skip to main content

Illuminating the Experience of Stigma among Persons Living with HIV using Participative Drawing Method

*Janet Alexis De los Santos orcid  -  College of Nursing, Visayas State University, Philippines
Open Access Copyright (c) 2022 Nurse Media Journal of Nursing
Creative Commons License This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Citation Format:
Abstract

Background: Arts-based techniques such as drawing is a helpful means in research because of its potential to capture taboo, culturally sensitive issues, and other critical health experiences. However, very few studies integrate the use of drawing as a qualitative method in HIV research.

Purpose: This study aims to explore the experience of stigma among persons living with HIV using the drawing method.

Methods: The study utilized a participative qualitative approach. There were eleven (11) participants who were recruited through snowballing and were asked to draw their experience of stigma as a Person Living with HIV/AIDS (PLHA). The participants were men who-have-sex with men (MSM) who have been diagnosed for at least one year, and are active members of a support group. This preliminary study was conducted in Central Philippines from November-December 2019. The narrative explanations were recorded, transcribed, and analyzed using thematic analysis.

Findings: Results revealed three themes: (1) Psycho-socio-emotional needs which illuminated their need for love and acceptance; (2) Profound feelings which reflected a plethora of negative towards positive convergence of emotions, and (3) Coping with HIV stigma which presented the three-pronged anchor to move forward and sustain a hopeful living.

Conclusion: A stigmatized PLHIV needs intimacy, interconnectedness, and inclusiveness in society. Likewise, they feel a plethora of feelings that transcend negative to positive emotions depending on their coping. A PLHIV copes with stigma and discrimination through the aid of their social circle, spirituality, and self-love. Future researchers may consider the use of participative drawing to explore HIV stigma apart from the conventional interview, as it is found to be a valuable method of facilitating the expression of emotions and experiences.
Fulltext View|Download
Keywords: Drawing, HIV stigma, PLHIV, Philippines, qualitative method

Article Metrics:

