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Stigma Mechanisms and Outcomes among Sub-Saharan African Descendants in Belgium—Contextualizing the HIV Stigma Framework

Author

Listed:
  • Lazare Manirankunda

    (Institute of Tropical Medicine Antwerp, 2000 Antwerp, Belgium)

  • Aletha Wallace

    (Department of Medical Sociology and Health Sciences, Vrije Universiteit Brussel, 1050 Brussels, Belgium)

  • Charles Ddungu

    (Institute of Tropical Medicine Antwerp, 2000 Antwerp, Belgium)

  • Christiana Nöstlinger

    (Institute of Tropical Medicine Antwerp, 2000 Antwerp, Belgium)

Abstract

HIV-related stigma and discrimination are recognized barriers to HIV prevention, testing and treatment among people of Sub-Saharan African descent (SSA) origin living in Belgium, but insights into HIV related-stigma mechanisms and outcomes are lacking for this population with high HIV prevalence. Guided by Earnshaw and Chaudoir’s stigma framework (2009), we conducted this qualitative study using 10 focus-groups with 76 SSA community members and 20 in-depth interviews with SSA descendants living with HIV to explore specific HIV-stigma mechanisms and outcomes and underlying drivers. Inductive and deductive thematic analysis showed high degrees of stigma among SSA communities driven by fear of HIV acquisition and misconceptions in a migration context, negatively affecting SSA descendants living with HIV. The results allowed for contextualization of the framework: At the community level, prejudices and stereotypes were major stigma mechanisms, while physical distancing, gossips, sexual rejection, violence and increased HIV prevalence emerged as stigma outcomes. Among SSA descendants living with HIV, enacted, anticipated and internalized stigmas were validated as stigma mechanisms, with witnessed stigma as an additional mechanism. Self-isolation, community avoidance and low utilization of non-HIV specialized healthcare were additional outcomes. These results are relevant for tailoring interventions to reduce HIV-related stigma.

Suggested Citation

  • Lazare Manirankunda & Aletha Wallace & Charles Ddungu & Christiana Nöstlinger, 2021. "Stigma Mechanisms and Outcomes among Sub-Saharan African Descendants in Belgium—Contextualizing the HIV Stigma Framework," IJERPH, MDPI, vol. 18(16), pages 1-17, August.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:16:p:8635-:d:614987
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    References listed on IDEAS

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    1. Nelsensius Klau Fauk & Karen Hawke & Lillian Mwanri & Paul Russell Ward, 2021. "Stigma and Discrimination towards People Living with HIV in the Context of Families, Communities, and Healthcare Settings: A Qualitative Study in Indonesia," IJERPH, MDPI, vol. 18(10), pages 1-17, May.
    2. Parker, Richard & Aggleton, Peter, 2003. "HIV and AIDS-related stigma and discrimination: a conceptual framework and implications for action," Social Science & Medicine, Elsevier, vol. 57(1), pages 13-24, July.
    3. Wyatt, G.E., 2009. "Enhancing cultural and contextual intervention strategies to reduce HIV/AIDS among African Americans," American Journal of Public Health, American Public Health Association, vol. 99(11), pages 1941-1945.
    4. Mak, Winnie W.S. & Cheung, Rebecca Y.M. & Law, Rita W. & Woo, Jean & Li, Patrick C.K. & Chung, Rita W.Y., 2007. "Examining attribution model of self-stigma on social support and psychological well-being among people with HIV+/AIDS," Social Science & Medicine, Elsevier, vol. 64(8), pages 1549-1559, April.
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