219668 Prevalence and predictors of HIV-related stigma among institutional- and community-based caregivers of orphans and vulnerable children living in five less wealthy countries

Tuesday, November 9, 2010

Lynne C. Messer, PhD , Duke Global Health Institute, Center for Health Policy and Inequalities Research, Duke University, Durham, NC
Brian Pence, MPH, PhD , Duke Global Health Institute, Center for Health Polic, Duke University, Durham, NC
Kathryn Whetten, MPH, PhD , Center of Health Policy, Duke University, Durham, NC
Rachel Whetten, MPH , Center of Health Policy, Health Inequalities Program, Duke University, Durham, NC
Nathan Thielman, MD, MPH , Department of Medicine and Infectious Disease, Duke University, Durham, NC
Karen O'Donnell, PhD , Department of Pediatrics, Duke Child and Family Studies, Duke University, Durham, NC
Jan Ostermann, PhD , Duke Global Health Institute Center of Health Policy, Kilimanjaro Christian Medical Centre/Duke University, Durham, NC
Background. In the face of the HIV / AIDS epidemic that has contributed to the dramatic increase in orphans and abandoned children (OAC) worldwide, caregiver attitudes about HIV is one attribute that may affect caregiving. Little research has considered the caregiving implications of individual attributes; this paper will describe HIV-related stigma among caregivers of OAC in 5 less wealthy nations. Methods. Caregiver characteristics (1,480 community- and 192 institution-based caregivers) are described using means and standard deviations (continuous variables) and percentages (categorical variables). Logistic regression models were fit, both for the full sample and separately for community- and institution-based caregivers, to explore predictors of HIV acceptance. Results. Approximately 80% of both community- and institution-based caregivers were female; and 84% of institution-based caregivers, compared to 66% of community-based caregivers, said that they would be willing to care for a relative with HIV. In a multivariable model predicting willingness to care for an HIV-infected relative, being an institution-based caregiver was associated with greater willingness (less stigma) than community-based caregivers. Decreased willingness was reported by older respondents; willingness increased with greater formal education. Adjusted models predicting willingness to allow one's child to play with an HIV-infected child are also considered. Conclusions. OAC already face stigma as a result of their orphaned or abandoned status; the addition of HIV-related stigma represents a double burden for these children. Further research on caregivers attributes and implications of stigma for child development will be critical as the policy community responds to the global HIV / AIDS orphan crisis.

Learning Areas:
Public health or related research
Social and behavioral sciences

Learning Objectives:
1. Define HIV-related stigma 2. Identify correlates of HIV-related stigma among caregivers of OAC 3. Discuss how HIV-related stigma differs between institution- and community-based caregivers 4. Name implications of HIV-related stigma for OAC health and development

Keywords: Caregivers, HIV/AIDS

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the project director on the study from which these data were collected.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4326.0: Poster Session 4: HIV/AIDS