Internalized stigma among African Americans living with HIV: Preliminary scale development based on qualitative data

Abstract

In 2004, the Centers for Disease Control reported that AIDS was the leading cause of death for African American women between the ages of 25 and 34 and African American men between the ages of 35 and 44 in the United States. Researchers have explained the impact of HIV/AIDS in African American communities in terms of delays in accessing care and difficulties in adhering to medication regimens. Research findings suggest that culturally appropriate interventions developed to reduce HIV/AIDS stigma could help improve treatment adherence and, in turn, improve health outcomes for African Americans living with HIV/AIDS. In order to better understand the cultural experience of HIV stigma, we conducted 20 individual cognitive interviews with African American men and women living with HIV in Chicago who were seeking treatment from an HIV clinic based at a large academic medical center. We analyzed transcriptions of these interviews using a phenomenological and content analytic framework. The data helped us to adapt a stigma scale to help us better assess the severity of stigma as it is experienced, perceived, and internalized.