Skip to main content
Erschienen in: Quality of Life Research 7/2014

01.09.2014

Enacted and internalized stigma and quality of life among people with HIV: the role of group identity

verfasst von: Maria J. Fuster-Ruizdeapodaca, Fernando Molero, Francisco Pablo Holgado, Sonia Mayordomo

Erschienen in: Quality of Life Research | Ausgabe 7/2014

Einloggen, um Zugang zu erhalten

Abstract

Purpose

This study analyzes the mediating role of social identity in the relationship between enacted stigma and internalized stigma and quality of life of people with HIV.

Methods

A total of 557 people with HIV participated in this study. Participants were recruited from hospitals and non-governmental organizations. Questionnaires measuring perceived stigma (Berger’s HIV Stigma Scale), social identity (Cameron’s three factor identity scale), and quality of life (Ruiz and Baca’s Quality of Life Questionnaire) were administered. The instruments were adapted for use with the Spanish population. Structural equation modeling (SEM) was used to test the mediation model, and multigroup SEM was conducted to evaluate its invariance.

Results

Both enacted stigma and internalized stigma had a negative influence on the quality of life of people with HIV, but this influence occurred in different ways. Enacted stigma had a direct negative influence on quality of life. No dimension of group identity protected people with HIV from its negative influence. However, the negative influence of internalized stigma was totally mediated by some dimensions of group identification, mainly through in-group affect.

