A Concept Analysis of HIV-Related Stigma


  • Natawan Khumsaen Boromarajonani College of Nursing, Suphanburi, Faculty of nursing, Praboromarajchanok Institute, Thailand
  • Supannee Peawnalaw Boromarajonani College of Nursing, Suphanburi, Faculty of nursing, Praboromarajchanok Institute, Thailand
  • Jintana Pechmanee Boromarajonani College of Nursing, Suphanburi, Faculty of nursing, Praboromarajchanok Institute, Thailand
  • Jittima Duangkaew Boromarajonani College of Nursing, Suphanburi, Faculty of nursing, Praboromarajchanok Institute, Thailand


HIV, stigma, concept analysis


HIV-Related Stigma has been important in nursing care and nursing research in people living with HIV (PLWH) and it is interesting concept, however, it is ambiguous in the phenomenon of HIV nursing. This paper aimed to analyze the concept of a HIV-related stigma and to clarify the meaning, define the attributes, and explain a term and the scope of the concept. The method used in the analysis
was based on Walker and Avant’s concept analysis which consisted of 8 important steps including selection of a concept of interest, determine the aims or purposes of analysis, identify all uses of the concept, determine the defining attributes, identify a model case, identify borderline, related, and contrary cases, identify antecedents and consequences, and define empirical referents, respectively.
Results of the concept analysis of HIV-related stigma are the following. HIV-related stigma was defined as negative feelings, beliefs, and attitudes towards people living with HIV. It is the prejudice that comes with labeling an individual as part of a group that is believed to be socially unacceptable. The defining attributes were 1) Unfavorable attitude from an individual or group; 2) Feeling devalued; 3) Unpleasant personal experience; 4) Perceived negative social norms; and 5) Discrimination. In conclusion, HIV-related stigma is a concept related to negative nursing outcomes. Hence, it should be utilized as a guide of assessing quality of nursing care and to develop measurements for the nursing research and nursing theory in the future.
the nursing research and nursing theory in the future.


