Perceived stigma and social risk of HIV testing and disclosure among Iranian-Australians living in the Sydney metropolitan area
Hassan Hosseinzadeh A C , Syeda Zakia Hossain A and Shahrzad Bazargan-Hejazi BA Discipline of Behavioural and Social Sciences in Health, Faculty of Health Sciences, University of Sydney, Cumberland Campus C42, East Street, PO Box 170, Lidcombe, NSW 2141, Australia.
B Department of Psychiatry, Charles Drew University of Medicine and Science, Semel Institute for Neuroscience and Human Behaviour, David Geffen School of Medicine, University of California, Los Angeles, 1731 East 120th Street, Los Angeles, CA 90059, USA.
C Corresponding author. Email: h.hosseinzadeh@ymail.com; h.hosseinzadeh@uws.edu.au
Sexual Health 9(2) 171-177 https://doi.org/10.1071/SH10111
Submitted: 8 September 2010 Accepted: 20 June 2011 Published: 24 August 2011
Abstract
Background: Fear of being stigmatised is a major social risk for seeking help in the HIV/AIDS arena. However, little is known about the social perceptions that people hold about the disease. This study explores the level of perceived stigma and its effect on the social risk of HIV testing and disclosure among Iranian-Australians immigrants living in the Sydney metropolitan area. Methods: A total of 236 Iranian-Australians immigrants aged 20–65 years participated in this cross-sectional study. Results: The majority of respondents (73.3%) perceived that HIV-infected people face a great deal of or some stigma. Participants were concerned about being stigmatised if they tested positive or were known to be HIV-positive in the future. A significant majority expressed that such concerns would affect their decision-making related to HIV testing and disclosure. Females were more likely to perceive HIV/AIDS stigma. Multiple regression analyses showed that perceived HIV/AIDS stigma could explain 28.6% of the variance in social risk of HIV testing and disclosure (B = 0.89, β = 0.53, P < 0.0001) and 24.6% of the variance in decision-making related to HIV testing and disclosure (B = 0.62, β = 0.49, P < 0.0001) after controlling for sociodemographic factors. Time since migration (predictive power of 4.8–6.78%) strongly influenced the associations. Conclusions: If social stigma is left unaddressed, individuals would be reluctant to undertake HIV testing or disclose their HIV status if tested positive. Further attempts are needed to change the current social construction of HIV/AIDS among Iranians-Australians living in Sydney.
Additional keywords: Australia, immigrants, HIV/AIDS, social perceptions.
References
[1] Goffman E. Stigma: notes on the management of spoiled identity. Englewood Cliffs, NJ: Prentice-Hall; 1963.[2] Herek GM, Widaman KF, Capitanio JP. When sex equals AIDS: symbolic stigma and heterosexual adults’ inaccurate beliefs about sexual transmission of AIDS. Soc Probl 2005; 52 15–37.
| When sex equals AIDS: symbolic stigma and heterosexual adults’ inaccurate beliefs about sexual transmission of AIDS.Crossref | GoogleScholarGoogle Scholar |
[3] Greene K, Derlega VJ, Yep GA, Petronio S. Privacy and disclosure of HIV in interpersonal relationships, 1st edition. Mahwah, NJ: Lawrence Erlbaum; 2003.
[4] Ma W, Detels R, Feng Y, Wu Z, Shen L, Li Y, et al Acceptance of and barriers to voluntary HIV counselling and testing among adults in Guizhou province, China. AIDS 2007; 21 S129–35.
| Acceptance of and barriers to voluntary HIV counselling and testing among adults in Guizhou province, China.Crossref | GoogleScholarGoogle Scholar | 18172381PubMed |
[5] Green G, Sobo EJ. The endangered self: managing the social risk of HIV. London: Routledge; 2000.
[6] Burris S. Surveillance, social risk, and symbolism: framing the analysis for research and policy. J AIDS 2000; 25 S120–7.
