As unfortunate as the reality may be, we all are aware of the social
stigmas placed on individuals with chronic disabilities and health disorders. In
a recent study examining the effects of social stigmas placed on men with HIV,
a link was established between stigma of the disease and their cognitive
abilities. Stigma clearly remains a reality for the millions of individuals
with HIV across the world, and it bears not only on mental health but on
cognition and function as well. HIV-related stigma contributed to a range of integrated
biopsychosocial factors that had distinct downstream effects leading to
significant decreases in quality of life and everyday function. The impact of
chronic stress on the brain due to stigma was a major factor for the decreased
cognitive abilities of individuals with HIV. The associated anxiety leads to
reduced participation in social activities and impairs everyday function and
quality of life. The evidence that health-associated stigmas are a threat to
not only mental health but are also cognitively detrimental suggests that
efforts to address social stigmas may have profound effects on individuals with
HIV as well as other populations suffering from chronic illnesses. Additionally, with increasing medical advancements, individuals suffering from these sorts of chronic diseases are living longer, and their emotional well-being and cognitive abilities are critical to a better quality of life. The
psychosocial effects of negative judgement and the feeling of exclusion from
society are tremendous and ought to be addressed. Education and promoting a positive
and inclusive culture can aid in bolstering the mental health and overall abilities
for millions of individuals. We should be practicing this sort of ethical and
moral confidence anyway, but this study highlights a need for interventions to
health-related stigmas. How as medical professionals can we assist in building
this sort of culture? This also highlights the ever-important and too often
overlooked issue of mental health associated with disability.
Austin, LB, Nancy, ME, Scott, S, Brouilette, MJ, & Fellows, LK. HIV-Related stigma affects cognition in older men living with HIV. Journal of Acquired Immune Deficiency Syndromes. Nov 13, 2018. doi: 10.1097/QAI.0000000000001898.
Very interesting topic and article. I firmly believe that this conversation not only impacts patients dealing with the stigma related to HIV, but also multiple disorders as well. This may in turn affect the level of care you can provide to you patient if they are reluctant to disclose medical information. After doing some research I that individuals ranging from 15-24 years old did not ask for a STD test during normal physical routine while they are were sexually active. Within the same research, they found that the cause may be due to the stigma that having an STD can cause (Cunningham, Kerrigan, Jennings, & Ellen, 2009). Basically saying, "out of sight, out of mind." This may lead to a large population of individuals being undiagnosed carries, increasing the spread their prevalence. One way we can counteract this stigma is by trying to make out patients comfortable with their environment and allowing them to feel trustworthy in not only disclosing the information, but also screening them as well. This conversation will largely depend on the provider/patient relationship and the level of trust you have with them talking about sexually related issues, as well as ethical stigmas on the topic as well.
ReplyDeleteCunningham, S. D., Kerrigan, D. L., Jennings, J. M., & Ellen, J. M. (2009). Relationships Between Perceived STD-Related Stigma, STD-Related Shame and STD Screening Among a Household Sample of Adolescents. Perspectives on Sexual and Reproductive Health, 41(4), 225–230. https://doi.org/10.1363/4122509