The rate of HIV/AIDS increases every year in China. Along with a diagnosis comes the physical and emotional toll. People who live with HIV/AIDS (PLWHA) must address a host of issues, including reduced physical ability, treatment adherence, emotional consequences, and the negative impact of stigma. China is a highly collective society in which individuals are very protective of the reputation of their families. They are taught to keep family matters private and rarely share their difficulties or problems with others in order to keep the image of their family intact. Because there is still a negative stigma attached to HIV/AIDS, Hongjje Liu of the Department of Epidemiology and Biostatistics at the University of Maryland wanted to see if this stigma was felt by caregivers of those living with HIV/AIDS as much as it was by the PLWHA themselves.
In the study, Liu used the actor-partner interdependence model (APIM) as a method of gauging the effects of stigma on 148 Chinese PLWHA and how these perceptions affected their caregivers. Additionally, Liu examined the reverse, specifically, how the caregiver’s perceptions affect the well-being and quality of life of the PLWHAs. The results revealed that the perceptions of the PLWHA and of the caregiver had a direct effect on their own quality of life. “In other words, the higher level of HIV stigma that is perceived by either PLWHAs or their caregivers contributes to lower quality of life for themselves.” Even though the overall perception of stigma was higher for the PLWHA than for the caregiver, the perception of stigma for one individual in the dyad directly predicted the actual level of quality of life by the other.
Liu believes this can be explained in several ways. First, individuals who themselves feel discriminated against or feel socially isolated may not seek out emotional support or medical attention. Second, regardless of whether they are caregivers or PLWHAs, individuals feeling the effects of stigma may internalize their psychological distress and put themselves at risk for depression and anxiety. These results clearly show that stigma is a global problem that affects people of different cultures in unique and varying ways. Liu added, “As HIV stigma and quality of life are complex phenomena rooted in cultures, intervention programs should be carefully planned based on social or cognitive theories and should be culturally adopted.”
Liu, H., Xu, Y., Lin, X., Shi, J., Chen, S. (2013). Associations between perceived HIV stigma and quality of life at the dyadic level: The actor-partner interdependence model. PLoS ONE 8(2): e55680. doi:10.1371/journal.pone.0055680
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