Examining Stigma and Disclosure Among Women With HIV in the Southern United States: Qualitative Study Guided by the Adaptive Leadership Framework for Chronic Illness.

J Assoc Nurses AIDS Care

Jacquelyn M. McMillian-Bohler, PhD, CNM, CNE, is an Assistant Professor and Director of the Institute for Educational Excellence, Duke University School of Nursing, Durham, North Carolina, USA. Lauren Holt, MSN, RN, is a PhD Candidate at the Duke University School of Nursing, Durham, North Carolina, USA. Adaora A. Adimora, MD, MPH, is the Sarah Graham Kenan Distinguished Professor of Medicine, School of Medicine and a Professor of Epidemiology, Gillings School of Global Public Health at the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. Donald "Chip" E. Bailey Jr., PhD, RN, FAAN, is an Associate Professor, Duke University School of Nursing, Durham, North Carolina, USA. Ragan Johnson, DNP, FNP-BC, CNE, is an Associate Professor, Duke University School of Nursing, Durham, North Carolina, USA. Amie Koch, DNP, FNP-C, RN, ACHPN, is Assistant Professor, Duke University School of Nursing, Palliative Care and Hospice Family Nurse Practitioner at Transitions LifeCare, and a COVID Nurse Practitioner at Lincoln Community Health Clinic, Durham, North Carolina, USA. Kara McGee, DMS, MSPH, PC-A, AAHIVS, is an Associate Professor, Duke University School of Nursing, Durham, North Carolina, USA. Catalina Ramirez, MPH, CCRP, is a Clinical Research Director, School of Medicine and the Project Director for the Women's Interagency HIV Study at the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. Schenita D. Randolph, PhD, MPH, RN, is an Associate Professor, Duke University School of Nursing, Durham, North Carolina, USA. Tiarney D. Ritchwood, PhD, is an Assistant Professor in the Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, North Carolina, USA. Michael V. Relf, PhD, RN, AACRN, ACNS-BC, ANEF, FAAN, is a Professor of Nursing and Global health at Duke University and is the Associate Dean for Global and Community Health Affairs, Duke, University, School of Nursing, Durham, North Carolina, USA.

Published: January 2023

Stigma is a fundamental cause of health inequities. Guided by the Adaptive Leadership Framework for Chronic Illness (ALFCI), this descriptive qualitative study explored the challenges of stigma and disclosure experienced by women with HIV (WWH) in the Southern United States. A convenience sample of 22 WWH aged 36 to 62 years were interviewed for this study. Analysis of participant interviews revealed that WWH face a multitude of stigma-related technical and adaptive challenges, which are consistent with the ALFCI. Once identified, technical challenges, such as recognizing the need for support, lack of trust, and fear of rejection, can be overcome by technical work, including providing assistance with HIV disclosure and building a trusted network. By identifying specific adaptive and technical challenges faced by WWH and engaging in technical and adaptive work, the WWH and the provider can reduce the fear of disclosure and the effect of stigma.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10122520PMC
http://dx.doi.org/10.1097/JNC.0000000000000354DOI Listing

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