The relationship between stigma and a rehabilitation framework [international classification of functioning, disability and health (ICF)]: three case studies of women living with HIV in Lusaka, Zambia.
PURPOSE
To explore how the International Classification of Functioning, Disability and Health, a rehabilitation framework, can provide a holistic understanding of stigma experiences of three women living with human immunodeficiency virus in Lusaka, Zambia.


METHODS
A secondary analysis of three cases by drawing on interview transcripts collected as part of a larger longitudinal study with eighteen women living with the virus. The interview tool used the rehabilitation framework to ask questions about the impact of the virus on the body, daily activities, social participation and the future. Vignettes were produced for each of the eighteen women including information on stigma and the rehabilitation framework. Three case studies were developed from women who provided comprehensive accounts of stigma and the International Classification of Functioning, Disability and Health.


RESULTS
Stigma experiences aligned well with three dimensions of the International Classification of Functioning, Disability and Health: participation restrictions, environmental and personal factors. These domains were used to understand stigma in three forms (i.e. enacted, self and structural stigma) as experienced by these women.


CONCLUSIONS
More research is needed to ascertain how stigma and rehabilitation are related in other environments and populations and to explore how to mitigate stigma within the rehabilitation context.IMPLICATIONS FOR REHABILITATIONRehabilitation professionals deal with aspects of stigma and discrimination in their clinical work and this analysis offers a way to consider HIV-related stigma within rehabilitation in an organized and theoretically-informed way.The insights from this study are important for the field of HIV and for advancing understanding of the complexities of stigma in the context of rehabilitation more broadly.This analysis offers guidance to rehabilitation providers about the nuanced and multi-faceted ways that stigma can occur in the context of rehabilitation, including within their own clinical practice.
['Stevens|Marianne E|ME|0000-0002-1870-0641', 'Parsons|Janet A|JA|', 'Read|Stanley E|SE|0000-0001-7035-0282', 'Bond|Virginia|V|', 'Solomon|Patricia|P|', 'Nixon|Stephanie A|SA|']
D000203:Activities of Daily Living D004185:Disability Evaluation D006233:Disabled Persons D005260:Female D015658:HIV Infections D006801:Humans D064702:International Classification of Functioning, Disability and Health D008137:Longitudinal Studies D015024:Zambia
stigma Rehabilitation International Classification of Functioning Disability and Health women HIV case reports