Electronic Theses and Dissertations

Date

2025

Document Type

Dissertation

Degree Name

Doctor of Philosophy

Department

Social & Behavioral Sciences

Committee Chair

Latrice Pichon

Committee Member

Heather Brandt

Committee Member

Marian Levy

Committee Member

Satish Kedia

Abstract

HIV-related stigma remains a substantial barrier to enhancing access to prevention, testing, and treatment, thereby perpetuating health disparities. Faith-based organizations, which serve as integral components of many Southern communities, possess the capacity to function as influential platforms for addressing this stigma and are pivotal allies in the Ending the HIV Epidemic (EHE) initiative. These environments, encompassing churches and health clinics, have the potential to cultivate supportive atmospheres for individuals living with HIV (PLWH) and to contribute to stigma reduction initiatives actively. A significant challenge in these efforts lies in the pressing need for more effective measurement tools to assess HIV-related stigma, particularly within faith-based communities. Current stigma measurement scales frequently fail to capture the nuanced lived experiences of people living with HIV (PLWH), often neglecting essential constructs such as internalized stigma. This dissertation presents a multi-study analysis designed to evaluate and enhance the efficacy of stigma measurement tools. The first study encompasses a systematic review that identifies critical gaps in existing scales, underscoring their limitations in addressing the complexity of stigma within faith-based contexts. The second study involves a secondary data analysis that juxtaposes quantitative measures, such as the Berger HIV Stigma Scale and the Wright Stigma Scale, against qualitative insights derived from the Snap Out Stigma Photovoice project. This mixed-methods approach elucidates that existing scales frequently overlook deeper, unmeasured dimensions of stigma, particularly in Black individuals living with HIV. The third study emphasizes the necessity of incorporating the perspectives of people living with HIV (PLWH) into the development of stigma scales, ensuring that these instruments accurately reflect the complex nature of stigma in faith-based settings. Findings indicate that comprehensive community engagement and inclusivity in the design and implementation of HIV stigma scale assessments are imperative for identifying internalized stigma. This research highlights the need for culturally sensitive, community-informed stigma reduction strategies that specifically address internalized stigma concerning age, identity, and religiosity. By refining stigma measurement tools and crafting inclusive interventions, public health endeavors can better align with the lived experiences of PLWH, thereby advancing the objectives of the EHE initiative and enhancing health outcomes within faith-based populations.

Comments

Data is provided by the student.

Library Comment

PDF

Notes

Open access.

Download

Share

COinS