  1. Andersson, G. Z., Reinius, M., Eriksson, L. E., Svedhem, V., Esfahani, F. M., Deuba, K., Rao, D., Lyatuu, G. W., Giovenco, D., & Ekström, A. M. (2020). Stigma reduction interventions in people living with HIV to improve health-related quality of life. The Lancet. HIV, 7(2), e129–e140. https://doi.org/10.1016/S2352-3018(19)30343-1
  2. Andrasik, M., Broder, G., Oseso, L., Wallace, S., Rentas, F., & Corey, L. (2020). Stigma, implicit bias, and long-lasting prevention interventions to end the domestic HIV/AIDS epidemic. American Journal of Public Health, 110(1), 67–68. https://doi.org/10.2105/AJPH.2019.305454
  3. Beck, E. J., Espinosa, K., Ash, T., Wickham, P., Barrow, C., Massiah, E., Alli, B., & Nunez, C. (2017). Attitudes towards homosexuals in seven Caribbean countries: Implications for an effective HIV response. AIDS Care, 29(12), 1557–1566. https://doi.org/10.1080/09540121.2017.1316355
  4. Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. https://doi.org/10.1191/1478088706QP063OA
  5. Braun, V., & Clarke, V. (2021). One size fits all? What counts as quality practice in (reflexive) thematic analysis? Qualitative Research in Psychology, 18(3), 328–352. https://doi.org/10.1080/14780887.2020.1769238
  6. Byrne, D. (2021). A worked example of Braun and Clarke’s approach to reflexive thematic analysis. Quality and Quantity, 56(3), 1391–1412. https://doi.org/10.1007/S11135-021-01182-Y/FIGURES/D
  7. Cantisano, N., Rimé, B., & Teresa Munoz Sastre, M. (2015). The importance of quality over in quantity in the social sharing of emotions (SSE) in people living with HIV/AIDS. Psychology, Health & Medicine, 20(1), 103–113. https://doi.org/10.1080/13548506.2014.901544
  8. Creswell, J. W., & Miller, D. L. (2010). Determining Validity in Qualitative Inquiry. Theory into Practice, 39(3), 124–130. https://doi.org/10.1207/S15430421TIP3903_2
  9. De los Santos, J. A. (2020). Healthcare workers attitude and stigma among people living with HIV/AIDS (PLHA): A literature review. Journal of Health and Caring Sciences, 2(2), 150-166. https://doi.org/10.37719/jhcs.2020.v2i2.ra001
  10. De los Santos, J., Milla, N.,Tuppal,C. & Labrague, L.(2022a). Development and psychometric evaluation of the nurse behavior toward confirmed and suspected HIV/AIDS patients (NB-CSHAP) scale. Frontiers of Nursing, 9(1) 103-113. https://doi.org/10.2478/fon-2022-0013
  11. De los Santos, J. A. A., Tuppal, C. P., & Milla, N. E., (2022b). The correlates of health facility-related stigma and health-seeking behaviors of people living with HIV. Acta Medica Philippina. https://doi.org/10.47895/AMP.VI0.4447
  12. DiPierro, M., Fite, P. J., & Johnson-Motoyama, M. (2018). The role of religion and spirituality in the association between hope and anxiety in a sample of Latino youth. Child and Youth Care Forum, 47(1), 101–114. https://doi.org/10.1007/S10566-017-9421-2
  13. Doherty, M., Power, L., Rahman, R., Ferdous, L., Akter, K., Quadir, S., Sharmin, S., Evans, E., & Khan, F. (2019). The psychosocial and spiritual experiences of patients with advanced incurable illness in Bangladesh: A cross-sectional observational study. Indian Journal of Palliative Care, 25(4), 487–493. https://doi.org/10.4103/IJPC.IJPC_113_19
  14. Du, H., Chi, P., & Li, X. (2018). High HIV prevalence predicts less HIV stigma: A cross-national investigation. AIDS Care, 30(6), 714–721. https://doi.org/10.1080/09540121.2017.1401039
  15. Durbin, A., Sirotich, F., Lunsky, Y., Roesslein, K., & Durbin, J. (2017). Needs among persons with human immunodeficiency virus and intellectual and developmental disabilities in community mental health care: A cross-sectional study. Journal of Intellectual Disability Research: JIDR, 61(3), 292–299. https://doi.org/10.1111/JIR.12322
  16. Gameiro, S., de Guevara, B. B., Refaie, E. el, & Payson, A. (2018). Drawing out – An innovative drawing workshop method to support the generation and dissemination of research findings. PLOS ONE, 13(9), e0203197. https://doi.org/10.1371/JOURNAL.PONE.0203197
  17. Handlovsky, I., Ferlatte, O., Kia, H., Knight, R., Broom, A., & Oliffe, J. (2022). Processes underpinning survival in gay men living with HIV and a history of suicidality. Sociology of Health & Illness, 44(7), 1132-1148. https://doi.org/10.1111/1467-9566.13500
  18. Harrison, S., & Li, X. (2019). Rebooting resilience: Shifts toward dynamic, multi-level, and technology-based approaches for people living with HIV. AIDS Care, 30(sup5), S1-S5. https://doi.org/10.1080/09540121.2018.1557592
  19. Heggeness, L. F., Brandt, C. P., Paulus, D. J., Lemaire, C., & Zvolensky, M. J. (2017). Stigma and disease disclosure among HIV+ individuals: The moderating role of emotion dysregulation. AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV, 29(2), 168–176. https://doi.org/10.1080/09540121.2016.1204419
  20. Huang, J., Zhang, J., & Yu, N. X. (2019). Couple identity and well-being in Chinese HIV serodiscordant couples: Resilience under the risk of stigma. AIDS Care, 30(sup5), S58-S66. https://doi.org/10.1080/09540121.2018.1510105
  21. Ibrahim, K., Kombong, R., & Sriati, A. (2019). The difference of perceived HIV stigma between people living with HIV infection and their families. Nurse Media Journal of Nursing, 9(2), 117-127. http://doi.org/10.14710/nmjn.v9i2.24256
