RESILSTIGMA. Resilience to self-stigmatization experienced by people living with HIV: Which self-reported factors improve awareness among health workers?

<h4>Background</h4>Self-stigmatization is the process by which environmental stigmas are internalized. It leads to a decline in self-esteem, isolation, denial and risk behavior, and impairs quality of life. The aims of our study were to investigate the psychological, social and medical f...

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Main Authors: Christine Jacomet, Cécile Miele, Emilie Goncalves, Céline Lambert, Clément Belletier, Françoise Linard, Josiane Phalip-Le Besnerais, Pierre Dellamonica, Michaël Dambrun
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0311776
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author Christine Jacomet
Cécile Miele
Emilie Goncalves
Céline Lambert
Clément Belletier
Françoise Linard
Josiane Phalip-Le Besnerais
Pierre Dellamonica
Michaël Dambrun
author_facet Christine Jacomet
Cécile Miele
Emilie Goncalves
Céline Lambert
Clément Belletier
Françoise Linard
Josiane Phalip-Le Besnerais
Pierre Dellamonica
Michaël Dambrun
author_sort Christine Jacomet
collection DOAJ
description <h4>Background</h4>Self-stigmatization is the process by which environmental stigmas are internalized. It leads to a decline in self-esteem, isolation, denial and risk behavior, and impairs quality of life. The aims of our study were to investigate the psychological, social and medical factors, in particular psychological flexibility and its defusion component, that are associated with resilience to self-stigmatization in people living with HIV (PLHIV), and to assess clinicians' perceptions of the condition.<h4>Methods</h4>A multicenter observational study was conducted in France using self-reports from PLHIV consulted between January 15, 2022 and June 15, 2022 and from professionals responsible for their care (study registration number 2021-A01588-33/SI:21.02814.000036). Self-stigmatization was measured by examining four domains: perceived stigma, anticipated stigma, internalized stigma and enacted stigma.<h4>Results</h4>Self-reports were collected from 45 hospital wards, 666 from PLHIV, of whom 71% were male with a mean age of 53 +/- 12.6 years, and 131 from health professionals, of whom 72.5% were clinicians. A total of 279 PLHIV (42%) reported items of self-stigmatization. Multivariable analysis showed that self-stigmatization was significantly associated with major depression (OR: 3.59, 95% CI: 1.19 to 10.80, p = 0.02), psychological inflexibility (OR: 1.53, 95% CI: 1.19 to 1.97, p = 0.001), and parental support deficit in childhood (OR parental support: 0.63, 95% CI: 0.40 to 0.98, p = 0.04). Among the dimensions of psychological inflexibility associated with HIV self-stigma, only fusion was positively associated (p<0.01). The proportion of PLHIV experiencing self-stigma was accurately estimated by only 31 (23.7%) health workers. Those health workers who did not minimize the prevalence of self-stigmatization among PLHIV had no particular characteristics.<h4>Conclusions</h4>While the best means to combat self-stigmatization would be a social-ecological approach, it is fundamental to target in parallel individual vulnerability and protective factors accessible to health workers' interventions. Psychiatric care and/or the new cognitive-behavioral therapies could be offered more often as part of personalized care.
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spelling doaj-art-447d7f5b26d74756a9d23d5db501a32f2025-02-12T05:30:57ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01202e031177610.1371/journal.pone.0311776RESILSTIGMA. Resilience to self-stigmatization experienced by people living with HIV: Which self-reported factors improve awareness among health workers?Christine JacometCécile MieleEmilie GoncalvesCéline LambertClément BelletierFrançoise LinardJosiane Phalip-Le BesneraisPierre DellamonicaMichaël Dambrun<h4>Background</h4>Self-stigmatization is the process by which environmental stigmas are internalized. It leads to a decline in self-esteem, isolation, denial and risk behavior, and impairs quality of life. The aims of our study were to investigate the psychological, social and medical factors, in particular psychological flexibility and its defusion component, that are associated with resilience to self-stigmatization in people living with HIV (PLHIV), and to assess clinicians' perceptions of the condition.<h4>Methods</h4>A multicenter observational study was conducted in France using self-reports from PLHIV consulted between January 15, 2022 and June 15, 2022 and from professionals responsible for their care (study registration number 2021-A01588-33/SI:21.02814.000036). Self-stigmatization was measured by examining four domains: perceived stigma, anticipated stigma, internalized stigma and enacted stigma.<h4>Results</h4>Self-reports were collected from 45 hospital wards, 666 from PLHIV, of whom 71% were male with a mean age of 53 +/- 12.6 years, and 131 from health professionals, of whom 72.5% were clinicians. A total of 279 PLHIV (42%) reported items of self-stigmatization. Multivariable analysis showed that self-stigmatization was significantly associated with major depression (OR: 3.59, 95% CI: 1.19 to 10.80, p = 0.02), psychological inflexibility (OR: 1.53, 95% CI: 1.19 to 1.97, p = 0.001), and parental support deficit in childhood (OR parental support: 0.63, 95% CI: 0.40 to 0.98, p = 0.04). Among the dimensions of psychological inflexibility associated with HIV self-stigma, only fusion was positively associated (p<0.01). The proportion of PLHIV experiencing self-stigma was accurately estimated by only 31 (23.7%) health workers. Those health workers who did not minimize the prevalence of self-stigmatization among PLHIV had no particular characteristics.<h4>Conclusions</h4>While the best means to combat self-stigmatization would be a social-ecological approach, it is fundamental to target in parallel individual vulnerability and protective factors accessible to health workers' interventions. Psychiatric care and/or the new cognitive-behavioral therapies could be offered more often as part of personalized care.https://doi.org/10.1371/journal.pone.0311776
spellingShingle Christine Jacomet
Cécile Miele
Emilie Goncalves
Céline Lambert
Clément Belletier
Françoise Linard
Josiane Phalip-Le Besnerais
Pierre Dellamonica
Michaël Dambrun
RESILSTIGMA. Resilience to self-stigmatization experienced by people living with HIV: Which self-reported factors improve awareness among health workers?
PLoS ONE
title RESILSTIGMA. Resilience to self-stigmatization experienced by people living with HIV: Which self-reported factors improve awareness among health workers?
title_full RESILSTIGMA. Resilience to self-stigmatization experienced by people living with HIV: Which self-reported factors improve awareness among health workers?
title_fullStr RESILSTIGMA. Resilience to self-stigmatization experienced by people living with HIV: Which self-reported factors improve awareness among health workers?
title_full_unstemmed RESILSTIGMA. Resilience to self-stigmatization experienced by people living with HIV: Which self-reported factors improve awareness among health workers?
title_short RESILSTIGMA. Resilience to self-stigmatization experienced by people living with HIV: Which self-reported factors improve awareness among health workers?
title_sort resilstigma resilience to self stigmatization experienced by people living with hiv which self reported factors improve awareness among health workers
url https://doi.org/10.1371/journal.pone.0311776
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