Exploring gender differences in HIV-related stigma and social support in a low-resource setting: A qualitative study in the Dominican Republic
Exploring gender differences in HIV-related stigma and social support in a low-resource setting: A qualitative study in the Dominican Republic
Date
2023-08-24
Authors
Amarilis Then Paulino
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Abstract
HIV-related stigma can affect health by compromising coping and social support. Gender
differences in stigma experiences and social support are underexplored, particularly in the
Caribbean. We conducted semi-structured interviews (N = 32) with patients at two HIV
clinics in the Dominican Republic. Transcripts were coded using qualitative content analysis
(deductive and inductive approaches) to identify themes regarding stigma experiences and
social support, which were then compared across men and women participants to identify
gender differences. While both men and women described experienced stigma, including
verbal abuse, men’s experience of stigma were subtler and women described outright
rejection and instances of physical violence, including intimate partner violence. Both men
and women described job discrimination, but women described severe disempowerment as
well as permanent loss of income and/or employment whereas men described temporary
changes in employment and /or decrease in income. Men and women described modifying
behavior due to anticipated stigma, but only women discussed isolating themselves and
discomfort taking HIV medication in front of others. Regarding internalized stigma, both
men and women described shame, guilt, and depression over their HIV status, though
these experiences were more common among women. Women’s experiences prevented
health care seeking and included suicidality, while men sometimes blamed women for their
HIV status and expressed a desire to “move on” and “look ahead.” Both men and women
described receiving financial support from family and friends, community support from
neighbors, governmental support, and support from other people living with HIV. Women
most frequently discussed receiving support from family and friends and using religiosity
to cope, whereas men referenced general family support and government benefits and were
less forthcoming about personal relationships and social networks, oftentimes not disclosing
HIV status to others. The social context of HIV-related stigma affects women and men
differently with physical and mental health impacts and may require distinct mitigation
approaches.
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Citation
Celeste-Villalvir A, Payan DD, Armenta G, Palar K, Then-Paulino A, Acevedo R, et al. (2023) Exploring gender differences in HIV-related stigma and social support in a low-resource setting: A qualitative study in the Dominican Republic. PLoS ONE 18(8): e0290228.