The Meaning of Stigma and Why It Is Relevant to an Understanding of the Experience of Health - Coursework Example

Nursing: What is stigma and why is it relevant to an understanding of the experience of health? Name Institution Course Date Introduction The social relations in the modern world are faced with ubiquitous issues that often tend to break the link of these relations. Several factors have contributed to the ongoing weakening of social ties including economic factors, health and medical conditions, race, ethnicity or tribe. On the basis of the majority of people’s perspective, having the characteristics of the minority group sets one apart from the large community and therefore not accepted in the social realms. However, the underlying reasons for one to be set apart lies in the history or known information that qualifies him or her to being in the minority category (Gaines 2010). For instance, in United States, although people are not supposed to be discriminated on basis of their color, disability or gender, it is not uncommon to find instances where people especially from the minority, blacks, being discriminated. This has been seen through use of excess force and brutality from police officers in apprehending a black suspect. The reason for the blacks being discriminated is their history and the common belief by majority of white people that African Americans are violent and aggressive people. Similarly, people with medical conditions are not spared of stigmatization and discrimination. This is not explicitly because of their medical or health condition but the perceived or reality of the issues that lead to getting the condition or the issues attributed to the medical conditions. These would include how the medical condition is transmitted and the likely fate of those living with such medical conditions. It has therefore been an issue of concern especially to people living with chronic illnesses or those that suffer from mental illnesses. The most common health conditions that have been discriminated include HIV/AIDs, Cancer, and Schizophrenia among others. This article discusses the meaning of stigma and why it is relevant to an understanding of the experience of health. This will be relation to HIV/AIDS and based impacts on social relations. General view on what Stigma is Different researchers and scholars provide different descriptions in relation to the concept of stigma. According to Galindo (2013), stigmatization is understood as an attribute which links one person to undesirable stereotype and which leads to other people reducing such an individual from an ordinary whole and usual person to a discounted and tainted person. However, this view of stigma has evolved to capture loss of status as well as discrimination and therefore appreciating the fact that stigmatization does occur where culture, power, health status and economical differences are witnessed. This consequently makes stigma to be categorized together with prejudice and discrimination which exist to in social interactions that leads to societal dynamics to progress oppression on the stigmatized lot (Durham 2003). Therefore in such respect, stigma is quite undesirable which is made worse by prejudice which induces negative attitude and discrimination which manifests the negative attitude towards the stigmatized person. Laurie (2005), comments that stigma is a phenomena with far reaching effects on the victims of stigmatization. It is an attribute that discredit a person in the eyes of the society. it is believed that stigmatization occurs when a person possess of is believed to have some features whether physical or intrinsic that convey social identity that is not valued in a given social context (Major & O’Brien 2005). This view believe that the characteristics that lead to stigma may be visible or invisible, controllable in uncontrollable and may be linked to the physical appearance, the behavior or membership to a group (Laurie 2005). Therefore this view is of the opinion that stigma deems to be a relationship that is context specific and which resides in the social context and not in a person. Stigma is associated with negative evaluation and stereotypes which are generally known and widely shared among the members of a community or a given group (Durham 2003). These negative evaluation and stereotypes become the basis for avoiding or excluding people or members of the stereotyped group. Powerful or powerless group members may stigmatize each other depending on the depending on the one in control of certain resources. Similarly, people from high status and low status groups may respond in dramatic ways when they are the target of stigma. Laurie (2005) says that without reference to power, stigmatization can be viewed in very broad way. It shows that stigma occurs when labeling, exclusion, discrimination, negative stereotyping as well as low status occur altogether in a power situation where these concepts do occur. Often, stigma is seen as social construction. The attributes that lead to stigma signal that the person with such attributes is an inadequate partner for social exchange, carries infection or is a member of an out-group that can be exploited for the benefit of in-group. In sociological understanding, the stigma arises as a result of blemishes on individual character, tribal stigma or abomination of the body (Major & O’Brien 2005). General effects of stigma Due to being limited to accessing the important domains of life, the stigmatized members are affected by discrimination psychologically as well as physically. They are discriminated against in workplace, market, housing, in families, in health care setting, educational context and even in the legal system. It is possible for accumulated institutional practices to function to the disadvantage