AIDSImpact.com:: - Santa Fe, USA 2011

Abstract #328 - The relationship between stigma and unsafe sexual practices amongst young people in Ghana
Authors: Presenting Author: Dr Dinah Baah-Odoom - Ghana Health Service
Additional Authors:
Aim: The study aimed to build on previous work using the social representation approach to HIV/AIDS to provide a more direct test of the central claim that distancing strategies (as measured by beliefs about the origin of HIV/AIDS, stigmatizing attitude towards people with HIV/AIDS and blaming of out-groups believed to spread HIV/AIDS) lead to lower risk perception and subsequently to higher risk-taking behaviour (e.g. Goodwin et al., 2004; Joffe, 1996; Joffe & Bettega, 2003; Lear, 1995).
Method / Issue: This was a questionnaire survey. A total of 500 students were made up of 400 secondary school students and 100 university students were randomly selected to participate in the study. The secondary school participants were selected from four schools (two coeducational schools, one girls’ school and one boys’ school) in two cities in Ghana. The boys’ school and one of the coeducational schools were from the top end of the academic spectrum. The remaining two were from the bottom end. These schools were selected for the study because they presented the most interesting mix of students. The age range of the participants was from 16 – 26 years with a mean age of 18 years (SD 1.9)
Results / Comments: The social representation hypothesis was tested using a mediation analysis (Kenny, Kashy& Bolger, 1998). The correlations relevant to the first step some evidence of an association in the direction predicted by the social representation hypothesis: higher stigma scores were associated with greater reported likelihood of taking sexual risks (R=-.31, p<.001) and reduced intention to practise safe sex (R= -.25 p<.001). However, higher blaming of out-group scores was associated with greater intention to practise safe sex (R=.23 p<.001) and a reported likelihood of safety in actual sexual practices (R-.15 p<.01). Belief about the origin of HIV/AIDS was not associated with safety in actual and intended safe sexual behaviours as predicted by social representations hypothesis. The correlations between the distancing variables and the perceived vulnerability variables (step 2) were also consistent with the social representation hypothesis: higher distancing (i.e. origin of HIV/AIDS and stigma) was associated with perceptions of lower vulnerability (R=-.10 p<.01 and R = -.31 p<.001 respectively). Blaming though significantly associated with perceived vulnerability was again not in the direction predicted by social representations (R=.19 p<.001). Because stigma showed the expected correlations in the first two steps, the last step of the mediation analysis was completed for this variable. Separate analyses were conducted for the two sexual behaviour variables. When both stigma and perceived vulnerability were entered as predictors of intended safe sex, both made a significant unique contribution to the outcome (beta coefficient for stigma = -.20, p<.001; beta coefficient for perceived vulnerability = .21, p<.001). This result indicates that there was a significant mediation effect, but that the mediation was only partial (i.e. there remained an association between stigma and intended safe sex that was not mediated by perceived vulnerability). For the outcome of actual safe sex, there was no mediation effect (beta coefficient for stigma = -.29, p<.001; beta coefficient for perceived vulnerability = .04, p=.682).
Discussion: The fact that there was a mediating role for perceived vulnerability in respect of intended, (though not for actual safe sex), supports the hypothesis that perceived vulnerability mediates the relationship between stigma and safe sex intention. Thus, the results gave some support to the conjecture that that distancing strategies (as measured by beliefs about the origin of HIV/AIDS, stigmatizing attitude towards people with HIV/AIDS and blaming of out-groups believed to spread HIV/AIDS) lead to lower risk perception and subsequently to higher risk-taking behaviour. Stigma showed the relationships predicted by the social representation hypothesis: Higher stigmatizing attitudes were associated with reduced safety in intended sexual behaviour through the mediation of reduced perceptions of vulnerability. This indicates a need for sigma reduction strategy and a social policy to address the issues in Ghana.
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