[7] Crandall CS, Coleman R. AIDS-related stigmatization and the disruption of social relationships. J Soc Pers Relat 1992; 9 163–77.
| AIDS-related stigmatization and the disruption of social relationships.Crossref | GoogleScholarGoogle Scholar |
[8] Jeffreys E, Matthews K, Thomas A. HIV criminalisation and sex work in Australia. Reprod Health Matters 2010; 18 129–36.
| HIV criminalisation and sex work in Australia.Crossref | GoogleScholarGoogle Scholar | 20541091PubMed |
[9] Grierson J, Power J, Pitts M, Croy S, Clement T, Thorpe R, et al. HIV futures 6: making positive lives count. Melbourne: The Australian Research Centre in Sex, Health and Society, Latrobe University; 2009. Available online at: http://www.latrobe.edu.au/hiv-futures/HIV%20FUTURES%206%20REPORT.pdf [verified March 2010].
[10] Korner H. Negotiating cultures: disclosure of HIV-positive status among people from minority ethnic communities in Sydney. Cult Health Sex 2007; 9 137–52.
| Negotiating cultures: disclosure of HIV-positive status among people from minority ethnic communities in Sydney.Crossref | GoogleScholarGoogle Scholar | 17364722PubMed |
[11] Matteson SE. The effect of knowledge, responsibility, homophobia and personal contact on perceptions of people with HIV and AIDS. Pennsylvania: Indiana University of Pennsylvania; 2000.
[12] Smith RA, Morrison D. The impact of stigma, experience, and group referent on HIV risk assessments and HIV testing intentions in Namibia. Soc Sci Med 2006; 63 2649–60.
| The impact of stigma, experience, and group referent on HIV risk assessments and HIV testing intentions in Namibia.Crossref | GoogleScholarGoogle Scholar | 16930796PubMed |
[13] Korner H. Late HIV diagnosis of people from culturally and linguistically diverse backgrounds in Sydney: the role of culture and community. AIDS Care – Psychological and Socio-Medical Aspects of AIDS/HIV. 2007; 19 168–78.
| 1:STN:280:DC%2BD2s7mt12ktA%3D%3D&md5=23942ac9daab214b507d527edf4eb0bdCAS |
[14] National Centre in HIV Epidemiology & Clinical Research (NCHECR). Australian HIV surveillance report. Sydney: NCHECR; 2009.
[15] Australian Bureau of Statistics. Community information summary. Sydney: Department of Citizenship and Immigration; 2006.
[16] United Nations Program on HIV/AIDS (UNAIDS). AIDS epidemic update 2008. Geneva: UNAIDS; 2008. Available online at: http://data.unaids.org/pub/GlobalReport/2008/jc1510_2008_global_report_pp1_10_en.pdf [verified February 2010].
[17] Ministry of Health and Medical Education (MoHME). HIV/AIDS statistics; update spring 2007. Tehran: MoHME; 2007.
[18] Obermeyer CM. HIV in the Middle East. BMJ 2006; 333 851–4.
| HIV in the Middle East.Crossref | GoogleScholarGoogle Scholar | 17053246PubMed |
[19] Montazeri A. AIDS knowledge and attitudes in Iran: results from a population-based survey in Tehran. Patient Educ Couns 2005; 57 199–203.
| AIDS knowledge and attitudes in Iran: results from a population-based survey in Tehran.Crossref | GoogleScholarGoogle Scholar | 15911193PubMed |
[20] Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine 2000; 25 3186–91.
| Guidelines for the process of cross-cultural adaptation of self-report measures.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3M7jt1Cmug%3D%3D&md5=924a110353c2e21dfc7826eb89634faaCAS | 11124735PubMed |
[21] Guillemin F, Bombardier C, Beaton D. Cross-cultural adaptation of health-related quality of life measures: literature review and proposed guidelines. J Clin Epidemiol 1993; 46 1417–32.