Conclusions

Group identification not only did not protect people with HIV from the negative effects of stigmatization, but it may even be detrimental in the case of internalized stigma. This suggests that in highly stigmatized groups, the salience of identity is negative and worsens the members’ opinion of their own group. This argues for different kinds of intervention to improve the quality of life of people with HIV.
Literatur
1.
Zurück zum Zitat Mahajan, A. P., Sayles, J. N., Patel, V. A., Remien, R. H., Ortiz, D., Szekeres, G., et al. (2008). Stigma in the HIV/AIDS epidemic: A review of the literature and recommendations for the way forward. AIDS, 22(2), 67–79. doi:10.1097/01.aids.0000327438.13291.62. Mahajan, A. P., Sayles, J. N., Patel, V. A., Remien, R. H., Ortiz, D., Szekeres, G., et al. (2008). Stigma in the HIV/AIDS epidemic: A review of the literature and recommendations for the way forward. AIDS, 22(2), 67–79. doi:10.​1097/​01.​aids.​0000327438.​13291.​62.
2.
Zurück zum Zitat Parker, R., & Aggleton, P. (2003). HIV and AIDS-related stigma and discrimination. A conceptual framework and implications for action. Social Science and Medicine, 57, 13–24. doi:10.1016/S0277-9536(02)00304-0. Parker, R., & Aggleton, P. (2003). HIV and AIDS-related stigma and discrimination. A conceptual framework and implications for action. Social Science and Medicine, 57, 13–24. doi:10.​1016/​S0277-9536(02)00304-0.
3.
Zurück zum Zitat Fuster M. J, Molero, F., Gil de Montes, L., Vitoria, A., & Agirrezabal A. (2013). HIV- and AIDS-related stigma: Psychosocial aspects in a representative Spanish sample. Spanish Journal of Psychology, 16, 1–8. doi:10.1017/sjp.2013.52. Fuster M. J, Molero, F., Gil de Montes, L., Vitoria, A., & Agirrezabal A. (2013). HIV- and AIDS-related stigma: Psychosocial aspects in a representative Spanish sample. Spanish Journal of Psychology, 16, 1–8. doi:10.​1017/​sjp.​2013.​52.
4.
Zurück zum Zitat Tsutsumi, A., & Izutsu, T. (2010). Quality of life and stigma. In V. R. Preedy & R. R. Watson (Eds.), Handbook of disease burdens and quality of life measures (pp. 3490–3499). New York: Springer. doi:10.1007/978-0-387-78665-0_202. Tsutsumi, A., & Izutsu, T. (2010). Quality of life and stigma. In V. R. Preedy & R. R. Watson (Eds.), Handbook of disease burdens and quality of life measures (pp. 3490–3499). New York: Springer. doi:10.​1007/​978-0-387-78665-0_​202.
8.
Zurück zum Zitat Herek, G., Gillis, J. R., & Cogan, J. C. (2009). Internalized stigma among sexual minority adults: Insights from a social psychological perspective. Journal of Counseling Psychology, 56, 32–43. doi:10.1037/a0014672.CrossRef Herek, G., Gillis, J. R., & Cogan, J. C. (2009). Internalized stigma among sexual minority adults: Insights from a social psychological perspective. Journal of Counseling Psychology, 56, 32–43. doi:10.​1037/​a0014672.CrossRef
11.
Zurück zum Zitat Franke, M. F., Muñoz, M., Finnegan, K., Zeladita, J., Sebastian, J. L., Bayona, J. N., et al. (2010). Validation and abbreviation of an HIV stigma scale in an adult spanish-speaking population in urban Peru. AIDS and Behavior, 14(1), 189–199.PubMedCrossRef Franke, M. F., Muñoz, M., Finnegan, K., Zeladita, J., Sebastian, J. L., Bayona, J. N., et al. (2010). Validation and abbreviation of an HIV stigma scale in an adult spanish-speaking population in urban Peru. AIDS and Behavior, 14(1), 189–199.PubMedCrossRef
12.
Zurück zum Zitat Steward, W. T., Chandy, S., Singh, G., Panicker, S. T., Osmand, T. A., Heylen, E., et al. (2011). Depression is not an inevitable outcome of disclosure avoidance: HIV stigma and mental health in a cohort of HIV-infected individuals from southern India. Psychology, Health and Medicine, 16(1), 74–85.PubMedCentralPubMedCrossRef Steward, W. T., Chandy, S., Singh, G., Panicker, S. T., Osmand, T. A., Heylen, E., et al. (2011). Depression is not an inevitable outcome of disclosure avoidance: HIV stigma and mental health in a cohort of HIV-infected individuals from southern India. Psychology, Health and Medicine, 16(1), 74–85.PubMedCentralPubMedCrossRef
13.
Zurück zum Zitat Logie, C., & Gadalla, T. M. (2009). Meta-analysis of health and demographic correlates of stigma towards people living with HIV. AIDS Care, 21(6), 742–753.PubMedCrossRef Logie, C., & Gadalla, T. M. (2009). Meta-analysis of health and demographic correlates of stigma towards people living with HIV. AIDS Care, 21(6), 742–753.PubMedCrossRef
