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While HIV infection has been a worldwide epidemic, minority and poor rural groups the world over have been disproportionately affected by the disease. People of color have been most affected, particularly in rural areas of sub-Saharan Africa and the United States. HIV/AIDS is a highly stigmatized disease, and the stigma attached to the disease has fed into, and in many ways strengthened, pre-existing stigma and prejudice against certain groups in the society. This paper gives an analysis of factors that create and sustain such stigma in rural communities, with particular reference to Nigeria, which is Africa's most populous country. The paper offers a participatory ecological model for community intervention. The human immunodeficiency viral (HIV) disease is a severe and progressive chronic illness that is a major source of excessive morbidity and mortality worldwide. Symptomatic HIV disease has a significant impact on the communities and lives of both infected individuals and their families. While HIV disease affects all nations, ethnic groups, communities and people of color have been most affected, particularly in rural areas of sub-Saharan Africa and the United States (CDC, 2002; Leonard, 2001; HIV/AIDS in Africa, 2002; Pan African New Agency, 2001; UNAIDS, 2001; UNAIDS/WHO, 1999; World Bank, 2002). Worldwide, the mental health consequences of the epidemic are substantial (WHO, 2001). Sowell et al. (1996) describe the spread of the disease to rural communities as a part of the "second wave" of the epidemic. AIDS stigma refers to prejudice, discounting, discrediting and discrimination directed at people perceived to have AIDS or HIV, as well as the individuals, groups and communities with which they are associated. The effect of intense stigma and discrimination against people with HIV/AIDS plays a major role in psychological stress, including disorders such as depression and anxiety, particularly in the rural areas. Stigma also hampers preventive efforts as people afflicted with the disease are reluctant to reveal their serostatus. Relationships are very important to people in the rural areas, therefore, community intervention for HIV/AIDS should employ a participatory approach aimed at building support networks for people living with HIV/AIDS (PLWHA) in the rural areas. Such a network will provide group support needed to function under a hostile atmosphere of stigma.

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International Journal of Global Health and Health Disparities





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©2004 International Journal of Global Health and Health Disparities



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