Felt stigma among people living with HIV/AIDS in rural and urban Kenya

VN Yebei, JB Fortenberry, DO Ayuku

Abstract
Background: Individuals suffer from felt stigma when they internalize negative perceptions regarding themselves. People living with HIV (PLWH) employ diverse coping mechanisms when their self worth and networks are disrupted by stigma. The social network perspective suggests response to stigma is shaped by social context.

Objective: This paper examines whether internalized HIV stigma among PLWH changes over time, and whether it differs with demographics and rural or urban location.

Methods: Semi-structured interviews were conducted with support group members in two waves that were 12 months apart. Current analyses focus on examining whether HIV felt stigma differs with demographic characteristics and rural or urban location. Further, we explore whether there is variation in magnitude of change at the two sites over time. T-tests are used to compare each stigma item by waves and sites. Factor analysis is utilized to correlate and reveal the relationship between stigma items, while bivariate and logit models investigate the relationship between stigma items and site, gender, marital status and education.

Results: Study findings highlight a gender and rural-urban dichotomy that seems to influence the experience of HIV felt stigma. Being urbanite and being female significantly decreases agreement with selected stigma items. While the urban sample reveals significant
difference between the two waves, the rural experience indicates insignificant change over time. The difference between the two sites reflects a distinction between modern and pre-modern social structures.

Conclusions: This study suggests internalized feelings of HIV stigma may vary with social context and gender. Thus, interventions to support PLWH in Kenya must take into account gender and unique social configurations.