IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0151078.html
   My bibliography  Save this article

Stigma against People Living with HIV/AIDS in China: Does the Route of Infection Matter?

Author

Listed:
  • Chen Zhang
  • Xiaoming Li
  • Yu Liu
  • Shan Qiao
  • Liying Zhang
  • Yuejiao Zhou
  • Zhenzhu Tang
  • Zhiyong Shen
  • Yi Chen

Abstract

In the current study, we tested the hypothesis that people who contracted HIV from “blameless” routes (e.g., blood transfusion, sex with stable partners) are less stigmatized compared to people who contracted HIV from “blamable” routes (e.g., injection drug use, sex with sex workers). A cross-sectional study was conducted among 2,987 participants in Guangxi province, China, between 2012 and 2013. We employed both explanatory and predictive modeling strategy by using multivariate linear regression models. In the explanatory models, we assessed the association between routes of infection and three types of stigma (perceived, internalized, and enacted). From identified routes of infection that significantly contributed to higher stigma, we employed predictive modeling to explore predictors for the specific type of stigma. Multiple-imputation was employed for sensitivity analyses. Of the total sample, 63% were male and the average age was 42.9 years (ranged between 18 and 88). Multivariate regression models revealed that contraction from commercial sex increased the perceived (β = 0.46, 95%CI = 0.02, 0.90) and internalized stigma (β = 0.60, 95%CI = 0.09, 1.10), while injecting drug use increased the perceived (β = 0.65, 95%CI = 0.07, 1.22) and enacted stigma (β = 0.09, 95%CI = 0.02, 0.16) after controlling for confounders. Among PLWHA who were infected via commercial sex partners, social support was negatively associated with perceived (β = -0.47, 95%CI = -0.79, -0.14) and internalized stigma (β = -0.80, 95%CI = -1.24, -0.35). Among PLWHA who were infected via injecting drugs, no adherence to antiretroviral treatment (β = 0.41, 95%CI = 0.01, 0.82) was positively associated with perceived stigma, and disclosure of serostatus to others was negatively associated with enacted stigma (β = -0.20, 95%CI = -0.34, -0.05). Knowledge of the association between routes of infection and stigma can guide health professionals and policy makers to develop tailored intervention strategies to mitigate the effects of stigma and enhance HIV care utilization among PLWHA in China.

Suggested Citation

  • Chen Zhang & Xiaoming Li & Yu Liu & Shan Qiao & Liying Zhang & Yuejiao Zhou & Zhenzhu Tang & Zhiyong Shen & Yi Chen, 2016. "Stigma against People Living with HIV/AIDS in China: Does the Route of Infection Matter?," PLOS ONE, Public Library of Science, vol. 11(3), pages 1-15, March.
  • Handle: RePEc:plo:pone00:0151078
    DOI: 10.1371/journal.pone.0151078
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0151078
    Download Restriction: no

    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0151078&type=printable
    Download Restriction: no

