Stamping out stigma: does social support hold the answer?
Social support found to be the most effective component in stigma interventions among African American women living with HIV. Workshop activities themselves were not associated with significant change in experiences of stigma.
When researchers assessed the impact of an HIV stigma-reduction workshop for African American women living with HIV they found the social support gained through the session to be more powerfully associated with reducing stigma than the workshop itself. Suggesting that peer support is an essential element of effective stigma interventions.
A growing body of research indicates that internalised HIV-related stigma is one of the main barriers to seeking or staying on treatment.
Amongst African American women, who are disproportionately affected by HIV, AIDS-related illnesses are one of the top 10 causes of death. Understanding HIV-related stigma, therefore, remains a key priority for this group. Yet, research into stigma interventions remains limited. Until now only two studies have successfully demonstrated stigma reduction through interventions such as these.
The researchers recruited 240 African American women living with HIV. Half were invited to attend an HIV-stigma reduction workshop, and half to attend a workshop on breast cancer.
The HIV workshop, known as ‘UNITY’, is designed to provide African American women living with HIV with the tools to handle intersectional stigmas associated with HIV, race, and sex, through discussion and assertiveness training among other activities. While the breast cancer education workshop involved skill building, counselling and support, relating to breast cancer rather than HIV.
Participants completed the same questionnaire before the workshop and immediately after it, and then at 4-month, 8-month and 12-month periods. The questions were designed to measure experiences of HIV-related stigma and social support.
Researchers found that experiences of stigma reduced in both groups in a similar way during the study, suggesting the UNITY workshop was not more effective at reducing stigma than the breast cancer education workshop.
However, many participants in both groups experienced increases in social support by attending the workshops, and these peer experiences were found to be associated with subsequent decreases in stigma.
This suggests that, although HIV stigma-specific content may not be necessary to reduce HIV-related stigma, the peer support provided through the experience of interacting with people in similar situations may be key to making such interventions work.
Interestingly, both groups displayed a decrease in their sense of HIV-related stigma immediately after the main workshop, then demonstrated slightly increased feelings of stigma in each subsequent questionnaire, although never to as high a level as was originally recorded.
This increase suggests people may be experiencing ongoing stigma in families, communities and places of work; negative experiences might be minimised should ongoing peer support be made available.