Abstract
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 language | English (US) |
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Pages (from-to) | 1-22 |
Number of pages | 22 |
Journal | Human Nature |
Volume | 30 |
Issue number | 1 |
DOIs | |
State | Published - Mar 15 2019 |
Externally published | Yes |
Keywords
- 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