HIV Critical Appraisal | Report

Running head: HIV CRITICAL APPRAISAL
HIV Critical Appraisal
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HIV CRITICAL APPRAISAL1
Table of Contents
Introduction......................................................................................................................................2
Methodology....................................................................................................................................5
Inclusion Criteria.........................................................................................................................6
Exclusion Criteria........................................................................................................................6
Critical Appraisal.............................................................................................................................7
Ethical Aspects..............................................................................................................................13
Alternative epistemological research designs................................................................................15
Conclusion.....................................................................................................................................16
References......................................................................................................................................17
APPENDICES...............................................................................................................................23
APPENDIX 1.............................................................................................................................23
APPENDIX 2.............................................................................................................................24
APPENDIX 4.............................................................................................................................26

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“A critical examination of HIV-related stigma and its association with symptoms of
depression and other negative thoughts among different people.”
Introduction
The human immunodeficiency virus (HIV) is an enclosed retrovirus that consists of two
duplicates of a single-stranded RNA gene. It causes AIDS, which is the last phase of HIV illness.
After HIV enters the body, around four to ten weeks later, the patient may grumble of side
effects of primary diseases. From that point onward, the long interminable HIV disease happens,
which can keep going for a considerable length of time. AIDS is principally portrayed by
adaptable contaminations and tumors, which are typically deadly without treatment (Toledano,
2018). In 2018, the UNAIDS estimated that there are 37.9 million people across the globe who
are suffering due to HIV/AIDS (UNAIDS, 2019). Among these, 36.2 million populations are
adults, and the rest are children below the age of 15 years. It has also been estimated that around
1.7 million have currently come in contact with HIV (UNAIDS, 2019).
In low and middle economic countries (LMICs), common mental disorders (CMDs),
chiefly state of mind and tension issue, have an expected lifetime incidence of 22 percent and
frequently stay undiscovered and untreated. CMDs, particularly sadness, is frequently comorbid
with other interminable ailments, for example, diabetes, epilepsy, cardiovascular infection, and
HIV/AIDS (Kidia et al., 2015).
Since 1981 onwards, there have been gigantic progressions in the treatment of HIV.
Factually, this cannot be questioned. The progressions in ‘Anti-Retroviral Therapy’ (ART) have
reformed the administration of HIV. Thus, in the current days, HIV infection can be stopped, and
its development can be forestalled. Anti-Retroviral Therapy is an excellent success on which

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many epidemiologists, biomedical researchers, and health organizations have worked
consistently to accomplish.
Because antiretroviral treatments (ART) have been adopted, HIV-positive people with
access to medical care may lead longer lives, transforming a once-fatal disease into a more
manageable chronic illness. While significant progress has been made, people living with HIV
(PLWH) are still experiencing potent stressors, one of which is the widespread social stigma
associated with HIV (Sweeney & Vanable, 2016).
Stigma and injustice are one of the most significant challenges facing people living with
HIV today, according to the International Network of People Living with HIV / AIDS. In this
sense, HIV-related stigma was described as discounting, discrediting, and discriminating against
people who consider themselves to have HIV (Rueda et al., 2016). HIV stigma is recognized as
an obstacle to both HIV prevention and HIV treatment, but little is understood about the
processes by which stigma contributes to worse health habits or effects (Turan, Hatcher, Weiser,
Johnson, Rice & Turan, 2017). Generally, in the sense of HIV, shame tends to exist, whether
measured in terms of the behaviors of those who are not diagnosed or in terms of the perceptions
of those living with HIV. Stigma and injustice have a negative effect on HIV-patients. A recent
review of the qualitative evidence showed that HIV-related stigma is a significant and
widespread social phenomenon in many social areas, including healthcare environments (Rueda
et al., 2016).
Depression rates can be as high as 50% for people living with HIV. In many contexts,
HIV-related shame is linked with depressive symptoms that may result in reduced treatment and,
eventually, poor health results (Endeshaw, Walson, Rawlins, Dessie, Alemu, Andrews & Rao,

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2014). Stigma is described as a discrediting attribute that reduces the psychological ability of an
individual. Given its connections with already oppressed activities, including injecting substance
usage, sexual promiscuity, and homosexual activity, HIV-related stigma is considered a
particularly complex phenomenon (Sweeney & Vanable, 2016).
Thirty years into the HIV crisis, people living with HIV (PLWH) continue to report in
clinical facilities witnessing HIV-related stigma. Although advancement in medication has
effectively turned the diagnosis of HIV from a near-death sentence into a controlled chronic
disease, successful HIV treatment needs continued involvement in HIV care (Stringer et al.,
2016). A growing body of research suggests that stigmatizing attitudes and behaviors towards
PLWH act as barriers to PLWH testing, adherence to medication, and retention in care and
adversely affect the quality of life and psychological well-being of both males and females
(Stringer et al., 2016).
This objective of this article is to conduct a critical appraisal of three selected research
papers using the Greenhalgh checklist (Bootland, Coughlan, Galloway, Goubet & McWhirter,
2016). The critical appraisal will ultimately answer the research question, which will be
developed using the PICO method.

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Methodology
In this article, the search strategy method was used to filter out the articles for critical
appraisal. A research question was formed applying the PICO structure to appraise current
research on the HIV related stigma. The resultant question was –
P - HIV related stigma
I – Community engagement programs
C - None
O – Reducing HIV stigma
“Can the involvement of the people facing HIV stigma in community programs help in the
prevention of HIV stigma?”
A search strategy is a system ordered of key terms used to scan a database. The search
approach incorporates the fundamental concepts of the search query to get detailed information.
The search engines like Pub Med, College library, EBSCO, AMED, Psyc info Medline,
EMBASE, CINAHL, NCBI, SAGE, and WHOLIS were used to search for different research
journals published between January 2014 and December 2019 regarding HIV-related stigma.
Medical subject headlines and keyword terms related to HIV/AIDS and stigma were used in the
search strategy.
Initially, we used the keywords such as stigma, depressive symptoms, suicidal behavior,
and people living with HIV/AIDS (PLWH). Several research papers were identified through this
method, though it was hard to filter out the desired research articles for the critical appraisal.