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1. Yang JP, Simoni JM, Dorsey S, Lin Z, Sun M, Bao M, et al. Reducing distress and promoting resilience:
a preliminary trial of a CBT skills intervention among recently HIV-diagnosed MSM in China.
AIDS Care 2018;30(sup5):S39-S48.
2. Ajong AB, Njotang PN, Nghoniji NE, Essi MJ, Yakum MN, Agbor VN, et al. Quantification and factors
associated with HIV-related stigma among persons living with HIV/AIDS on antiretroviral therapy at
the HIV-day care unit of the Bamenda Regional Hospital, North West Region of Cameroon. Global
Health 2018;14(1)56:1-7.
3. Rice WS, Crockett KB, Mugavero MJ, Raper JL, Atkins GC, Turan B. Association between internalized
HIV-related stigma and HIV care visit adherence. J Acquir Immune Defic Syndr 2017;76(5):482-7.
4. Smit PJ, Brady M, Carter M, Fernandes R, Lamore L, Meulbroek M, et al. HIV-related stigma within
communities of gay men: a literature review. AIDS Care 2012;24(4):405-12.
5. Khumsaen N, Aoup-Por W, Thammachak P. Factors influencing quality of life among people living
with HIV (PLWH) in Suphanburi province, Thailand. J Assoc Nurses AIDS Care 2012;23(1):63-72.
6. Holtz C, Sowell R, VanBrackle L, Velasquez G, Hernandez-Alonso V. A quantitative study of factors
influencing quality of life in rural Mexican women diagnosed with HIV. J Assoc Nurses AIDS Care
7. Dubov A, Galbo P, Altice FL, Fraenkel L. Stigma and shame experiences by MSM who take PrEP
for HIV prevention: a qualitative study. Am J Mens Health 2018;12(6):1843-54.
8. Scambler G. Health-related stigma. Social Health Illn 2009;31(3):441-55.
9. Rodgers BL, Jacelon CS, Knafl KA. Concept analysis and the advance of nursing knowledge:
state of the science. J Nurs Scholarsh 2018;50(4):451-9.
10. Walker LO, Avant KC. Strategies for theory construction in nursing. 6. Pearson Prentice Hall; Upper
Saddle River, NJ: 2019.
11. Wu F, Zhang A, Babbitt A, Ma Q, Eyal N, Pan X, et al. Overcoming HIV stigma? A qualitative
analysis of HIV cure research and stigma among men who have sex with men living with HIV.
Arch Sex Behav 2018;47(7):2061-9.
12. Goffman, Erving. Stigma: note on the management of spoiled identity. New York: Simon and
Schuster; 1963.
13. Chaiyasit Y, Piboonrungroj P. Stigmatization: nursing application to reduce effects for HIV/AIDS
patients. Journal of Nursing Division 2013;40(3):114-25. (in Thai)
14. Chaichan M, Kampraw P. Stigma of HIV: social illness. Journal of the royal Thai Army Nurses.
2014;15(3):170-3. (in Thai).
15. Alexandra Marshall S, Brewington KM, Kathryn Allison M, Haynes TF, Zaller ND. Measuring
HIV-related stigma among healthcare providers: a systematic review. AIDS Care. 2017;29(11):
16. Bharat S. A systematic review of HIV/AIDS-related stigma and discrimination in India: current
understanding and future needs. SAHARA J 2011;8(3):138-49.
17. Sengupta S, Banks B, Jonas D, Miles MS, Smith GC. HIV interventions to reduce HIV/AIDS stigma:
a systematic review. AIDS Behav. 2011;15(6):1075-87.
18. Churcher S. Stigma related to HIV and AIDS as a barrier to accessing health care in Thailand:
a review of recent literature. WHO South East Asia J Public Health 2013;2(1):12-22.
19. Florom-Smith AL, De Santis JP. Exploring the concept of HIV-related stigma. Nurs Forum
20. Stuenkel DL, Wong VK. Stigma. In: Lubkin IM, Larsen PD, editors. Chronic illness impact and
intervention. Burlington: Jones & Bartlett Learning; 2012. p. 47-74.
21. Scambler G. Epilepsy. London: Tavistock Press; 1989.
22. Zarei N, Joulaei H, Darabi E, Fararouei M. Stigmatized attitude of healthcare providers: a barrier
for delivering health services to HIV positive patients. Int J Community Based Nurs Midwifery
23. Thapa S, Hannes K, Cargo M, Buve A, Peters S, Dauphin S, et al. Stigma reduction in relation to HIV
test uptake in low-and middle-income countries: a realist review. BMC Public Health. 2018 Nov
24. Kimera E, Vindevogel S, Reynaert D, Justice KM, Rubaihayo J, De Maeyer J, et al. Experiences and
effects of HIV-related stigma among youth living with HIV/AIDS in Western Uganda: A photovoice
study. PLoS ONE 2020;15(4):1-21.
25. Yeo TED, Chu TH. Social-cultural factors of HIV-related stigma among the Chinese general
population in Hong Kong. AIDS Care. 2017;29(10):1255-9.
26. Fatoki B. Understanding the causes and effects of stigma and discrimination in the lives of
HIV people living with HIV/AIDS: qualitative study. J AIDS Clin Res. 2016;7(12): 1-6.
27. Reinius M, Wettergren L, Wiklander M, Svedhem V, Ekström AM, Eriksson LE. Development of
a 12-item short version of the HIV stigma scale. Health Qual Life Outcomes. 2017;15(1):115
28. Hernansaiz-Garrido H, Alonso-Tapia J. Internalized HIV stigma and disclosure concerns:
development and validation of two scales in Spanish-speaking populations. AIDS Behav. 2017
29. Wagner AC, Hart TA, McShane KE, Margolese S, Girard TA. Health care provider attitudes and
beliefs about people living with HIV: initial validation of the Health Care Provider HIV/AIDS
Stigma Scale (HPASS). AIDS Behav. 2014;18(12):2397-408.
30. Wiklander M, Rydström LL, Ygge BM, Navér L, Wettergren L, Eriksson LE. Psychometric properties
of a short version of the HIV stigma scale, adapted for children with HIV infection. Health Qual
Life Outcomes 2013;14(11):195.
31. Nyblade L, Jain A, Benkirane M, Li L, Lohiniva AL, McLean R, et al. A brief, standardized tool
for measuring HIV-related stigma among health facility staff: results of field testing in China,
Dominica, Egypt, Kenya, Puerto Rico and St. Christopher & Nevis. J Int AIDS Soc 2013;16 (3 Suppl 2):
32. Stringer KL, Turan B, McCormick L, Durojaiye M, Nyblade L, Kempf MC, et al. HIV-related stigma
among healthcare providers in the Deep South. AIDS Behav 2016; 20(1):115-25.
33. Rongkavilit C, Wright K, Chen X, Naar-King S, Chuenyam T, Phanuphak P. HIV stigma, disclosure and
psychosocial distress among Thai youth living with HIV. Int J STD AIDS 2010;21(2):126-32.
34. Fongkaew W, Viseskul N, Suksatit B, Settheekul S, Chontawan R, Grimes RM, et al. Verifying
quantitative stigma and medication adherence scales using qualitative methods among Thai
youth living with HIV/AIDS. J Int Assoc Provid AIDS Care 2014;13(1):69-77.
35. Maluwa M, Aggleton P, Parker R. HIV and AIDS-related stigma, discrimination and human rights.
Health and Human Rights 2002;6:1-18.
36. Parker R, Aggleton P. HIV and AIDS-related stigma and discrimination: a conceptual framework
and implications for action. Soc Sci Med 2003;57(1):13-24.
37. Hatzenbuehler ML, Phelan JC, Link BG. Stigma as a fundamental cause of population health
inequalities. Am J Public Health 2013;103(5):813-21.
38. Park S, Park KD. Family stigma: a concept analysis. Asian Nursing Research 2014;8(3): 165-171.



How to Cite

Khumsaen ณ, Peawnalaw ส, Pechmanee จ, Duangkaew จ. A Concept Analysis of HIV-Related Stigma. JHNR [Internet]. 2020 Nov. 28 [cited 2022 Jun. 26];36(3):305-16. Available from: https://he01.tci-thaijo.org/index.php/bcnbangkok/article/view/247018