| Cross-cultural adaptation of health-related quality of life measures: literature review and proposed guidelines.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2c%2Foslalsg%3D%3D&md5=63fb107fea61e018949e2e115b9f143dCAS | 8263569PubMed |
[22] Herek GM, Capitanio JP, Widaman KF. Stigma, social risk, and health policy: public attitudes toward HIV surveillance policies and the social construction of illness. Health Psychol 2003; 22 533–40.
| Stigma, social risk, and health policy: public attitudes toward HIV surveillance policies and the social construction of illness.Crossref | GoogleScholarGoogle Scholar | 14570537PubMed |
[23] de Bruyn M, Paxton S. HIV testing of pregnant women – what is needed to protect positive women’s needs and rights? Sex Health 2005; 2 143–51.
| HIV testing of pregnant women – what is needed to protect positive women’s needs and rights?Crossref | GoogleScholarGoogle Scholar | 16335542PubMed |
[24] Parker R, Aggleton P.. HIV and AIDS-related stigma and discrimination: a conceptual framework and implications for action. Social Science & Medicine 2003; 57 13–24.
| HIV and AIDS-related stigma and discrimination: a conceptual framework and implications for action.Crossref | GoogleScholarGoogle Scholar |
[25] Wolfe WR, Weiser SD, Bangsberg DR, Thior I, Makhema JM, Dickinson DB, et al Effects of HIV-related stigma among an early sample of patients receiving antiretroviral therapy in Botswana. AIDS Care 2006; 18 931–3.
| Effects of HIV-related stigma among an early sample of patients receiving antiretroviral therapy in Botswana.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD28rotVSlsQ%3D%3D&md5=aebe93c4d25c913dbb42de6e5e29b43aCAS | 17012082PubMed |
[26] Parasnis J. Segregation in the Australian labour market. Aust Econ Pap 2006; 45 318–32.
| Segregation in the Australian labour market.Crossref | GoogleScholarGoogle Scholar |
[27] Link BG, Phelan JC. Conceptualizing stigma. Annu Rev Sociol 2001; 27 363–85.
| Conceptualizing stigma.Crossref | GoogleScholarGoogle Scholar |
[28] Kinsler JJ, Lee SJ, Sayles JN, Newman PA, Diamant A, Cunningham W. The impact of acculturation on utilization of HIV prevention services and access to care among an at-risk Hispanic population. J Health Care Poor Underserved 2009; 20 996–1011.
| The impact of acculturation on utilization of HIV prevention services and access to care among an at-risk Hispanic population.Crossref | GoogleScholarGoogle Scholar | 20168013PubMed |
[29] Lopez-Quintero C, Shtarkshall R, Neumark YD. Barriers to HIV-testing among Hispanics in the United States: analysis of the National Health Interview Survey, 2000. AIDS Patient Care STDS 2005; 19 672–83.
| Barriers to HIV-testing among Hispanics in the United States: analysis of the National Health Interview Survey, 2000.Crossref | GoogleScholarGoogle Scholar | 16232051PubMed |
[30] Parra EO, Doran TI, Ivy LM, Ramirez Aranda JM, Hernandez C. Concerns of pregnant women about being tested for HIV: a study in a predominately Mexican-American population. AIDS Patient Care STDS 2001; 15 83–93.
| Concerns of pregnant women about being tested for HIV: a study in a predominately Mexican-American population.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3MvptFCnsA%3D%3D&md5=f10d9f8844adb98659f1162c0b97942bCAS | 11224934PubMed |
[31] Persson A, Richards W. From closet to heterotopia: a conceptual exploration of disclosure and ‘passing’ among heterosexuals living with HIV. Cult Health Sex 2008; 10 73–86.
| From closet to heterotopia: a conceptual exploration of disclosure and ‘passing’ among heterosexuals living with HIV.Crossref | GoogleScholarGoogle Scholar | 18038282PubMed |
