Elkington Katherine S, Hackler Dusty, Walsh Tracy A, Latack Jessica A, McKinnon Karen, Borges Cristiane, Wright Eric R, Wainberg Milton L
HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute (NYSPI) and Columbia University, NY, NY.
Columbia Mental Health HIV Training Project, New York State Psychiatric Institute, NY, NY.
J Adolesc Res. 2013 May;28(3):378-404. doi: 10.1177/0743558412467686.
The current study examines the role of mental illness-related stigma on romantic or sexual relationships and sexual behavior among youth with mental illness (MI), including youths' experiences of stigma, the internalization of these experiences, and the behavior associated with managing stigma within romantic and sexual relationships. We conducted in-depth interviews with N=20 youth with mental illness (MI) (55% male, 16-24 years, 75% Latino) from 4 psychiatric outpatient clinics in New York City. We conducted a thematic analysis to investigate shared experiences of MI stigma and its impact on youth's sexual or romantic relationships and associated behaviors. Our analysis revealed four main themes: 1) societal perceptions of those with MI as partners (societal stigma); 2) individual experiences of stigma within relationships (individual level); 3) internalized stigma of self as a partner (social-psychological processes); and 4) managing a stigmatized identity, of which some of the behaviors directly placed them at increased risk for HIV. We found that just under half of the sample (n=9/20) endorsed all themes, including engaging in HIV/STI sexual risk behaviors as a method to manage a stigmatize identity, which suggests that MI stigma and sexual risk may be linked. We discuss differences by gender and diagnosis. Findings provide new information for providers and researchers to address on the role of stigma experiences in the romantic and sexual behavior of youth in psychiatric treatment. Implications for stigma and HIV/STI prevention interventions are discussed.
本研究考察了与精神疾病相关的污名对患有精神疾病（MI）的青少年在恋爱或性关系及性行为方面的影响，包括青少年的污名经历、这些经历的内化，以及在恋爱和性关系中与应对污名相关的行为。我们对来自纽约市4家精神科门诊诊所的N = 20名患有精神疾病（MI）的青少年（55%为男性，年龄在16 - 24岁之间，75%为拉丁裔）进行了深入访谈。我们进行了主题分析，以调查精神疾病污名的共同经历及其对青少年性或恋爱关系及相关行为的影响。我们的分析揭示了四个主要主题：1）社会对患有精神疾病者作为伴侣的看法（社会污名）；2）恋爱关系中个体的污名经历（个体层面）；3）自我作为伴侣的内化污名（社会心理过程）；4）管理有污名的身份，其中一些行为直接使他们面临更高的感染艾滋病毒风险。我们发现，样本中近一半（n = 9/20）认可所有主题，包括将参与艾滋病毒/性传播感染的性风险行为作为管理有污名身份的一种方式，这表明精神疾病污名与性风险可能存在关联。我们讨论了性别和诊断方面的差异。研究结果为提供者和研究人员提供了新的信息，以探讨污名经历在接受精神科治疗的青少年恋爱和性行为中的作用。还讨论了污名及艾滋病毒/性传播感染预防干预措施的意义。