14.
Zurück zum Zitat Rao, D., Kekwaletswe, T. C., Hosek, S., Martinez, J., & Rodriguez, F. (2007). Stigma and social barriers to medication adherence with urban youth living with HIV. AIDS Care, 19(1), 28–33.PubMedCrossRef Rao, D., Kekwaletswe, T. C., Hosek, S., Martinez, J., & Rodriguez, F. (2007). Stigma and social barriers to medication adherence with urban youth living with HIV. AIDS Care, 19(1), 28–33.PubMedCrossRef
15.
Zurück zum Zitat Rintamaki, L. S., Davis, T. C., Skripkauskas, S., Bennett, C. L., & Wolf, M. S. (2006). Social stigma concerns and HIV medication adherence. AIDS Patient Care & STDs, 20(5), 359–368.CrossRef Rintamaki, L. S., Davis, T. C., Skripkauskas, S., Bennett, C. L., & Wolf, M. S. (2006). Social stigma concerns and HIV medication adherence. AIDS Patient Care & STDs, 20(5), 359–368.CrossRef
16.
Zurück zum Zitat Strachan, E. D., Murray, W. R., Russo, J., & Roy-Byrne, P. P. (2007). Disclosure of HIV status and sexual orientation independently predicts increased absolute CD4 cells counts over time for psychiatric patients. Psychosomatic Medicine, 69, 74–80.PubMedCrossRef Strachan, E. D., Murray, W. R., Russo, J., & Roy-Byrne, P. P. (2007). Disclosure of HIV status and sexual orientation independently predicts increased absolute CD4 cells counts over time for psychiatric patients. Psychosomatic Medicine, 69, 74–80.PubMedCrossRef
17.
Zurück zum Zitat Dovidio, F., Major, B., & Crocker, J. (2000). Stigma: Introduction and overview. In T. F. Heatherton, R. E. Kleck, M. R. Hebl, & J. G. Hull (Eds.), The social psychology of stigma (pp. 1–28). New York: Guilford Press. Dovidio, F., Major, B., & Crocker, J. (2000). Stigma: Introduction and overview. In T. F. Heatherton, R. E. Kleck, M. R. Hebl, & J. G. Hull (Eds.), The social psychology of stigma (pp. 1–28). New York: Guilford Press.
18.
Zurück zum Zitat Branscombe, N. R., Schmitt, M. T., & Harvey, R. D. (1999). Perceiving pervasive discrimination among African Americans: Implications for group identification and well-being. Journal of Personality and Social Psychology, 77, 135–149. doi:10.1037/0022-3514.77.1.135.CrossRef Branscombe, N. R., Schmitt, M. T., & Harvey, R. D. (1999). Perceiving pervasive discrimination among African Americans: Implications for group identification and well-being. Journal of Personality and Social Psychology, 77, 135–149. doi:10.​1037/​0022-3514.​77.​1.​135.CrossRef
19.
Zurück zum Zitat Outten, H. R., Schmitt, M. T., Garcia, D. M., & Branscombe, N. R. (2009). Coping options: Missing links between minority group identification and psychological well-being. Applied Psychology: An International Review, 58, 146–170. doi:10.1111/j.1464-0597.2008.00386.x.CrossRef Outten, H. R., Schmitt, M. T., Garcia, D. M., & Branscombe, N. R. (2009). Coping options: Missing links between minority group identification and psychological well-being. Applied Psychology: An International Review, 58, 146–170. doi:10.​1111/​j.​1464-0597.​2008.​00386.​x.CrossRef
20.
Zurück zum Zitat Schmitt, M. T., & Branscombe, N. R. (2002). The meaning and consequences of perceived discrimination in disadvantaged and privileged social groups. In W. Stroebe & M. Hewstone (Eds.), European Review of Social Psychology (Vol. 12, pp. 167–199). Chichester: Wiley. doi:10.1002/0470013478.ch6. Schmitt, M. T., & Branscombe, N. R. (2002). The meaning and consequences of perceived discrimination in disadvantaged and privileged social groups. In W. Stroebe & M. Hewstone (Eds.), European Review of Social Psychology (Vol. 12, pp. 167–199). Chichester: Wiley. doi:10.​1002/​0470013478.​ch6.
23.
Zurück zum Zitat Leach, C. W., van Zomeren, M., Zebel, S., Vliek, M. L. W., Pennekamp, S. F., Doosje, B., et al. (2008). Group-level self-definition and self-investment: A hierarchical (multicomponent) model of ingroup identification. Journal of Personality and Social Psychology, 95, 144–165. doi:10.1037/00223514.95.1.144.PubMedCrossRef Leach, C. W., van Zomeren, M., Zebel, S., Vliek, M. L. W., Pennekamp, S. F., Doosje, B., et al. (2008). Group-level self-definition and self-investment: A hierarchical (multicomponent) model of ingroup identification. Journal of Personality and Social Psychology, 95, 144–165. doi:10.​1037/​00223514.​95.​1.​144.PubMedCrossRef
26.