    File URL: https://libkey.io/10.1371/journal.pone.0151078?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Valdiserri, R.O., 2002. "HIV/AIDS stigma: An impediment to public health," American Journal of Public Health, American Public Health Association, vol. 92(3), pages 341-342.
    2. Dickens Akena & Seggane Musisi & John Joska & Dan J Stein, 2012. "The Association between Aids Related Stigma and Major Depressive Disorder among HIV-Positive Individuals in Uganda," PLOS ONE, Public Library of Science, vol. 7(11), pages 1-6, November.
    3. 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.
    4. Rao, Deepa & Angell, Beth & Lam, Chow & Corrigan, Patrick, 2008. "Stigma in the workplace: Employer attitudes about people with HIV in Beijing, Hong Kong, and Chicago," Social Science & Medicine, Elsevier, vol. 67(10), pages 1541-1549, November.
    5. Frieden, T.R., 2010. "A framework for public health action: The health impact pyramid," American Journal of Public Health, American Public Health Association, vol. 100(4), pages 590-595.
    6. Maria H Lindberg & Lena Wettergren & Maria Wiklander & Veronica Svedhem-Johansson & Lars E Eriksson, 2014. "Psychometric Evaluation of the HIV Stigma Scale in a Swedish Context," PLOS ONE, Public Library of Science, vol. 9(12), pages 1-16, December.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Abadía-Barrero, César Ernesto & Castro, Arachu, 2006. "Experiences of stigma and access to HAART in children and adolescents living with HIV/AIDS in Brazil," Social Science & Medicine, Elsevier, vol. 62(5), pages 1219-1228, March.
    2. Beatriz Casais & João F. Proença, 2010. "Inhibitions and implications associated with celebrity participation in social marketing programs focusing on HIV prevention: an exploratory research," FEP Working Papers 360, Universidade do Porto, Faculdade de Economia do Porto.
    3. Nella Otoobea Anakwa & Enoch Teye-Kwadjo & Irene A. Kretchy, 2021. "Effect of HIV-Related Stigma and HIV-Related Stress on HIV Disclosure Concerns: a Study of HIV-Positive Persons on Antiretroviral Therapy at Two Urban Hospitals in Ghana," Applied Research in Quality of Life, Springer;International Society for Quality-of-Life Studies, vol. 16(3), pages 1249-1264, June.
    4. Bayer, Ronald, 2008. "Stigma and the ethics of public health: Not can we but should we," Social Science & Medicine, Elsevier, vol. 67(3), pages 463-472, August.
    5. Bluthenthal, Ricky N. & Palar, Kartika & Mendel, Peter & Kanouse, David E. & Corbin, Dennis E. & Derose, Kathryn Pitkin, 2012. "Attitudes and beliefs related to HIV/AIDS in urban religious congregations: Barriers and opportunities for HIV-related interventions," Social Science & Medicine, Elsevier, vol. 74(10), pages 1520-1527.
    6. Mazanderani, Fadhila & Paparini, Sara, 2015. "The stories we tell: Qualitative research interviews, talking technologies and the ‘normalisation’ of life with HIV," Social Science & Medicine, Elsevier, vol. 131(C), pages 66-73.
    7. Bolte, Gabriele, 2018. "Epidemiologische Methoden und Erkenntnisse als eine Grundlage für Stadtplanung und gesundheitsfördernde Stadtentwicklung," Forschungsberichte der ARL: Aufsätze, in: Baumgart, Sabine & Köckler, Heike & Ritzinger, Anne & Rüdiger, Andrea (ed.), Planung für gesundheitsfördernde Städte, volume 8, pages 118-134, ARL – Akademie für Raumentwicklung in der Leibniz-Gemeinschaft.
    8. Winskell, Kate & Sabben, Gaëlle, 2016. "Sexual stigma and symbolic violence experienced, enacted, and counteracted in young Africans’ writing about same-sex attraction," Social Science & Medicine, Elsevier, vol. 161(C), pages 143-150.
    9. Sebastian del Busto & Inés Galindo & Juan Jesús Hernandez & Francisco Camarelles & Esther Nieto & Águeda Caballero & María Sandín Vázquez, 2019. "Creating a Collaborative Platform for the Development of Community Interventions to Prevent Non-Communicable Diseases," IJERPH, MDPI, vol. 16(5), pages 1-14, February.
    10. Katie Adamek & Sarah Bardin & So O'Neil & Dara Lee Luca, "undated". "Accelerating Teen Pregnancy Prevention in Phillips County, Arkansas and Coahoma County, Mississippi," Mathematica Policy Research Reports 7fda86cbb1bf4303a84f466e8, Mathematica Policy Research.
    11. Grdenić, Goran & Delimar, Marko & Robić, Slavica, 2020. "Framing the context of energy poverty in Croatia: A case-study from Zagreb," Energy Policy, Elsevier, vol. 147(C).
    12. Rivers, Ian & Gonzalez, Cesar & Nodin, Nuno & Peel, Elizabeth & Tyler, Allan, 2018. "LGBT people and suicidality in youth: A qualitative study of perceptions of risk and protective circumstances," Social Science & Medicine, Elsevier, vol. 212(C), pages 1-8.
    13. Rita Ferreira Gomes & Beatriz Casais, 2018. "Feelings generated by threat appeals in social marketing: text and emoji analysis of user reactions to anorexia nervosa campaigns in social media," International Review on Public and Nonprofit Marketing, Springer;International Association of Public and Non-Profit Marketing, vol. 15(4), pages 591-607, December.
    14. Frederick, Angela, 2017. "Visibility, respectability, and disengagement: The everyday resistance of mothers with disabilities," Social Science & Medicine, Elsevier, vol. 181(C), pages 131-138.
    15. Yang, Lawrence Hsin & Kleinman, Arthur, 2008. "'Face' and the embodiment of stigma in China: The cases of schizophrenia and AIDS," Social Science & Medicine, Elsevier, vol. 67(3), pages 398-408, August.
    16. Sean Lucan & Nandita Mitra, 2012. "Perceptions of the food environment are associated with fast-food (not fruit-and-vegetable) consumption: findings from multi-level models," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 57(3), pages 599-608, June.
    17. Yang, Lawrence H. & Chen, Fang-pei & Sia, Kathleen Janel & Lam, Jonathan & Lam, Katherine & Ngo, Hong & Lee, Sing & Kleinman, Arthur & Good, Byron, 2014. "“What matters most:” A cultural mechanism moderating structural vulnerability and moral experience of mental illness stigma," Social Science & Medicine, Elsevier, vol. 103(C), pages 84-93.
    18. Ahmed, Shahira & Autrey, Jessica & Katz, Ingrid T. & Fox, Matthew P. & Rosen, Sydney & Onoya, Dorina & Bärnighausen, Till & Mayer, Kenneth H. & Bor, Jacob, 2018. "Why do people living with HIV not initiate treatment? A systematic review of qualitative evidence from low- and middle-income countries," Social Science & Medicine, Elsevier, vol. 213(C), pages 72-84.
    19. Syed Mustafa Ali & Naveed Anjum & Muhammad Ishaq & Farah Naureen & Arif Noor & Aamna Rashid & Syed Muslim Abbas & Kerri Viney, 2019. "Community Knowledge about Tuberculosis and Perception about Tuberculosis-Associated Stigma in Pakistan," Societies, MDPI, vol. 9(1), pages 1-12, January.
    20. Holly Swan, 2016. "A Qualitative Examination of Stigma Among Formerly Incarcerated Adults Living With HIV," SAGE Open, , vol. 6(1), pages 21582440166, February.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0151078. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.