The relationship between expressed HIV/AIDS-related stigma and beliefs and knowledge about care and support of people living with AIDS in families caring for HIV-infected children in Kenya

Abstract

At the end of 2001, AIDS-related deaths had left an estimated 900,000 living orphans in Kenya (UNAIDS/WHO Epidemiology fact sheet, Kenya report, 2004). Many of those orphans are also HIV+. In Eastern Kenya, the Lea Toto Kangemi Outreach Program provides support to families caring for HIV+ children, many of whom are orphaned or soon to be orphaned. A major challenge for these families is the stigma attached to the family. In 2003, the Kangemi Program conducted a household survey of client families. We examined markers of expressed stigma and the association between expressed stigma and other demographic and belief/knowledge domains. The focus of the present study was the specific belief/knowledge domain surrounding care/support of HIV+ persons. Our goal was to explore this domain in the Kangemi families and to examine its relationship to expressed stigma. We created an AIDS-related stigma scale from selected items in the household survey and cross-tabulated stigma scores with care/support knowledge items. We found significant associations between less expressed stigma and greater care/support knowledge. Our results have implications for interventions that reduce expressed stigma and/or improve quality of care.

Acknowledgments

Our collaborators in Kenya have made this work possible. Father D'Agostino, founder and medical director of Nyumbani, invited us to visit Kenya and gave us tremendous access to his programs for HIV+ AIDS orphans. The administrators and managers of Nyumbani and of the Lea Toto programs, Protus Lumiti and Nicholas Makau, facilitated the access we needed and contributed significantly to the direction of the study. We thank all of them.Finally, we would like to thank John Atkinson, DrPH for his assistance in structuring the data files for easy and efficient analysis.