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

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.