Developing a Theory-Based Intervention to Reduce HIV-Related Stigma in a Community in Northern Thailand Pubblico

Abstract

HIV-related stigma is a complex phenomenon that affects different stakeholders in different ways and at different levels. Both people living with HIV/AIDS (PLWHA) and the community are affected by stigma, albeit in different ways. In Thailand, instrumental stigma, i.e. fear of infection, is more common than symbolic stigma, i.e. negative attitudes toward PLWHA, because behaviors associated with HIV are not stigmatized behaviors in Thailand. Social status is likely to influence susceptibility to instrumental stigma in Thailand. In terms of socioeconomic status, less powerful individuals seem to be more vulnerable to stigma and its consequences than the more powerful. Instrumental HIV-related stigma in Thailand can also be present in the form of resource-based stigma especially in communities with limited resources. In summary, HIV-related stigma in Thailand can be characterized as arising from fear of infection and influenced by socioeconomic power.

A multi-level intervention program is proposed in this special study project to reduce HIV-related stigma and ultimately improve the quality of life of PLWHA. Hope House, a faith-based organization in Northern Thailand, and Wang Tao village, the neighboring community of Hope House, are the chosen site where the program will be implemented. The program aims to reduce internalized stigma in PLWHA residents of Hope House by increasing their self-esteem and to decrease instrumental stigma in the community by means of an education program. By empowering PLWHA residents to the level of self- reliance, it should also lessen the degree of resource-based stigma in PLWHAs and people in the community. An HIV/AIDS education program that increases the opportunity for community members to interact with PLWHAs is also envisaged to reduce instrumental stigma. Activities that encourage communication between people in the community and PLWHA residents should reduce stigma in both groups and thus improve the quality of life in PLWHA residents of Hope House.

Table of Contents

Table of Contents
CHAPTER 1: INTRODUCTION...1

1.1 Introduction and Rationale...1
1.2 Hope House: Background...4
1.3 Problem Statement...6
1.4 Purpose Statement...6
1.5 Research Question...7
1.6 Significance Statement...7
1.7 Methodology...8
1.8 Definition of Terms...8

CHAPTER 2: LITERATURE REVIEW...10

2.1 Status of HIV/AIDS Epidemics in Thailand...10
2.2 HIV/AIDS Stigma...12
2.3 HIV/AIDS Stigma Measures...14
2.4 Impacts of HIV/AIDS Stigma...15

2.4.1 Impacts on PLWHA individual...16
2.4.2 Impacts on the uninfected, including family and community...16
2.4.3 Impact on epidemic control and healthcare...17

2.5 Characteristics of HIV/AIDS Stigma in Thailand...18
2.6 Interventions to Help Reduce HIV/AIDS Stigma...18
2.7 Role of Religions (Buddhism and Christianity) to Help Reduce HIV/AIDS Stigma in Thailand...21

CHAPTER 3: PRODUCT PROJECT...24

3.1 Current Situation and Need Statement...24
3.2 Conceptual Framework...26
3.3 Activities for PLWHA Residents of Hope House...27

3.3.1 Activities to encourage networking with other care programs for PLWHA...27
3.3.2 Activities to promote self-esteem and strengthen individual capacity...28
3.3.3 Activities to provide spiritual support and encourage spiritual well-being...30
3.3.4 Activities to promote community connection...31

3.4 Activities for Wang Tao Village Community...33

3.4.1 Activity to provide HIV information to the community...33
3.4.2 Activity to promote communication and contact with PLWHAs...33

3.5 Impact of Activities...34
3.6 Evaluation...35

CHAPTER 4: DISCUSSION AND CONCLUSION...36
REFERENCES...39
APPENDIX A...45
APPENDIX B...48

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Parola chiave	HIV stigma, stigma reduction intervention, resource-based stigma, faith-based organization, Northern Thailand
Committee Chair / Thesis Advisor	Winskell Enger, Kate, Emory University
Partnering Agencies	Does not apply (no collaborating organization)

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