Mariam Davtyan
University of California, USA
Title: A Grounded Theory Study of HIV-related Stigma in US-based Health Care Settings
Biography
Biography: Mariam Davtyan
Abstract
Despite biomedical advances in the treatment and care of people living with HIV/AIDS (PLHIV), stigma has remained a persistent global challenge. Health care settings and workers have been identified as important sources of stigma directed towards PLHIV. Studies have addressed the construct of stigma in US health care settings, but mainly from the perspectives of PLHIV. We used grounded theory to understand how health care professionals conceptualize HIV stigma in health care settings and how it may impact HIV patients to describe the pertinent concepts involved in the operationalization of stigma in health care settings and to develop a substantive model that projects a purposive view of HIV stigma in the health context. Our model indicates that stigma may be rooted in historically derogatory representations of HIV and intensified by patient-provider power inequalities. Stigma may be triggered by fear of contracting an incurable disease, inadequate clinical education and training on HIV and stigma, unintentional behaviors, and limited contact with HIV patients. Stigma was perceived as injurious to both patient and provider outcomes. Patient outcomes included engagement in care and psychological functioning, and provider outcomes included anxiety and nervousness when delivering care to HIV patients. Additional research on provider perceptions of stigma and programs that encourage empowerment, communication, and training may be needed for stigma reduction.