From self-stigma to self-worth: understanding self-stigma through developing, implementing and evaluating a selfstigma intervention among people living with HIV and AIDS “Change your thoughts and you change the world”

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dc.check.chapterOfThesisChapter 8en
dc.contributor.advisorArensman, Ella
dc.contributor.advisorMatvienko-Sikar, Karen
dc.contributor.advisorexternalByrne, Elaine
dc.contributor.advisorexternalConroy, Ronan
dc.contributor.authorFerris France, Nadineen
dc.date.accessioned2025-01-31T15:16:02Z
dc.date.available2025-01-31T15:16:02Z
dc.date.issued2023
dc.date.submitted2023
dc.description.abstractBackground Stigma is a global public health threat that can have consequences for the epidemiology of HIV and other health conditions. Though research has been conducted examining stigma in the context of HIV and AIDS, disability and illness, mental health and physical deformities, much less is understood about self-stigma. HIV-related self-stigma is the result of complex interactions between social, contextual, and self factors. Self-stigma can have serious negative effects, including feelings of isolation, lower quality of life and mental health status, impaired social interaction, and reduced health service utilisation, treatment compliance and adherence. This thesis aims to better understand self-stigma among people living with HIV, in terms of what it is and how it manifests through developing, implementing and evaluating a self-stigma intervention. Methods This doctoral work adopted a mixed methods research design using an implementation science approach, and is comprised of five studies. Study 1 was an exploratory qualitative study that explored the core beliefs of people living with HIV in Ireland (Chapter 3). Study 2 was an implementation mixed methods study to examine the potential role of an inquiry-based stress reduction (IBSR) intervention in helping adults living with HIV (PLHIV) to overcome self-stigma and associated states in Zimbabwe (Chapter 4). Study 3 was an exploratory qualitative study to explore the beliefs, experiences and impacts of HIV-related self-stigma amongst adolescents and young people living with HIV in Zimbabwe (AYPLHIV) (Chapter 5). Study 4 was a qualitative study to understand the perceived impact and process of an IBSR intervention aimed at increasing self-worth and wellbeing by reducing selfstigma among AYPLHIV in Zimbabwe (Chapter 6). Finally, Study 5 was a systematic review to identify, assess and summarise the extant literature to explore what interventions exist to reduce and measure self-stigma among PLHIV (Chapter 7). Results The first study (Chapter 3) identified core beliefs and functions of self-stigma, categorising them into four main areas: disclosure; sexuality and sexual pleasure; self-perception and body; and illness and death. Findings also indicate coping strategies such as community involvement, personal development, and positive attitude. The community-based intervention using IBSR developed and evaluated in the second study, (Chapter 4) demonstrated significant reductions in self-stigma, depression, and fears around disclosure. The third study (Chapter 5), found that selfstigma is frequently experienced by AYPLHIV in Zimbabwe, leading to negative self-perceptions, impact on relationships, and isolation. The fourth study (Chapter 6) built on the findings of the previous studies to develop and evaluate a peer-led intervention for AYPLHIV, combining IBSR with creative techniques and mindfulness, resulting in improvements in self-worth, self-agency, and communication. Findings of the fifth study (Chapter 7), a systematic review of interventions to reduce self-stigma among people living with HIV, identified 31 studies using various intervention approaches, the majority of which showed promise for self-stigma reduction. Conclusion Overall, this doctoral work makes a unique and valuable contribution to the existing gaps in that it increased understanding of the causes, impacts and core-beliefs of self-stigma as well as developed and evaluated an IBSR-based intervention that demonstrates improvement in wellbeing and self-worth among adults and adolescents living with HIV. A number of recommendations for research, policy and future practice are made.
dc.description.statusNot peer revieweden
dc.description.versionAccepted Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationFerris France, N. 2023. From self-stigma to self-worth: understanding self-stigma through developing, implementing and evaluating a selfstigma intervention among people living with HIV and AIDS “Change your thoughts and you change the world”. PhD Thesis, University College Cork.
dc.identifier.endpage279
dc.identifier.urihttps://hdl.handle.net/10468/16952
dc.language.isoenen
dc.publisherUniversity College Corken
dc.rights© 2023, Nadine Ferris France.
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subjectStigma
dc.subjectSelf-stigma
dc.subjectInternalised stigma
dc.subjectHIV
dc.subjectInquiry-based stress reduction
dc.subjectIBSR
dc.subjectInternal stigma
dc.subjectCreativity
dc.titleFrom self-stigma to self-worth: understanding self-stigma through developing, implementing and evaluating a selfstigma intervention among people living with HIV and AIDS “Change your thoughts and you change the world”
dc.typeDoctoral thesisen
dc.type.qualificationlevelDoctoralen
dc.type.qualificationnamePhD - Doctor of Philosophyen
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