Verbal and Physical Abuse and Neglect as Manifestations of HIV/AIDS Stigma in Five African Countries

Authors

  • Priscilla S. Dlamini,

    1. Ph.D., R.M., R.N., is Senior Lecturer, Department of General Nursing Science, Faculty of Health Sciences, University of Swaziland, Mbabane, Swaziland.
    Search for more papers by this author
  • Thecla W. Kohi,

    1. Ph.D., R.M., R.N., is Lecturer, School of Nursing, College of Health, Muhimbili University College of Health Sciences, Dar es Salaam, Tanzania.
    Search for more papers by this author
  • Leana R. Uys,

    1. R.M., R.N., D.Soc.Sc., is Professor, Deputy Vice Chancellor, and Head of the College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
    Search for more papers by this author
  • René Deliwe Phetlhu,

    1. M.N., R.M., R.N., is Lecturer, School of Nursing Science, North-West University, Potchefstroom Campus, Potchefstroom, South Africa.
    Search for more papers by this author
  • Maureen L. Chirwa,

    1. Ph.D., R.M., R.N., is Senior Lecturer, Kamuzu College of Nursing, University of Malawi, Lilongwe, Malawi.
    Search for more papers by this author
  • Joanne R. Naidoo,

    1. M.S., R.M., R.N., is Project Manager, School of Nursing, University of KwaZulu-Natal, Durban, South Africa.
    Search for more papers by this author
  • William L. Holzemer,

    1. Ph.D., R.N., FAAN, is Professor and Associate Dean, UCSF School of Nursing, University of California-San Francisco, San Francisco, California, USA.
    Search for more papers by this author
  • Minrie Greeff,

    1. Ph.D., R.M., R.N., is Professor, School of Nursing Science, North-West University, Potchefstroom Campus, Potchefstroom, South Africa.
    Search for more papers by this author
  • Lucy N. Makoae

    1. R.M., R.N., is Lecturer, School of Nursing, National University of Lesotho, Maseru, Lesotho.
    Search for more papers by this author


Priscilla Dlamini, Department of General Nursing Science, Faculty of Health Sciences, University of Swaziland, PO Box 369, Mbabane, Swaziland. E-mail: pdlamini@healthsci.uniswa.sz and spdlamini@swazi.net

Abstract

ABSTRACT Objective: To explore the experience of HIV/AIDS-related stigma for people living with HIV/AIDS (PLWA) in Lesotho, Malawi, South Africa, Swaziland, and Tanzania.

Design and sample: Descriptive study using 43 focus groups (n=251 participants), which included male and female PLWA from both rural and urban areas and nurses working with PLWA.

Methods: Participants were asked to relate incidents of HIV/AIDS-related stigma that they had experienced or observed. Focus group discussions were taped, and data were content analyzed to identify examples of abuse (verbal and physical abuse and neglect) related to HIV/AIDS stigma. Data analysis also explored targets of abuse, abusers, and consequences of abuse.

Results: Participant reports documented extensive verbal and physical abuse and neglect or negating (disallowing of access to services and opportunities) experienced by PLWA and observed by nurses caring for them, and identified negative consequences experienced by PLWA whose HIV-positive status was disclosed to family, friends, or community members.

Conclusions: Health care workers who encourage PLWA to disclose their HIV status must carefully consider the implications of encouraging disclosure in an environment with high levels of stigma, and must recognize the real possibility that PLWA may experience serious verbal and physical abuse as a consequence of disclosure.

Ancillary