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Gossips, rumours and `making me funny': exploring the role of stigma and its impact on disclosure reported by individuals attending an antiretroviral drug clinic in Cape Town, South Africa

Date: Poster sessions
Source: Forum 11
Authors: Naeemah Abrahams, Researcher, Gender and Health Research Unit, South African Medical Research Council, South Africa
with Siphokazi Dada and Rachel Jewkes


Stigma and discrimination against HIV positive individuals has been identified as one of the greatest barriers to the successful implementation of the South African national HIV plan, and the need to understand how stigma is experienced is important for the development of strategies to improve HIV testing and treatment.

The objective of the research was to explore the role of stigma among a group of individuals attending an antiretroviral drug clinic in Cape Town, South Africa.

Qualitative research methods using in-depth interviews were conducted with 20 women and men who attended an antiretroviral treatment clinic. Between 1 and 3 interviews were conducted with each individual to explore the social experience of being HIV positive and being on antiretroviral treatment.

A treatment buddy was a precondition to commence antiretroviral treatment and this person was chosen based on whether the person was trusted by the patient. All participants chose same sex buddies, with elder sisters often the preferred person. Determining if someone frequented shebeens (township bars), which could provide opportunities for gossip, was also considered. Involvement in arguments, where the risk for insults related to HIV status arises, was also avoided. Body shape was an important source of rumours, including both weight loss and physical changes as a result of antiretroviral treatment. All participants spoke of being the victims of mockery and had developed strategies to determine potential stigma responses during conversations with others. A few participants did not reside in the research area and preferred to attend a clinic outside of their community to avoid stigma. Health workers were also often identified as a source of gossip.

The study has highlighted the huge burden carried by people living with HIV and showed the many strategies they have to developed to avoid stigma. The HIV epidemic in South Africa has reached the stage where many more people will require antiretroviral treatment and decreasing stigma should be an essential aspect of the national treatment plan.