The conceptualization of stigma within a rehabilitation framework using HIV as an example

Abstract

Stigma theory is concerned with inclusion and opportunities that influence well-being. Rehabilitation is also concerned with social inclusion and well-being. This is a central concern in one of the leading rehabilitation theories, the World Health Organization’s International Classification of Functioning, Disability and Health. Despite these shared concerns, the relationship between the fields of stigma and rehabilitation has not been well theorized to date. Using human immunodeficiency virus (HIV) as an example, this article presents an analysis of three ways that stigma may be conceptualized within the context of the International Classification of Functioning, Disability and Health. Three broad spheres of stigma are described: enacted, self, and structural stigma. These three forms of stigma are then aligned in unique ways with three particular constructs of the International Classification of Functioning, Disability and Health: participation restrictions, environmental, and personal contextual factors. This conceptualization illustrates how rehabilitation professionals and other practitioners, policy makers and researchers can better understand the dynamic and nuanced forms of stigma and how they relate to rehabilitation.

Implications for rehabilitation

• This article enables rehabilitation professionals to better understand stigma as it relates to rehabilitation and human immunodeficiency virus.

• Rehabilitation professionals have the important job of allies and advocates for persons experiencing restrictions in these domains as a result of stigma.

Keywords:

• Rehabilitation
• stigma
• HIV
• World Health Organization
• International Classification of Functioning, Disability and Health

Disclosure statement

The authors report no conflicts of interest. The authors alone were responsible for all aspects of writing this paper.

Additional information

Funding

This work was supported by a Canadian Institutes of Health Research (CIHR) Fellowship, HIV/AIDS Priority to Marianne Stevens and a CIHR New Investigator Award to Stephanie Nixon.