Abstract Book Vol. 2 [International Conference on AIDS (14th: 2002: Barcelona, Spain)]

XIV International AIDS Conference

Abstracts ThPeE7913-ThPeE7916 565

in the workplace, family, and community? These issues, plus possible stigmareduction activities, are explored among workers at a large power company in
South Africa and their household members.
Methodology: 69 in-depth interviews and 8 focus groups were conducted with
workers, managers, worker's families, and HIV/AIDS service providers.
Results: A greater fear of stigma in the community as opposed to the workplace
was reported by workers. The main manifestation of HIV-related stigma appeared
to be the social isolation and ridicule of those thought to be positive. Most respondents were reluctant to discuss an HIV-positive status with anyone, until they
became ill and needed assistance. Those who were willing to disclose prior to
becoming ill felt that other services, such as psycho-social counseling, were important. Stigma-reduction interventions suggested by respondents included additional education in the workplace and community and assistance from HIV/AIDS
counselors.
Conclusion: HIV-related stigma perceived by workers and their families is manifested differently in the workplace, family, and community. Preferred methods of
disclosure of HIV status differed depending on the context, and degree of illness.
In addition to protection through workplace policies, it is important to take into
account the role of social isolation when attempting to develop stigma-reduction
activities for workers and their families.
Presenting author: Rachel Kaufman, 4301 Connecticut Ave. NW, Suite 280,
Washington, DC, 20008, United States, E-mail: [email protected]
ThPeE7913 Gauging stigma associated with HIV-Infected
persons
D. Eroglu, D.R. Newman, T.A. Peterman. U.S. Centers for Disease Control and
Prevention, U.S. Centers for Disease Control and Prevention, 1600 Clifton Road,
Mailstop E-46, Atlanta, Georgia 30333, United States
Background: Stigma adversely affects many persons and the HIV epidemic. Single indicators have been used to gauge stigma related to HIV-infected persons.
We studied changes in these indicators and propose a multi-item measure as a
better way to gauge stigma.
Methods: Surveys were mailed in 2000 and 2001 in the US to representative
samples of adults. Respondents indicated on a 5-point scale their agreement
with statements used as indicators of stigma.
Results: 2353 surveys were returned (75%) in 2000 and 3719 (66%) in 2001.
Some changes suggest decreased stigma. Fewer persons agreed in 2001 than
in 2000 that: it should be a crime if an infected person knowingly has sex with another (63% to 76%); foreigners with HIV should be barred from entering US (46%
to 53%). Yet, other changes suggest increased stigma. Fewer agreed in 2001
than in 2000 that: it is good to provide clean needles to drug addicts to prevent
HIV, (45% to 56%); or that US government should pay for treatment of uninsured
persons with HIV, (31% to 38%) (for all differences, p<.01). Opposing changes on
single items suggest different trends in stigma. To search for commonality, all 24
items were factor-analyzed using 2000 data. 4 factors emerged with satisfactory
reliability (Cronbach's Alpha > 0.70 for all). Two reflect negative stereotyping (NS)
and willingness to discriminate (WD) against HIV-infected persons and are proposed as measure of stigma. The other two indicate compassion (C) and support
(S) for favorable policies toward HIV-infected persons. Identical factors emerged
in 2001 with acceptable reliabilities. Comparison of the proposed measures show
no change in stigma from 2000 to 2001: 9.5 and 9.6 for NS; 26.2 and 25.6 for
WD; 17.6 and 17.4 for C and 18.9 and 18.5 for S.
Conclusions: Single indicators of stigma can be driven by other factors (e.g.,
political views or economic concerns) in addition to stigma. Reliable and valid
multi-item scales should be used to measure stigma.
Presenting author: Dogan Eroglu, U.S. Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop E-46, Atlanta, Georgia 30333, United States,
Tel.: [phone], Fax: [phone], E-mail: [email protected]
ThPeE7914 Impact of AIDS death on family and society
M. Suhadev, B. Thomas, M. Dilip, S. Swaminathan, D. Vijayakumar,
N. Arunkumar. Tuberculosis Research Centre, HIVIAIDS Division, Tuberculosis
Research Centre, Mayor Ramanathan Road, Chetput, Chennai - 600 031, Tamil
Nadu, India
Issues: AIDS is a family as well as a social disease. Impact of an AIDS death in
the family and society is multi-farious and lot of socio-economic and psychological
issues related to death such as financial, occupation and inter-personal problems
arise apart from the unresolved fears about death and dying.The refusal to conduct funeral rites, ostracisation of family members, the adverse impact on the
surviving members especially their widows are not uncommon. This study explores the repercussions of death of an AIDS victim in his/her family and society
in detail.
Description: Tuberculosis Research Centre(TRC) is a premier Institute under Indian Council of Medical Research (ICMR) and a WHO collaborating Centre for

