The Rutgers Scholar, electronic journal, Undergraduate Education, undergraduate research
The Rutgers Scholar, electronic journal, Undergraduate Education, undergraduate research

HIV/AIDS and mental disability: The role of stigma

Faryal Mahmud* and James Walkup1
1Institute for Health, Health Care Policy, and Aging Research

*fsm3777@hotmail.com

*Rutgers Undergraduate Research Fellow


Abstract

     Serious mental illness, mental retardation, and HIV/AIDS are highly stigmatized conditions. Little is known about how people respond to people who have more than one stigmatized condition. Since some seriously mentally ill and some mentally retarded people are infected with HIV, it is important to understand better how people respond to combined conditions. Using an experimental design (ie. Paired Comparisons), this issue was examined.


Purpose


     We investigate the perceived stigma of HIV, a mental illness (MI), mental retardation (MR), or a combination of two of the three. Perceived stigma is important because it might cause caregivers to have negative attitudes toward patients, or it may cause them to ignore patient rights. It may also cause individuals to be reluctant to get tested for HIV. A limitation of prior studies has been the failure to study combined conditions.


Hypotheses


     We hypothesize that:
  1. target individuals (i.e., individuals likely to be stigmatized) with a combined condition (e.g., HIV and MI) are more stigmatized than target individuals with a single condition;

  2. target individuals with a single condition are stigmatized in the following order:
    MOST, Mental Illness, Ex-convict, or Mentally Retarded;
    LEAST, HIV.

  3. target individuals with a combined condition are stigmatized in the following order:
    MOST, Mentally Ill and HIV, Mentally Retarded and Mental Illness;
    LEAST, Mentally Retarded and HIV.

  4. Subjects attach more stigma to target individuals engaged in an activity in a private sphere than in a public sphere.
     To test these hypotheses, we administered a questionnaire.


Questionnaire


     Reproduced below are the instructions for the questionnaire that was used for this study.



Instructions for questionnaire

     On the next few pages, you'll find some questions that ask you which of two types of people most people would choose in a given situation. For example:

Most people would prefer to go out for a night on the town with:

a. a movie star
or
b. a Rutgers psychology professor
     If you think most people would prefer to go out for a night on the town with a movie star, then you would circle that answer (as shown above).

     Each question will have more than one set of choices.. For EACH set, choose either a or b as your selection.

     **Please note that we're not asking your personal preference, but what you think most people would say.**

     We recognize that the task would be easier if you had lots of detail about the particular individuals being compared, but most people find they are able to make a judgment.

Sample questions

     1. Most people would feel comfortable working on the same project at work or having as a neighbor: (Public Sphere)

a. mentally retarded individual or mentally ill individual b. individual with HIV or ex-convict
     2. Who would most people want to watch their kids for a few hours? (Private Sphere)
a. mentally retarded individual or mentally ill individual b. individual with HIV or ex-convict


Materials

     The questions were presented using the paired comparisons method adapted from Barnard (1995); by using this method a ranking of the different conditions can be obtained: all of the conditions are paired with one another once (each single condition with each other single condition and combined conditions with combined conditions); Of each pair, the condition or combined condition that is chosen is the "winner"; the one not chosen is the "loser"; the winner is the one rating the least stigmatization/most social comfort and the loser is the one rating highest stigmatization/lowest social comfort (or the one that is stigmatized).


Methods

     A sample of 126 Rutgers University undergraduates was obtained. The two stigma questions were selected in order to observe whether the target individual was present in a public sphere or a private sphere created a difference in the degree of social comfort. The first item, "Most people would feel comfortable working on the same project at work or having as a neighbor" deals with interacting with an individual with one or more of the conditions with an individual in a public sphere. The second item, "Who would most people want to watch their kids for a few hours?", deals with interacting with an individual with one or more of the conditions in private sphere (in one's home).

     Subjects were divided into two group. Stimuli presentation were counterbalanced to correct for any primacy effect from order of presentation.


Results: stigma ratings

     Single Condition. Our results showed, in order of decreasing stigmatization: MI, EX, MR, HIV (least stigmatized).

     Combined Condition. Our results showed, in order of decreasing stigmatization: MI/HIV, MR/MI, MR/HIV (least stigmatized).


Discussion

Anticipated results

     We anticipated that:

  1. Individuals with a combined condition would be more stigmatized than individuals with a single condition
  2. Individuals with a single condition would be stigmatized in the following order, going from most to least stigmatized:
    MI > Ex> MR > HIV
  3. Individuals with a combined condition would be stigmatized in the following order, going from most to least stigmatized:
    MR/HIV > MR/MI > MR/HIV
  4. The private sphere question would elicit higher stigma ratings

Findings

      We hypothesized that combined conditions would be more stigmatized than a single conditions (Item (1), of the previous paragraph). Insufficient data were collected to test this hypothesis.

      The data support the rankings anticipated for both the single and combined conditions (Items (2) and (3) above).

      Contrary to what was anticipated, greater stigmatization was not found in the private sphere relative to the public sphere: in both public and private, the conditions considered were equally stigmatized (Item (4) above).


Conclusions

      Since it was not proved that individuals were stigmatized more in a private sphere than in a public sphere, we infer that whether an interaction takes place in public or private sphere will have no bearing on the degree of stigmatization/social comfort.

      The failure to find higher stigma in a private sphere than a public sphere may be due to an inadequate sample size or it may suggest that a public versus a private sphere does not influence stigma rating.



Copyright 2001 by Faryal Mahmud and James Walkup
Current URL: http://rutgersscholar.rutgers.edu/volume03/walkmahm/walkmahm.htm