Stigma Consciousness, Coping Strategies And Cd4 Counts Of Persons With Hiv/aids

2001), devaluation of their persons bringing negative emotion and causing reduction in immune system.

Based on the foregoing, the internal state of an individual infected with HIV/AIDS is bastardized, leading to developing stigma consciousness. People living with HIV/AIDS show cognitive impairment such as forgetfulness, concentration difficulties, mental slowness, mild motor difficulties, apathetic, and withdrawn behaviour (Sarason & Sarason, 2008). The authors further reported that early symptoms might include depression, apathy, irritability, and psychotic symptoms. The progression of cognitive impairment results in majority of patients developing severe dementia with global loss of cognitive functions, severe psychomotor retardation, mutism, and motor weakness. Literatures have not considered stigma consciousness as one of the psychological experiences of PLWHA except in this study.

Stigma consciousness of PLWHA

The psychological conditions analyzed above can cause stigma consciousness among people living with HIV/AIDS. The issue of concealability can reveal that people living with HIV/AIDS are in continuous battle with their internal states based on the phenomenological experience of the illness. Consciousness may be referred to as the state of the mind through which an individual is aware of mental experiences such as perceptions, thoughts, emotions, and wishes. According to Myers (2005), Pinel (1999) stigma consciousness is viewed as how likely an individual expects that others will stereotype him. Applied to HIV/AIDS, it is how likely those living with HIV/AIDS expect that others will negatively stereotype them because of their HIV/AIDS seropositive status, a situation that creates diversified worries about living with HIV/AIDS.

Feelings of stigma consciousness were established among gays and lesbians on “interpret all my behaviours” in terms of women and other homosexuality (Pinel, 1999). Observing oneself as a victim of pervasive prejudice, such as living with HIV/AIDS, has its ups and downs. This study is interested in the downside, of which Myers (2005) contended that those who perceive themselves as frequent victims live with the stress of stereotype threats (disruptive concern facing negative stereotype) and presumed antagonism and therefore experience lower well-being, that may result to reduction in immune system. This can also be true of those living with HIV/AIDS as stigma consciousness engulfs them resulting to psychological problems that cause downward change in immune system.

Stigma consciousness resembles two related constructs, group identity and group consciousness (Gurin, 1985; Gurin, Miller, & Gurin, 1980). Group identity refers to the extent to which people perceive themselves as being similar and linked in some way to their group members (Gurin etal, 1980; Gurin & Townsend, 1986). Although people high in stigma consciousness may feel a certain degree of connection to other members of their group, such feelings are not a requirement for being high in stigma consciousness (Pinel, 1999). A similar argument applies to the difference between group consciousness and stigma consciousness. Group consciousness refers to a particular political stance, one in which people reject the status of their group and endorse collective action as a means of elevating their groups status (Gurin, et al, 1980; Gurin & Townsend, 1986). Members of virtually any group, advantaged or disadvantaged, can be high in stigma consciousness. People need not feel dissatisfied with the position their group occupies in society at large to be high in stigma consciousness; all that is required is an expectation of being judged on the basis of one’s group membership (Pinel, 1999). But, those living with HIV/AIDS are dissatisfied with their conditions. Therefore stigma consciousness of HIV/AIDS is the expectation by PLWHA that others will negatively stereotype them based on their HIV/AIDS seropositive status. It is a psychological internal state which disposes people living with HIV/AIDS to believe or feel that others will negatively stereotype them because of their HIV/AIDS seropositive status.

Research has demonstrated that disadvantaged or stigmatized group experience stigma consciousness. In one such study Pinel (1999) found that individuals differ in their levels of stigma consciousness. And that, woman high in stigma consciousness are concerned with how they appear to others. Also, there is evidence that scores on stigma consciousness questionnaire for women predicted the perceptions of discrimination, supporting the claim that people who differ in levels of stigma consciousness also differ in the extent to which they feel as though they are judged on the basis of their group membership (Pinel, 1999). In a separate study, Pinel (1999) used 66 participants made up of gay men and lesbians. The participants completed a 10 - item questionnaire for women modified for use with gay men and lesbians. The study found that gay men and lesbians who are high in stigma consciousness, relative to those low in stigma consciousness, are more likely to focus on themselves and worry about how others view them. Evidence has shown that stigma consciousness exist among disadvantaged or stigmatized group. People living with HIV/AIDS (PLWHA) are said to be stigmatized and disadvantaged. Invariably, PLWHA as stigmatized and disadvantaged group experience stigma consciousness. Whether stigma consciousness among PLWHA will influence their immune systems, as measured in CD4 counts has remained unexplored in literature. Thus, this study examined how stigma consciousness would influence immune system among PLWHA.

Coping strategies

Generally, nature has made it that human beings respond to forces impinging on them. People infected with HIV/AIDS and other life threatening illnesses attempt to evoke positive responses to escape or reduce their stressful experiences. Coping is any effort, healthy or unhealthy, conscious or unconscious which an individual adopts to prevent, eliminate or weaken negative emotional feelings or to tolerate their effects in the least hurtful manner. Therefore, coping strategy is any action taken by an individual to reduce the effect of some stressful circumstances in his environment and or escape from their adversity (Weber & Manning, 2001). Three areas of coping strategies of interest to this study are social support, information and problem copings.

Social support

Evidences showing the influence of social support on illness related behaviours have been widely documented in literature. For example, people with few friends or relatives (low social support) tend to have a higher mortality rate than those with higher level of social support (Kaplan, Manuck, Williams & Strawn, 1994). Also, higher levels of social support have been found to be related to lower rates of atherosclerosis (clogging of the arteries) (Seeman & Syme, 1989) and to the ability of women to adjust to chronic rheumatoid arthritis (Goodenow, Reisine, & Grady, 1990). It is possible that social support exert beneficial effects on health related behaviours because of the possibility that those people who have higher levels of social support can eat a healthy diet, not smoking and moderating alcohol intake (Davison & Neal, 2001). In alternative, social support or lack of it could have direct effect on biological processes. For example, low levels of support are related to an increase in negative emotions (Kessler & Mcleod, 1985) and this may affect some hormone levels and immune system (Kiecolt-Glasser et al, 1985). The amount and adequacy of social support available to a person play a part in both vulnerability and other coping processes. Vulnerability to physical and psychological breakdown increases as social support decreases (Sarason & Sarason, 2008). That is, social support can serve as a buffer against psychological upsets. Social support has also been studied in the laboratory to establish cause and effects. In one such a study college–aged women were assigned to high or low stress conditions and experienced them with or without a close friend. In one part of the study, having the experimenter behave coldly and impersonally telling participants to improve in their performance as they worked on a challenging task created stress. For each woman in a social support condition, a close friend “silently cheer on” and sat close to her, placing a hand on her wrist. The dependent variable was blood pressure measured while participants performed the task. The study found, consistent to expectation that high stress led to higher blood pressure levels. The study found that the high stress condition produce its effects on blood pressure primarily in those women who experienced the stress alone. The study concluded that social support has a causal effect on a physiological process (Karmarck, Annunziato & Amaeteau, 1995). Evidence has further shown that social support influence health behaviour only when the support comes from a friend and not when it comes from a stranger. Of course, only a friend can lead an individual to appraise stressful situation such as living with HIV/AIDS as less threatening.

 Since low level of social support is related to an increase in negative emotion, and coping involves cognitive processes that can affect emotion, it is possible that differential levels of social support will interact with the use of coping strategies among people infected with life threatening disease, for example HIV/AIDS, which will invariably affect health, that is immune system, by increasing negative emotion.