Reframing HIV Stigma and Fear: Considerations from Social-ecological and Evolutionary Theories of Reproduction

Caitlyn D. Placek, Holly Nishimura, Natalie Hudanick, Dionne Stephens, Purnima Madhivanan

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


HIV stigma and fears surrounding the disease pose a challenge for public health interventions, particularly those that target pregnant women. In order to reduce stigma and improve the lives of vulnerable populations, researchers have recognized a need to integrate different types of support at various levels. To better inform HIV interventions, the current study draws on social-ecological and evolutionary theories of reproduction to predict stigma and fear of contracting HIV among pregnant women in South India. The aims of this study were twofold: compare the social-ecological model to a modified maternal-fetal protection model and test a combined model that included strong predictors from each model. The study took place in 2008–2011 in Mysore District, Karnataka, India. Using data from a cross-sectional survey and biological indicators of health, we statistically modeled social-ecological variables representing individual, interpersonal, and community/institutional levels. Participants were 645 pregnant women. The social-ecological and combined models were the best-fitting models for HIV-related stigma, and the combined model was the best fit for HIV-related fear. Our findings suggest that combining reproductive life history factors along with individual, interpersonal, and community/institutional factors are significant indicators of HIV-related stigma and fear. Results of this study support a multifaceted approach to intervention development for HIV-related stigma and fear. The combined model in this study can be used as a predictive model for future research focused on HIV stigma and fear, with the intent that dual consideration of social-ecological and evolutionary theories will improve public health communication efforts.

Original languageEnglish (US)
Pages (from-to)1-22
Number of pages22
JournalHuman Nature
Issue number1
StatePublished - Mar 15 2019
Externally publishedYes


  • Evolutionary medicine
  • HIV/AIDS stigma
  • India
  • Maternal-fetal protection
  • Pregnancy
  • Social-ecological model

ASJC Scopus subject areas

  • Ecology, Evolution, Behavior and Systematics
  • Anthropology
  • Arts and Humanities (miscellaneous)
  • Social Sciences (miscellaneous)
  • Sociology and Political Science


Dive into the research topics of 'Reframing HIV Stigma and Fear: Considerations from Social-ecological and Evolutionary Theories of Reproduction'. Together they form a unique fingerprint.

Cite this