Tuberculosis research and training. Recently, HIV/AIDS Division is conducting
both basic and applied research on HIV/TB. Pre and Post test counselling, counselling for terminally ill patients and family counselling for HIV/AIDS patients are
done by the trained social workers. From the experience gained in this field, a
sociological study has been designed to find out the discrimination, stigma and
social exclusion besides occupation and financial problems faced by the contacts
or the family members of HIV/AIDS patients who died. The study is conducted

at Chennai, a metropolitan city in India. Both qualitative (In-depth interviews, vignettes etc;) and quantitative (interview schedules and medical records) research
methods are employed. The study is ongoing.
Lessons learned: HIV infections and AIDS death in men outnumber those in
women.Distress stories of the young widows of AIDS patients being thrown out
of their homes ostracised by their own families and society and even denied admission and medical care in hospitals are many.
Recommendations: This study would help plan health education programs and
intervention strategies for the families of HIV/AIDS patients and empower them to
face the crisis.
Presenting author: Mohanarani Suhadev, HIV/AIDS Division, Tuberculosis Research Centre, Mayor Ramanathan Road, Chetput, Chennai - 600 031, Tamil
Nadu, India, E-mail: [email protected]
ThPeE7915I5 Constructing Masculinity: Homophobia, social
exclusion and sexual risk in Peru
A.M. Rosasco1, C.E Cceres2, R.P. Fernandez1, X. Salazar2, P Aggleton3.
1Redess J6venes, Trinidad Mordn 451, LIMA, 14, Peru; 2Universidad Peruana
Cayetano Heredia, LIMA, Peru; 3Thomas Coram Research Unit, London, United
Kingdom
Background: The ways in which traditional male socialization deals with existing homo/bisexuality may have sexual health implications. In a study of constructions of masculinity in Peru,male discourses around homosexuality and
gay/homosexual men in particular were explored.
Methods: An ethnography was conducted in 5 contexts: Lima-working and middle class-, fishermenpeasants in an Andean cityand drivers in an Amazonian
town.Individual and group interviews were conducted with young adult malesand
individual interviews with women,gay and bisexual men.Accounts (mainly from
men,including MSM) were analysed with regard to the social status of homosexuality and gay men,feelings related to maleness and social interaction with gay
men.
Results: Diversity was found in ideas and experiences around homosexuality,although homosexuality was never accepted as a legitimate masculine option.Homophobic discourses were found in the Lima middle class (where the
gay men elicited anxiety in spite of politically-correct openness),as well as in the
fishing town and Andean city (with little visibility of gay men).Less homophobia
was found among the Lima working class,where interaction and compensated
sex with gay men were customary and in the Amazonian town,where the sexual
pleasure did not exclude homosexuality.Wherever norms were more homophobic,homosex was more often described as occurring in the context of high alcohol
intake and the sexual escapades of married men.However,in less homophobic
contexts, poverty still favoured high risk sex between men.
Conclusions: Diversity in masculinity in Peru was accompanied by diversity
in the importance of homophobic discourses to deal with existing homosexuality.While higher homophobia/sexual exclusion favoured higher risks,other forms
of exclusion (poverty) maintained risks in less homophobic contexts.Attention
should be paid to all forms of exclusion,since all contribute to social vulnerability
and sexual health/HIV risks.
Presenting author: ANA ROSASCO DULANTO, Trinidad Moran 451, LIMA, 14,
Peru, Tel.: +(51-1) 241-6929, Fax: +(51-1) 241-8334, E-mail: [email protected].
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ThPeE7916 The impact of stigma on the adjustment of young
HIV+ persons
D.T. Swendeman, W.S. Comulada, M. Lee, M.J. Rotheram-Borus. UCLA Center
for Community Health, 10920 Wilshire Blvd., Suite 350, Los Angeles, CA, 90024,
United States
Background: HIV is a highly stigmatized disease in the U.S. The impact of
HIV related stigma can be compounded for those most likely to be infected with
HIV who are also stigmatized due to their race/ethnicity, sexual orientation, and
SES, or because they acquired HIV through their own risk behaviors (e.g., substance use, bartering sex). Experienced and perceived stigma are anticipated to
decrease personal adjustment, influence how HIV+ persons disclose and cope
with stress, and impact mental health problems, transmission behaviors and substance use.
Methods: Young HIV+ persons aged 13 to 29 (n=180) were recruited in 3
U.S. AIDS epicenters (Los Angeles, New York City, San Francisco) in 1999 -2000. Youth were African American (23%), Latino (32%) or mixed race/ethnicity
(25%); about 50% used hard drugs recently; most had no income; 65% were
gay/bisexual.
Results: HIV+ youth who experienced more HIV related stigma were more likely
to be clinically depressed and anxious, attempt suicide, be sexually abused,
trade sex for money or drugs, use hard drugs, use more negative coping strategies (e.g., depression/withdrawal, non-disclosure coping, passive problem solv
ing, self-destructive escape) and were less likely to disclose HIV status to sex
partners. Gay and bisexual youth who experienced stigma related to their sexual orientation had higher emotional distress, less social support, more negative
coping styles, higher lifetime drug use, higher recent jail experiences, felt poorly
about their HIV status, and were less likely to disclose HIV status to sex partners.
Conclusions: Interventions must be designed and mounted to reduce stigma
regarding HIV in the general population. The negative impact of stigma is clear