AIDS Stigma and Gender: Health Consequences in Urban India

[Guest guest]

New research project.

AIDS Stigma and Gender: Health Consequences in Urban India

Project Staff: Ekstrand, Jayashree Ramakrishna, Shalini Bharat,

Herek and

Suneeta Krishnan.

Project Description: AIDS stigma is a major barrier in the fight against

HIV/AIDS. It adds to the suffering of those infected and interferes with

decisions toseek HIV counseling and testing, disclosure of HIV infection, and

seeking treatment for HIV-related problems.

Members of marginalized groups often experience dual stigma, forcing them to

conceal their lifestyles and making it more difficult for them to access AIDS

prevention programs and treatment. Family members and health care workers who

provide care to HIV positive patients also become the target of AIDS stigma and

discrimination. Our research suggests that these problems exist in India as

well. Previous qualitative work in urban India by Bharat has identified AIDS

stigma attitudes and overt discrimination, both in the health care setting

and the family. This has included refusal to care for HIV infected individuals,

additional charges for protective equipment such as extra gloves, masks,

fumigation of rooms, and lack of confidentiality. The data also suggest that

AIDS stigma in urban India is a gendered phenomenon. Reports of women being

neglected and maltreated by their husbands and inlaws were common, and many

women were found to have less access to treatment than their husbands.

Although many important culture-specific issues were identified in Bharat's

qualitative research, there is now a need to extend this work to develop

culture-specific quantitative models and measures of AIDS stigma and its health

consequences and to examine the prevalence and correlates of stigma in the

Indian context.

The current study has been designed to meet this need. It will build on the

qualitative work by Bharat, by incorporating the culture-specific themes into a

modified version of a quantitative measure developed and administered in the US

by Herek. This measure will be administered in a range of health care settings

in two large Indian cities situated in high HIV prevalence states.

Specifically we propose to:

• Examine the nature, extent, and context of AIDS stigma and discrimination by

gender, at multiple levels, among people coming into contact with urban health

care systems, including

a) People Living with HIV/AIDS (PLWHAs),

b)families of PLWHAs,

c) healthcare staff; and

d) general hospital outpatients.

• Measure the potential health-relevant consequences of AIDS stigma and

discrimination among both perpetrators and targets of stigma at each of the

above levels.

• Develop a) a culture-specific theoretical understanding of AIDS stigma and

health in urban India as well as measures of AIDS stigma that can be used to

evaluate future stigma reduction policies and programs in health care and

community settings among both victims and perpetrators of stigma.

• Develop specific data-based program and policy recommendations to reduce

AIDSrelated stigma and discrimination in urban Indian health care settings and

to disseminate these among regional stakeholders

Estimated Project End Date: June 2008

Center for AIDS Prevention Studies * Research Portfolio * Spring 2004

http://www.caps.ucsf.edu/portfolio/

[Guest guest]

Dear All,

Please note that although the study below has been funded by the NIH, it

is currently under review by ICMR and no field work has been conducted yet.

We'd be happy to discuss the study and share our findings with the

members of this forum once the study starts.

Sincerely,

Ekstrand

E-mail: <mekstrand@...>