of the stigmatized even when there is absence of prejudice or explicit discrimination. Secondly, the stigmatized might be affected through expectancy confirmation process (Laurie 2005). In this, the stereotype and expectations may lead to people to behave towards the stigmatized people in manner that impacts the feeling, thoughts as well as behavior. The stigma victim would then confirm the erroneous expectation and may lead to confirm the negative expectation about self perception. This only requires that the stigmatized to know the prejudice or stereotype from others for the process to unfold. In addition, dominant cultural stereotypes of groups such as those living with HIV/ AIDs or African American in US are widely known and may even affect the behavior even in absence of discrimination on the part of others. Stereotype consistent behaviors may result among the stigmatized. That is why it is possible to see a person with HIV/AIDs being alone even when no one discriminate him or her. Stigma in HIV/ AIDS context From the various views and descriptions of stigma, it is therefore possible to apply the concept of stigma in the HIV/AIDs context. People living with HIV/AIDs have been on the spotlight as far as stigmatization is concerned. People in different part of the country have some negative attitude towards people living with HIV/AIDs. Stigma related to HIV/AIDs can be said to be the devaluation of those people who are living with or are related to those living with AIDs (Hong, Nguyen & Ogden 2004). Such stigma comes from the underlying negative perception about sex and drugs use. These two are known to be the major of one being infected with HIV. The stigma is followed by discrimination which is describes the unjust and unfair treatment towards a person based on his or her perceived or real HIV status. Rao et al (2008), argues that one of the most powerful stigmas of the most contemporary society is the one directed towards people living with HIV. It is believed that HIV/AIDS is viewed more negatively than most of the other stigmatizing condition such as mental as well as well as physical health conditions. These stigmatization perceptions are spread all over America just like it is in other communities in the world. The effects that HIV/AIDS stigma has on people living with AIDs are viewed as pervasive and multifaceted (Ganzak 2007). First, it is known because of stigma, most people are being dissuaded to be tested for HIV. People living with HIV/ AIDs have over time experienced lowered self esteem and self stigma which leads to depression, hopelessness and anxiety. In addition, the anti-retroviral therapies administered by the medical institutions have been linked to side effects that change the appearance of the persons living with HIV/AIDs. This makes the people who already have HIV/AIDs to avoid or not adhere to the therapies. According to Rao et al (2008), this in turn impedes the reduction of the virus in the body and leads to emergence of resistant strains of the virus among people. In the US just like in the other parts of the world, the rate of infection has increased. The minority group, the blacks especially men in their mid ages are the major culprits of this epidemic. It is the leading cause of death among the middle aged African Americans and this has been attributed poverty, racism and social inequality. The situation is worsened by cases of homosexuality who due to their belonging to minority groups do not seek assistance from the homosexual social support networks. As a result the intense stigma within the racial or ethnical minority groups has lead to many people living with HIV to feel uncomfortable disclosing the status to others or even their sexual partners (Rao et al 2008) It therefore adds to the view that stigma towards people living with AIDs have negative effects on efforts dedicated to fighting the spread of HIV within the communities considered to be minority. However, this does not suggest that stigma towards people living with HIV is limited to African Americans, it applies to all. Even among the whites and Hispanics, those people who are infected with AIDs face a similar stigmatization. They are looked down upon as they are associated with what society considers immoral or even illegal when drugs are considered. There are a number of reasons why HIV/AIDs is highly stigmatized. The first reason is that this medical condition is perceived to be self inflicted and a bearer’s responsibility. The people living with HIV are looked at as immoral since the disease’s modes of transmission are behaviors which are considered voluntary as well as voluntary. Those infected with HIV are seen to ignore the caution in life; are sexually immoral or are drug users –the main activities that lead to contraction of HIV. Secondly, people’s perception about the disease is that once a person is infected, he or she sooner or later dies as there is no known cure. The disease has for a long time been seen as unalterable and fatal but this perception has been changed with emergence of highly active anti retroviral therapies. Thirdly, it is known that that health conditions that are highly contagious often are highly stigmatized. It is within the common knowledge that HIV is caused when body fluids especially the seminal fluids and blood that are infected with the virus come into contact with those of another person who is not infected. The infection rate of HIV has been rampant and with its associated rate of death, people tend to dread this medical condition and therefore stigmatize those living with HIV (Kaya et al 2011). Often the stigma results because of people not being informed. Most people do not understand how exactly it is transmitted and instead of risking they end up stigmatizing the one with HIV. Lastly, HIV