM). Methods A cross-sectional study nested within a 2014 Stigma Reduction Cohort in Uganda was used. The PLHIV Stigma Index version 2008, was used to collect data from a random sample of 666 people living with HIV (PLHIV) stratified by gender and age. SPSS24 with Amos27 softwares were used to build a sequential-mediation model. Results The majority of participants were women (65%), aged ≥ 40 years (57%). Overall, IHSM was 45.5% among PLHIV, that increased with age. Specifically, higher IHSM correlated with men and older women "masculine identities" self-disclosure of HIV-diagnosis to family, sharing experiences with peers. However, lower IHSM correlated with feminine gender, the experience of social exclusion stress, fear of future rejection, and fear of social intimacy. Thus, IHSM social exclusion with its negative effects and age-related cognition are integrated into a multidimensional IHSM theoretical framework with a good model-to-data fit. Conclusion Internalised HIV-related Stigma Mastery is common among men and older women. Specificially, "masculine identities" self-disclose their own HIV-positive diagnosis to their family, share experiences with peers to create good relationships for actualising or empowerment in stigma mastery. However, social exclusion exacerbates series of negative effects that finally undermine stigma mastery by young feminine identities. Thus, stigma mastery is best explained by an integrated empowerment framework, that has implications for future practice, policy, and stigma-related research that we discuss.
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Affiliation(s)
- Charles Patrick Namisi
- The Ugandan Academy of Health Innovation and Impact, Infectious Diseases Institute, College of Health Sciences, Makerere University, P.O.Box 22418 Kampala, Cassia Hill Road, 4th Floor, Mckinnell Knowledge Centre, Kampala, Uganda
- School of Public Health, College of Health Sciences, Makerere University, P.O.Box 7072, Kampala, Upper Mulago Hill Road, Mulago, Kampala +256, Uganda
| | - John C. Munene
- PhD Programme, Makerere University Business School, Plot 21A, Port Bell Road, Kampala, Uganda
| | - Rhoda K. Wanyenze
- School of Public Health, College of Health Sciences, Makerere University, P.O.Box 7072, Kampala, Upper Mulago Hill Road, Mulago, Kampala +256, Uganda
| | | | - Rosalinda M. Parkes-Ratanshi
- The Ugandan Academy of Health Innovation and Impact, Infectious Diseases Institute, College of Health Sciences, Makerere University, P.O.Box 22418 Kampala, Cassia Hill Road, 4th Floor, Mckinnell Knowledge Centre, Kampala, Uganda
- Institute of Public Health Cambridge University, Cambridge, UK
| | - Stella Kentutsi
- The National Forum of People Living with HIV Networks in Uganda or NAFOPHANU, P.O.Box 70233, Plot 213, Sentema Road, Mengo, Kampala +256, Uganda
| | - Maria M. Nannyonga
- Nsambya Home Care Department, St Francis Hospital, Nsambya, P.O.BOX 7146, Kampala, Nsambya Hill Road, Kampala +256, Uganda
| | - Robina N. Ssentongo
- Kitovu Mobile Limited, P.O.Box 207, Masaka, Plot 4 & 10 Delhi Road, Masaka +256, Uganda
| | - Mabel K. Ogola
- Catholic Agency for Overseas Development or CAFOD, PO Box 66153, Nairobi, Plot 209/75/75, Vihiga Road, Nairobi, +254, Kenya
| | - Maria Sarah Nabaggala
- Infectious Diseases Institute, College of Health Sciences, Makerere University, P.O.Box 22418, Cassia Hill Road, 4th Floor, Mckinnell Knowledge Centre, Kampala +256, Uganda
| | - Geofrey Amanya
- Infectious Diseases Institute, College of Health Sciences, Makerere University, P.O.Box 22418, Cassia Hill Road, 4th Floor, Mckinnell Knowledge Centre, Kampala +256, Uganda
| | - Agnes N. Kiragga
- Infectious Diseases Institute, College of Health Sciences, Makerere University, P.O.Box 22418, Cassia Hill Road, 4th Floor, Mckinnell Knowledge Centre, Kampala +256, Uganda
| | - Richard Batamwita
- FHI 360 Uganda, P.O Box 5768, Kampala, Plot 15 Kitante Close, Kampala +256, Uganda
| | - Nazarius M. Tumwesigye
- School of Public Health, College of Health Sciences, Makerere University, P.O.Box 7072, Kampala, Upper Mulago Hill Road, Mulago, Kampala +256, Uganda
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