A model for understanding the relationship between stigma and healthcare-seeking behaviour among people living with HIV/AIDS in sub-Saharan Africa

Abstract

People living with HIV or AIDS (PLHIV) in sub-Saharan Africa sometimes have care-seeking behaviours that result in a suboptimal quality of life. This paper seeks to examine the role of stigma in the  care-seeking behaviour of PLHIV. We hypothesise that stigma relates to the behaviour of PLHIV themselves and with societal reactions,  including those of healthcare professionals. From a literature review, we identified the following as important correlates of care-seeking behavior: beliefs about pathways of HIV infection and people infected with HIV, social reactions, coping strategies, knowledge of HIV and AIDS, and self-efficacy in finding care and treatment in addition to  coping with the disease. Poverty, gender, age, religion and policy were  found to be moderating variables. The Precede-Proceed model was  adapted to build an explanatory model of healthcare-seeking behaviour among PLHIV and particularly to explore the role of stigma in the non-utilisation of healthcare institutions.

Keywords: coping, healthcare professionals, literature review, PLHIV, Precede-Proceed model, self-efficacy, social conditions, stigma

African Journal of AIDS Research 2009, 8(2): 201–212