Evaluating layered stigma from comorbid HIV and epilepsy among Zambian adults.

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dc.contributor.affiliationUniversity Teaching Hospital, Department of Paediatrics and Child Health, Nationalist Way, Lusaka, Zambia.
dc.contributor.affiliationInfectious Disease Service, Brooke Army Medical Center, 3851 Roger Brooke Dr., Fort Sam Houston, TX 78234, USA.
dc.contributor.affiliationEpilepsy Care Team, Chikankata Hospital, Private Bag S2, Mazabuka, Zambia.
dc.contributor.affiliationCentre for Infectious Disease Research in Zambia, 532 Great North Road, PO Box 24681, Lusaka, Zambia.
dc.contributor.affiliationDepartment of Epidemiology and Biostatistics, Michigan State University, 909 Fee Road, Room B629, East Lansing, MI 48824, USA.
dc.contributor.affiliationStrong Epilepsy Center, Department of Neurology, University of Rochester, 265 Crittenden Blvd, CU420694, Rochester, NY 14642, USA.
dc.contributor.affiliationInternational Neurologic and Psychiatric Epidemiology Program, Michigan State University, 909 Fee Road, Room 324, East Lansing, MI 48824, USA.
dc.contributor.affiliationCIDRZ
dc.contributor.affiliationCentre for Infectious Disease Research in Zambia (CIDRZ)
dc.contributor.authorElafros MA
dc.contributor.authorGardiner JC
dc.contributor.authorSikazwe I
dc.contributor.authorOkulicz JF
dc.contributor.authorPaneth N
dc.contributor.authorChomba E
dc.contributor.authorBirbeck GL
dc.date.accessioned2025-05-23T11:41:27Z
dc.date.issued2018-Dec
dc.description.abstractBACKGROUND AND PURPOSE: Stigma hinders care for patients with neurologic illness. Layered stigma due to comorbid disease is common yet poorly characterized due to lack of instruments. Epilepsy and HIV are prototypical stigmatized conditions widespread in sub-Saharan Africa. METHODS: We assessed layered stigma among people with HIV and epilepsy (n = 21), epilepsy only (n = 88), and HIV only (n = 40) in Zambia. Epilepsy-associated stigma was assessed using the Stigma Scale of Epilepsy and Jacoby's Stigma Scale. HIV-related stigma was assessed using the HIV/AIDS Stigma Instrument-People Living with HIV/AIDS and Jacoby's Stigma Scale. Stigma was compared across groups using RESULTS: 55% (60/109) with epilepsy reported some epilepsy-associated stigma and 20% (12/61) with HIV reported HIV self-stigmatization. Those with HIV and epilepsy were more likely to associate seizures with fear (OR 6.1 [95% CI: 1.3-27.9]) and epilepsy with dependence (OR 4.6 [1.1-19.6]), controlling for age, gender, marital status, and employment. Those with comorbid disease were more likely to report they were "no longer a person" and felt "blamed" for their HIV. Controlling for age and gender, the difference in depersonalization remained (OR: 6.4 [1.1-36.1]). CONCLUSION: Individuals carrying the burden of one stigmatized condition may be more vulnerable to stigma from a comorbid disease.
dc.identifier.doi10.1016/j.ensci.2017.12.001
dc.identifier.urihttps://pubs.cidrz.org/handle/123456789/10481
dc.sourceeNeurologicalSci
dc.titleEvaluating layered stigma from comorbid HIV and epilepsy among Zambian adults.

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