is characterized by opportunistic illnesses which often appear towards the advanced stage of the disease. The diseases manifest themselves in severe ways that devastate the personality and capability of a person. These attract negative perception from the people and stigma becomes inevitable. Why is stigma relevant to an understanding of the experience of health? Family members have a great role to play in caring for their members who live with AIDS. However, there are always fears of being infected especially when the health condition has reached its advanced stages. It is therefore common to find families hiring a person to care for the sick member. Although this shows their concern for such a family member, it reduces the love and affection as would be perceived by the patient and this adds self hatred and anxiety which deteriorates his or her health condition (Castro & Farmer 2005). The member might not see this as stigma but from the ailing person, this is one of the ways of showing stigma. Issues related to health are directed to medical and health institutions and facilities to handle. It is expected that the personnel in these institution are trained to handle all issues surrounding health conditions. However, it is important to note that AIDS related stigma is also present in health institutions and until recently, there had been no response towards this attitude directed to people living with HIV (Mahendra et al 2007). The stigma against such people has often been an obstacle to providing adequate health intervention. In the recent days, steps are being taken to ensure that nurses and other health facilities personnel change their attitude and provide intervention as is required. According to Hong Nguyen and Ogden (2004), people living with HIV feel that the attitudes of the health workers towards them is more often than not, negative. Such negative attitudes are manifested through rudeness and sometimes avoidance. Some believe that the health care providers provide the health services reluctantly. Just like the family members, although some health providers may try not to manifest stigma, people living with HIV do not fail to recognize elements of stigma and discrimination. The situation is even serious for women living with AIDs especially when giving birth in the health institutions. The health practitioners dread contracting the disease. Some may end up sending them to other medical institutions even when there are no complications just because they learn that the pregnant woman is HIV positive (Lee & Kochman 2002). This has negative outcome since most of the pregnant women living with HIV tend to avoid public health institution services and instead erect to try giving birth at home. This may lead to death of the mother, the child or both. On its side, the community members, according Hong Nguyen and Ogden (2004), also attributes the highest level of HIV related stigma to hospitals since the risk is seem t be highest there. There seem to be many chances of infection in the hospital setting because the health workers come into contact with the blood of the infected often especially when injecting medicine into their body or when testing the blood or other fluids. Fear of being infected spread to other patients who feel that they should not go to the hospital or health institutions where people living with HIV are admitted or treated. Despite the knowledge that the devices to be used are sterilized first before use, the patients and family of the patient always ask that they be moved if they discover they are in the same ward with people living HIV. This in itself is a manifestation of stigma. It therefore seems that even as campaigns to shun stigma against people living with Aids continue, the attitude that people have about HIV/AIDs is not easily changed. From all spheres, people living with AIDs face stigma at times because people do not have adequate information on what HIV really is and how it is transmitted or because of fear. This brings in the question of moral issues regarding stigma in both the community and health settings. Although people attribute HIV as self inflicted health condition is it justifiable to stigmatize such people. Many responses can address this but considering that some people living with AIDs were innocent and could be victims of rape or similar event that can lead to infection, it would not be right to conclude that stigmatization is right. Conclusion In conclusion, it is important to reiterate that stigma is not desirable in almost all circumstances. Stigmatized people suffer low self esteem, low self efficacy anxiety and tend to set themselves apart from the rest of the family or community. Lack of love for the minority based on health condition, economic status or power condemns one to isolation. When stigma is directed to people living with HIV/ AIDs, it becomes more devastating for them. For one, they suffer physically from illnesses associated with HIV and secondly, they lack love and affection from people. This makes them loose sense of belonging and may be the cause of committing suicide among people living with AIDs. They are hopeless and are treated with negative attitude by all the people surrounding them. At home family members do not want to be in contact with them, in the community, they lack acceptance and in the health facilities they are treated by health providers who are fearful. All these sources of stigma make a person living with HIV experience difficulty in his or her attempt to lead a normal life. 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Rao, D., Pryor, J.B., Gaddist, B.W. & Mayer, R. 2008, "Stigma, Secrecy, and Discrimination: Ethnic/Racial Differences in the Concerns of People Living with HIV/AIDS", AIDS and Behavior, vol. 12, no. 2, pp. 265-71. Read More