Rehabilitation and how it Applies to Stigma using HIV as an Example

Adults living with HIV face numerous challenges and the application of rehabilitation principles may help alleviate many of them. Stigma is a challenge many individuals living with HIV face every day and it can have important consequences for their participation in valued activities and roles in their lives. The impact of stigma associated with HIV has not been well studied from a rehabilitation science perspective. This thesis explores research on the rehabilitation interventions used by adults living with HIV to help them manage their experiences of disability and investigate how stigma intersects with the rehabilitative framework of the International Classification of Functioning, Disability and Health (ICF). A series of interrelated investigations – a scoping review, a theoretical analysis and an empirical study – were completed. The scoping review revealed the extent, range and nature of research on rehabilitation interventions used by adults living with HIV to manage their experiences of disability. The theoretical investigation illustrated how stigma and rehabilitation interrelate, specifically demonstrating how three forms of stigma (enacted, self and structural) interrelated with the ICF domains of participation restrictions, environmental and personal contextual factors. A final empirical study illustrated the real-world application of the theoretical contribution through secondary analysis of interviews with Zambian women living with HIV. These women faced enacted, self and structural stigma, which were shown to interrelate with the domains of the ICF, through accounts of their lived experiences. The concepts of rehabilitation, stigma and HIV are uniquely connected in this dissertation. The findings illustrate how stigma and rehabilitation are interrelated both theoretically and empirically using HIV as an example. The resulting insights have implications for rehabilitation professionals and researchers who can apply this information to their clinical and scientific work to strengthen the role of rehabilitation in mitigating stigma as experienced by people living with HIV.Ph.D