Date of Award


Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

First Advisor

Brian Forsyth


Human Immunodeficiency Virus (HIV)-associated stigma is pervasive throughout the world. This stigma affects the ability of HIV-positive individuals to cope with their illness and it also affects behaviors around sexual practices, disclosure to others and the use of healthcare. The purpose of the research project was to examine the experience of internalized stigma among HIV-positive persons and their perceptions of stigmatizing attitudes in the community. The study also examined disclosure of HIV serostatus and identified factors contributing to disclosure and stigma in Senegal, a low prevalence Muslim country in West Africa. A cross-sectional study was conducted at Centre Hospitalier Universitaire de Fann in the form of a structured interview using a newly developed stigma instrument. The interviews were carried out in French and/or Wolof and the participants were interviewed during a routine visit to Fann Hospital. 15 men and 28 women aged between 19 and 55 years participated in the study. The mean period of time since diagnosis was 3.6 years (+/- 2.5 years). The stigma instrument showed a mean internalized stigma score of 5.4 +/- 3.5 (maximum score: 15) and an even higher level of perceived stigmatizing attitudes in the community of 7.9 +/- 4.8. Males had greater stigma scores than females. Almost 80 percent of the people interviewed had received some counseling, yet less than two-thirds of the study participants had disclosed their HIV status to others. People who had disclosed their HIV status used counseling less. The majority of subjects reported positive experiences with healthcare personnel in the Infectious Diseases Clinic of Fann Hospital. The level of internalized stigma and the perception of stigmatizing attitudes in the community are high with males experiencing more guilt. About three-fifths of the participants in the study had not disclosed their HIV status to even one other person; men disclosed their serostatus more frequently than women. Women were more likely to use counseling services compared to their male counterparts, and individuals who had disclosed their serostatus attended counseling less. Finally, despite the level of stigma perceived, the majority of people interviewed reported positive experiences with healthcare workers.



Open Access

This Article is Open Access