Affiliate stigma among family caregivers of people living with HIV/AIDS: a concept analysis

Family caregivers of people living with HIV/AIDS often experience affiliate stigma due to their close association with affected individuals, which adversely affects their well-being and care quality. However, a standardized conceptual definition of this phenomenon remains lacking. This study aimed to clarify the concept of affiliate stigma among family caregivers using Rodgers' evolutionary concept analysis. A systematic literature search across nine electronic databases yielded 40 studies from 11 countries across Africa, Asia, Europe, and North America. Five core attributes were identified: associative passivity, social labeling, associative social exclusion, emotional internalization, and behavioral concealment. Antecedents included demographic factors, disease-related awareness, sociocultural factors, and social support. Consequences included significantly heightened negative emotions, deteriorating physical health, altered family dynamics, and reduced quality of life. This analysis provides a structured conceptual understanding of affiliate stigma and offers a theoretical foundation for developing culturally sensitive assessment tools and targeted interventions to support family caregivers and improve care outcomes.