Exploring AIDS related stigma in Puerto Rico

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DESCRIPTION (Provided by applicant): The HIV/AIDS epidemic is one that poses multiple challenges such as prevention, working conditions for affected people, access to treatment, medical insurance for those affected, psychological services, and human rights protection. These challenges are embedded in another type of epidemic, which co-exists with the biological one; that is an epidemic of stigma. In other words, negative meanings and attributions are linked to the disease itself or to people living with it. Detrimental effects of stigma includes the deterioration of interpersonal relations, the manifestation of negative emotions, avoidance of HIV testing, experimenting stress, and the development of punitive policies by government officials. AIDS related stigma also has negative psychological effect which include: anxiety, depression, guild, loss of social support, isolation, disruption of family dynamics, physical and emotional violence, and the deterioration of productive relations with physical and mental health related professionals. These stigmatizing attitudes towards people living with HIV/AIDS have been documented amongst society in general. Particularly alarming is their existence among health service providers. Considering the important role that these professionals play in the lives of those affected by this epidemic, it is important to address AIDS related stigma among them. Still, little research has been carried out to understand AIDS related stigma among Latinos/as or to develop interventions for stigma reduction among health professionals. The objective of this proposal is to explore: a) the stigmatizing experiences of people living with HIV/AIDS in Puerto Rico, b) the negative consequences of this stigmatization, and c) the manner in which people cope with them. With this information an intervention module will be developed and implemented with a sample of HIV/AIDS related health services professionals with the aim of: a) raising their awareness of the existence and consequences of AIDS related stigma on people living with HIV/AIDS, b) providing them with skills to help people living with HIV/AIDS manage the effects of feeling stigmatized, and c) reducing their own stigma towards people living with HIV/AIDS. Due to the exploratory nature of this research, its novelty in the Puerto Rican context, and previous recommendations by AIDS related stigma researchers a qualitative method is proposed. The initial research question will be explored through the implementation of in-depth interviews. These will be carried out with seropositive people (n=30) infected via drug injection, heterosexual contact, and homosexual contact so as to gather information on the different stigmatizing situations that people infected through the most common means of infection in Puerto Rico have experienced. Afterwards, an intervention module of health services providers (n=25) will be developed, implemented and evaluated.