Zurück zum Zitat Molero, F., Fuster, M. J., Jetten, J., & Moriano, J. A. (2011). Living with HIV/AIDS: A psychosocial perspective on coping with prejudice and discrimination. Journal of Applied Psychology, 41, 609–626. doi:10.1111/j.1559-1816.2011.00729.x. Molero, F., Fuster, M. J., Jetten, J., & Moriano, J. A. (2011). Living with HIV/AIDS: A psychosocial perspective on coping with prejudice and discrimination. Journal of Applied Psychology, 41, 609–626. doi:10.​1111/​j.​1559-1816.​2011.​00729.​x.
28.
Zurück zum Zitat Berger, B. E., Ferrans, C. E., & Lashley, F. R. (2001). Measuring stigma in people with HIV: Psychometric assessment of the HIV Stigma Scale. Research in Nursing Health, 24, 518–529. doi:10.1002/nur.10011.PubMedCrossRef Berger, B. E., Ferrans, C. E., & Lashley, F. R. (2001). Measuring stigma in people with HIV: Psychometric assessment of the HIV Stigma Scale. Research in Nursing Health, 24, 518–529. doi:10.​1002/​nur.​10011.PubMedCrossRef
29.
Zurück zum Zitat Ruiz, M. A., & Baca, E. (1993). Design and validation of the Quality of Life Questionnaire (Cuestionario de Calidad de Vida, CCV): A generic health-related quality-of-life instrument. European Journal of Psychological Assessment, 9, 19–32. Ruiz, M. A., & Baca, E. (1993). Design and validation of the Quality of Life Questionnaire (Cuestionario de Calidad de Vida, CCV): A generic health-related quality-of-life instrument. European Journal of Psychological Assessment, 9, 19–32.
33.
Zurück zum Zitat Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 1173–1182.PubMedCrossRef Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 1173–1182.PubMedCrossRef
34.
Zurück zum Zitat Chan, W. Y., Lau, S., Nie, Y., Lim, S., & Hogan, D. (2008). Organizational and personal predictors of teacher commitment: The mediating role of teacher efficacy and identification with school. American Educational Research Journal, 45, 597–630.CrossRef Chan, W. Y., Lau, S., Nie, Y., Lim, S., & Hogan, D. (2008). Organizational and personal predictors of teacher commitment: The mediating role of teacher efficacy and identification with school. American Educational Research Journal, 45, 597–630.CrossRef
35.
Zurück zum Zitat Kalichman, S. C., Simbayi, L. C., Cloete, A., Mthembu, P. P., Mkhonta, R. N., & Ginindza, T. (2009). Measuring AIDS stigmas in people living with HIV/AIDS: The Internalized AIDS-related Stigma Scale. AIDS Care, 21, 87–93. doi:10.1080/09540120802032627.PubMedCrossRef Kalichman, S. C., Simbayi, L. C., Cloete, A., Mthembu, P. P., Mkhonta, R. N., & Ginindza, T. (2009). Measuring AIDS stigmas in people living with HIV/AIDS: The Internalized AIDS-related Stigma Scale. AIDS Care, 21, 87–93. doi:10.​1080/​0954012080203262​7.PubMedCrossRef
38.
Zurück zum Zitat Cronin, T. J., Levin, S., Branscombe, N. R., van Laar, C., & Tropp, L. R. (2012). Ethnic identification in response to perceived discrimination protects well-being and promotes activism: A longitudinal study of Latino college students. Group Processes and Intergroup Relations, 15, 393–407. doi:10.1177/1368430211427171.CrossRef Cronin, T. J., Levin, S., Branscombe, N. R., van Laar, C., & Tropp, L. R. (2012). Ethnic identification in response to perceived discrimination protects well-being and promotes activism: A longitudinal study of Latino college students. Group Processes and Intergroup Relations, 15, 393–407. doi:10.​1177/​1368430211427171​.CrossRef
39.
Zurück zum Zitat Schmitt, M. T., Branscombe, N. R., Kobrynowicz, D., & Owen, S. (2002). Perceiving discrimination against one’s gender group has different implications for well-being in women and men. Personality and Social Psychology Bulletin, 28, 197–210. doi:10.1177/0146167202282006.CrossRef Schmitt, M. T., Branscombe, N. R., Kobrynowicz, D., & Owen, S. (2002). Perceiving discrimination against one’s gender group has different implications for well-being in women and men. Personality and Social Psychology Bulletin, 28, 197–210. doi:10.​1177/​0146167202282006​.CrossRef
41.
Metadaten
Titel
Enacted and internalized stigma and quality of life among people with HIV: the role of group identity
verfasst von
Maria J. Fuster-Ruizdeapodaca
Fernando Molero
Francisco Pablo Holgado
Sonia Mayordomo
Publikationsdatum
01.09.2014
Verlag
Springer International Publishing
Erschienen in
Quality of Life Research / Ausgabe 7/2014
Print ISSN: 0962-9343
Elektronische ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-014-0653-4

Weitere Artikel der Ausgabe 7/2014

Quality of Life Research 7/2014 Zur Ausgabe