Understanding Correlates of Stigma and Coping Strategies Among Women Living with HIV/AIDS in Bangladesh:
[Thesis]
Sultana, Shirin
A Cross-sectional Study
Ross-Sheriff, Fariyal
Howard University
2019
219
Ph.D.
Howard University
2019
Background: Bangladesh is a patriarchal society where gender inequality and oppression exist almost in every sphere of women's lives including access to education and health care. HIV-related stigma including the feelings of fears, guilt and shame often leads to low coping skills. Furthermore, both high HIV-related stigma and low coping skills impede the well-being of Women Living with HIV/AIDS (WLWHA). Purpose: The purpose of this quantitative cross-sectional study was to understand the correlates of HIV-related stigma and coping strategies among WLWHA in Bangladesh. The study also aimed to develop regression models to understand the factors that best explain HIV-related stigma, coping strategies and well-being. Methodology: Two hundred women from a non-profit organization, named "Ashar Alo Society" in Bangladesh were recruited to participate in this cross-sectional research study. Seven standardized instruments including (1) India HIV-related Stigma Scale (Steward, Herek, Ramakrishna, Bharat, Chandy, Wrubel, & Ekstrand, 2008), (2) Social Support (Sherbourne & Stewart, 1991), (3) Coping Self-Efficacy (Chesney, Neilands, Chambers, Taylor, & Folkman, 2006), (4) Beck Depression Inventory (Beck, Ward, Mendelson, Mock, and Erbaugh, 1961), (5) Rosenberg Self-Esteem (RSE) (Rosenberg, 1979), (6) Knowledge, Attitudes and Behavior toward HIV/AIDS (DiClemente, Zorn, & Temoshok, 1986) and (7) Religiosity (Haj-Yahia, 1998) were utilized to collect the study data. Findings: Participants were between 18 and 60 years old with the majority between 30 and 39 years old. A majority (60%) had secondary levels of education. The vast majority (87.5%) had a monthly income below US usd 62.5. Religiosity (r= -.18, p <.001), social support (r= .27, p <.001), depression (r= -.18, p <.001), and knowledge and attitudes (r= -.33, p <.001) were correlated with HIV-related stigma. Levels of social support (r= .34, p <.001), self-esteem (r= -.21, p < .001), knowledge and attitudes (r= -.30, p < .001), and depression (r= -.40, p <.001) were associated with coping strategies. Multiple regression analysis found that knowledge and attitudes towards HIV/AIDS (β= -.29, p <.001), and social support β= .21, p <.05) best predicted HIV-related stigma and explained for 15% of the variance. On the other hand, levels of depression (β= -.31, p <.001), and social support β= .25, p <.05) best predicted coping strategies, and explained 18% of the variance. The results of the Canonical Correlation Analysis, specifically, the overall Wilks' lamba multivariate test of significance showed a statistically significant correlation between the demographic and other factors' variate and wellbeing variate (Wilks' Lambda= .68, (F(df=8,388), p <.001). The determinants of wellbeing variate accounted for 59.41% of the variance in levels of depression and self-esteem. Implications: Implications from this study include considerations for international social work practice and policy, providing both practitioners and policymakers ideas about predictors of HIV-related stigma, coping strategies and well-being of WLWHA in Bangladesh. Finding from this study might be used in social work education introducing specialized or elective courses for students to prepare trained human service providers including social workers, counselors, and therapists to address the diverse needs of this population.