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Issues Ment Health Nurs. 2018 Jun;39(6):482-489. doi: 10.1080/01612840.2017.1423426. Epub 2018 Feb 15.

Stigma and Spiritual Well-being among People Living with HIV/AIDS in Southern Appalachia.

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a College of Nursing, University of Tennessee , Knoxville , Tennessee , USA.
b University of Tennessee Graduate School of Medicine , Knoxville , Tennessee , USA.
c University of Alabama , Tuscaloosa , Alabama , USA.


The Appalachian South is disproportionately affected by HIV/AIDS. Partly due to the negative connotation that this disease carries in religiously conservative areas, HIV-related stigma remains a critical barrier to HIV care in the South. However, spirituality is a well-documented, effective coping mechanism among persons living with HIV/AIDS (PLWH). The purpose of this study was to examine the relationship between HIV-related stigma and spiritual well-being among a sample of PLWH (n = 216) in Appalachian counties of Tennessee and Alabama using the HIV Stigma Scale and the Spiritual Well-being Scale. Overall, disclosure of HIV status was the most highly reported stigma concern. Women reported higher levels of stigma and religious well-being than men. While existential well-being was negatively correlated with stigma, no significant overall correlation was found between religious well-being and stigma. Our findings reveal the importance of defining theology and differentiating between cultural religious conditioning and internalized beliefs.

[Indexed for MEDLINE]

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