  22. Li, A. T. W., Fung, K. P. L., Maticka-Tyndale, E., & Wong, J. P. H. (2018). Effects of HIV stigma reduction interventions in diasporic communities: Insights from the CHAMP study. AIDS Care, 30(6), 739–745. https://doi.org/10.1080/09540121.2017.1391982
  23. Literat, I. (2013). “A pencil for your thoughts”: Participatory drawing as a visual research method with children and youth. Journal of Qualitative Methods, 12(1), 84–98. https://doi.org/10.1177/160940691301200143
  24. Mahamboro, D. B., Fauk, N. K., Ward, P. R., Merry, M. S., Siri, T. A., & Mwanri, L. (2020). HIV stigma and moral judgement: Qualitative exploration of the experiences of HIV Stigma and discrimination among married men living with HIV in Yogyakarta. International Journal of Environmental Research and Public Health, 17(2), 636. https://doi.org/10.3390/IJERPH17020636
  25. Mao, Y., Li, X., Qiao, S., Zhao, Q., Zhou, Y., & Shen, Z. (2018). Social support, stigma, and HIV disclosure among parents living with HIV in Guangxi, China. AIDS Care, 30(2), 168-172. https://doi.org/10.1080/09540121.2017.1387639
  26. Mutonyi, H., & Kendrick, M. E. (2011). Cartoon drawing as a means of accessing what students know about HIV/AIDS: An alternative method. Visual Communication, 10(2), 231–249. https://doi.org/10.1177/1470357211398447
  27. Nyblade, L., Mbuya-Brown, R. J., Ezekiel, M. J., Addo, N. A., Sabasaba, A. N., Atuahene, K., Kiwia, P., Gyamera, E., Akyoo, W. O., Vormawor, R., Manyama, W., Shoko, S., Mingkwan, P., Stewart, C., Balampama, M., Bowsky, S., Jacinthe, S., Alsoufi, N., & Kraemer, J. D. (2020). A total facility approach to reducing HIV stigma in health facilities: Implementation process and lessons learned. AIDS (London, England), 34 Suppl 1, S93–S102. https://doi.org/10.1097/QAD.0000000000002585
  28. Olley, B. O., Ogunde, M. J., Oso, P. O., & Ishola, A. (2016). HIV-related stigma and self-disclosure: The mediating and moderating role of anticipated discrimination among people living with HIV/AIDS in Akure Nigeria. AIDS Care, 28(6), 726–730. https://doi.org/10.1080/09540121.2016.1140894
  29. Philip, S., Neuer Colburn, A. A., Underwood, L., & Bayne, H. (2019). The impact of religion/spirituality on acculturative stress among international students. Journal of College Counseling, 22(1), 27–40. https://doi.org/10.1002/JOCC.12112
  30. Reinius, M., Zeluf Andersson, G., Svedhem, V., Wettergren, L., Wiklander, M., & Eriksson, L. E. (2021). Towards a new understanding of HIV-related stigma in the era of efficient treatment- A qualitative reconceptualization of existing theory. Journal of Advanced Nursing, 77(5), 2472–2480. https://doi.org/10.1111/JAN.14774
  31. Sezgin, F., & Erdoğan, O. (2018). Humility and forgiveness as predictors of teacher self-efficacy. Educational Research and Reviews, 13(4), 120–128. https://doi.org/10.5897/ERR2017.3449
  32. Shrestha, R., Altice, F. L., Sibilio, B., & Copenhaver, M. M. (2019). HIV sero-status non-disclosure among HIV-infected opioid-dependent individuals: The roles of HIV-related stigma, risk behavior, and social support. Journal of Community Health, 44(1), 112-120. https://doi.org/10.1007/S10900-018-0560-7
  33. Stockton, M. A., Giger, K., & Nyblade, L. (2018). A scoping review of the role of HIV-related stigma and discrimination in noncommunicable disease care. PLOS ONE, 13(6), e0199602. https://doi.org/10.1371/JOURNAL.PONE.0199602
  34. Tolleson, A., & Zeligman, M. (2019). Creativity and posttraumatic growth in those impacted by a chronic illness/disability. Journal of Creativity and Mental Health, 14(4), 499–509. https://doi.org/10.1080/15401383.2019.1632769
  35. Tuppal, C. P., Nonobla, N. M. G., Renosa, M. D. C., Ruiz, M. G. D., Loresco, R. C., Tuppal, S. M. P., & Panes, I. I. (2019) Living with HIV/AIDS among men having sex with men (MSM) in the Philippines: Internet ethnography of HIV life stages. Journal of Global Health Reports, 3:e2019090. http://doi.org./10.29392/joghr.3.e2019090
  36. van der Kooij, Y. L., Kupková, A., den Daas, C., van den Berk, G. E. L., Kleene, M. J. T., Jansen, H. S. E., Elsenburg, L. J. M., Schenk, L. G., Verboon, P., Brinkman, K., Bos, A. E. R., & Stutterheim, S. E. (2021). Role of self-stigma in pathways from HIV-related stigma to quality of life among people living with HIV. AIDS Patient Care and STDs, 35(6), 231–238
  37. Wei, W., Li, X., Harrison, S., Zhao, J., & Zhao, G. (2016). The relationships between HIV stigma, emotional status, and emotional regulation among HIV-affected children in rural China. AIDS Care, 28 Suppl 2(sup2), 161–167. https://doi.org/10.1080/09540121.2016.1178974

Last update:

  1. Parents’ Experiences of Caring for Children with Congenital Rubella Syndrome (CRS) in Remote and Rural Areas of Indonesia

    Petrus Kanisius Siga Tage, Herliana Monika Azi Djogo, Erna Febriyanti, Yulia Martiningsih Karmila Letor, Maria Yoanita Bina, Maria Yasintha Goa Goa, Angela Muryanti Gatum. Nurse Media Journal of Nursing, 13 (1), 2023. doi: 10.14710/nmjn.v13i1.50633

Last update: 2024-11-21 11:22:51

No citation recorded.