Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Aurum Institute for Health Research, Johannesburg, South Africa.
AIDS Educ Prev. 2021 Jun;33(3):202-215. doi: 10.1521/aeap.2021.33.3.202.
People transitioning from incarceration to community-based HIV care experience HIV stigma, incarceration stigma, and the convergence of these stigmas with social inequities. The objective of this study is to understand intersectional stigma among people returning from incarceration with HIV in Gauteng Province, South Africa. Qualitative interviews were conducted with 42 study participants. We analyzed transcript segments and memos from these interviews. Our results showed that anticipated HIV stigma increased participants' difficulty with disclosure and treatment collection. Incarceration stigma, particularly the mark of a criminal record, decreased socioeconomic stability in ways that negatively affected medication adherence. These stigmas converged with stereotypes that individuals were inherently criminal "bandits." Male participants expressed concerns that disclosing their HIV status would lead others to assume they had engaged in sexual activity with men while incarcerated. AIDS education and prevention efforts will require multilevel stigma interventions to improve HIV care outcomes.
从监禁转为社区为基础的艾滋病毒护理的人会经历艾滋病毒耻辱感、监禁耻辱感,以及这些耻辱感与社会不平等的融合。本研究的目的是了解南非豪登省从监禁中返回的艾滋病毒感染者的交叉耻辱感。我们对 42 名研究参与者进行了定性访谈。我们分析了这些访谈的转录片段和备忘录。我们的结果表明,预期的艾滋病毒耻辱感增加了参与者在披露和治疗方面的困难。监禁耻辱感,特别是犯罪记录的标志,以负面方式降低了社会经济稳定性,从而对药物依从性产生了不利影响。这些耻辱感与刻板印象融合在一起,即个人本质上是犯罪的“土匪”。男性参与者表示担心,披露他们的艾滋病毒状况会导致其他人认为他们在监禁期间与男性发生了性行为。艾滋病教育和预防工作需要多层次的耻辱感干预措施,以改善艾滋病毒护理的结果。