"It's Better If I Die Because Even in the Hospital, There is a Stigma, People Still Gossip": Gossip as a Culturally Shaped Labeling Process and Its Implications for HIV-Related Stigma in Botswana

Ohemaa B Poku; Evan L Eschliman; Patlo Entaile; Shathani Rampa; Haitisha Mehta; Danielle Tal; Lea Silvert; Tingyu Li; Timothy D Becker; Darshini Govindasamy; Melissa A Stockton; Adebola Adedimeji; Ari Ho-Foster; Michael B Blank; Derek T Dangerfield 2nd; Lawrence H Yang; Sarah M Murray

doi:10.1007/s10461-023-03980-x

"It's Better If I Die Because Even in the Hospital, There is a Stigma, People Still Gossip": Gossip as a Culturally Shaped Labeling Process and Its Implications for HIV-Related Stigma in Botswana

AIDS Behav. 2023 Aug;27(8):2535-2547. doi: 10.1007/s10461-023-03980-x. Epub 2023 Jan 17.

Authors

Ohemaa B Poku¹, Evan L Eschliman², Patlo Entaile³, Shathani Rampa⁴, Haitisha Mehta⁵, Danielle Tal⁵, Lea Silvert⁵, Tingyu Li⁵, Timothy D Becker⁶, Darshini Govindasamy⁷, Melissa A Stockton^{8

9}, Adebola Adedimeji¹⁰, Ari Ho-Foster¹¹, Michael B Blank¹², Derek T Dangerfield 2nd¹³, Lawrence H Yang^#^{14

15}, Sarah M Murray^#¹⁶

Affiliations

¹ Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. op2190@cumc.columbia.edu.
² Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
³ Botswana-UPenn Partnership, Gaborone, Botswana.
⁴ Department of Psychology, Queens College, City University of New York, New York, NY, USA.
⁵ Department of Clinical and Counselling Psychology, Teachers College, Columbia University, New York, NY, USA.
⁶ Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
⁷ Medical Research Council, South Africa, Cape Town, South Africa.
⁸ Department of Psychiatry, Vagelos College of Physicians and Surgeons Columbia University, New York, NY, USA.
⁹ New York State Psychiatric Institute, New York, NY, USA.
¹⁰ Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA.
¹¹ University of Botswana, Gaborone, Botswana.
¹² Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
¹³ Johns Hopkins School of Nursing, Baltimore, MD, USA.
¹⁴ School of Global Public Health, New York University, New York, NY, USA.
¹⁵ Mailman School of Public Health, Columbia University, New York, NY, USA.
¹⁶ Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

^# Contributed equally.

Abstract

This study qualitatively explores HIV-related gossip as both a manifestation and driver of HIV-related stigma, which is a known barrier to HIV testing and treatment in Botswana. Data were elicited from 5 focus group discussions and 46 semi-structured in-depth interviews with individuals living with HIV and community members with undisclosed serostatus in Gaborone, Botswana in 2017 (n = 84). Directed content analysis using the 'What Matters Most' theoretical framework identified culturally salient manifestations of HIV-related stigma; simultaneous use of Modified Labeling Theory allowed interpretation and stepwise organization of how the social phenomenon of gossip leads to adverse HIV outcomes. Results indicated that HIV-related gossip can diminish community standing through culturally influenced mechanisms, in turn precipitating poor psychosocial well-being and worsened HIV-related outcomes. These harms may be offset by protective factors, such as appearing healthy, accepting one's HIV status, and community education about the harms of gossip.

Keywords: Botswana; Culture; Gossip; HIV/AIDS; Stigma.

MeSH terms

Botswana
HIV Infections* / psychology
Hospitals
Humans
Social Stigma
Stereotyping*

Abstract

MeSH terms

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