HIV-related stigma across cultures: Adding family into the equation

Abstract

The experience of people living with HIV/AIDS (PLWHA) and that of their family is intertwined in varying extent across cultures. Although the lives of both parties would be affected by the disease regardless of their ethnicity and culture, the impact may be manifested in various ways within different cultures and contexts. Within individualistic cultures, HIV contraction is more likely to be regarded as a personal issue or responsibility, and thus, the reputation of the family having a member with HIV/AIDS may be left intact. On the other hand, within collectivistic cultures, HIV-related stigma may, in a moral sense, bring shame to the family, which may threaten the reputation and identity of the entire family. In this chapter, the situation of HIV-related stigma within and beyond the family context will be discussed. In addition to addressing the effects of HIV-related stigma on the family, the effects of family relationships and communication on self-stigma and well-being of people living with HIV/AIDS (PLWHA) will be explored. On the one hand, family can be an essential resource for promoting the health and well-being of PLWHA; on the other hand, it can potentially incur stress and burden onto them as well as how they perceive the illness. Moreover, the heightened HIV-related stigma in collectivistic cultures will be examined with illustration from research on the Chinese communities. Some current family-based HIV interventions and recommendations on related research will be made at the end of the chapter. Given that HIV/AIDS is a chronic illness that impacts both physical and mental health of PLWHA, the integration of familial and cultural considerations in the promotion of PLWHA's well-being is essential in service planning and delivery.