Public health services and intersectional stigma: a social sciences perspective with implications for HIV service design and delivery DOI
Rayner Kay Jin Tan, Weiming Tang, Joseph D. Tucker

et al.

Current Opinion in HIV and AIDS, Journal Year: 2022, Volume and Issue: 18(1), P. 18 - 26

Published: Nov. 29, 2022

Purpose of review Understanding stigma is important for improving HIV care services and gaps in service delivery have been attributed to stigma. This article synthesizes recent evidence on its implications design delivery. Given the intersectional nature stigma, we will focus as well related forms based one's race, sexual identity, gender identity other identities. Recent findings Stigma remains a barrier achieving equity services. Individualistic measures remain influential are associated with barriers accessing health work also highlights measured at structural level impact contexts. Individuals situated intersections marginalized identities continue face greatest injustices, although approaches adapted micro level, few change. mitigating indicates some success psychosocial interventions that target internalized Furthermore, community-led show promise addressing manifests settings. Summary Interventions address individual-level needed. Theoretical applied antistigma research needed make more equitable.

Language: Английский

Interventions for stigma reduction in HIV treatment and prevention designed to enhance antiretroviral uptake and adherence: A systematic review DOI Creative Commons
Amit Mickey Dhir, Amteshwar Singh, Sunil S. Solomon

et al.

PLOS Global Public Health, Journal Year: 2025, Volume and Issue: 5(5), P. e0004604 - e0004604

Published: May 12, 2025

HIV remains a significant public health burden worldwide, especially in developing countries, despite the availability of effective prevention and treatment modalities, namely PrEP ART, respectively. HIV-related stigma is barrier to optimal uptake or adherence ART vulnerable populations. Therefore, there need for interventions that can address improve This systematic review aimed identify effectively reduce individuals. A methodology following PRISMA guidelines was used. The sources information included MEDLINE (via PubMed search engine), Embase, Scopus, Web Science, CINAHL, PsycINFO. Studies were eligible if they randomized controlled trials (RCTs) quasi-experimental studies investigating effectiveness any intervention addressing among persons living with improving ART/PrEP adherence. We adopted narrative synthesis approach present our findings. For quality appraisal studies, we used Cochrane Risk Bias (RoB 2) tool.Eight RCTs, but no met eligibility criteria. Among seven RCTs on adherence, four investigated cognitive behavioral components (two showing positive impact reduction adherence). Other improved while reducing empowerment program youth peer-mentoring. Only one study focused (comprising motivational interviewing, client-centered counseling), which showed Although many have promise simultaneously medication larger scale are needed generalizability. heterogeneity measurement instruments underscores standardized scales. Cognitive therapy, interventions, peer-mentoring, counseling all show self-stigma, Future should consider inclusion diverse populations refining HIV- stigma, about PrEP. It critical incorporate validated tools enhance comparability across research endeavors complex interplay between PROSPERO number : CRD42023455610.

Language: Английский

Citations

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Prevalence of HIV-related stigma manifestations and their contributing factors among people living with HIV in Sweden – a nationwide study DOI Creative Commons

Lena Nilsson Schönnesson,

Marie Dahlberg, Maria Reinius

et al.

BMC Public Health, Journal Year: 2024, Volume and Issue: 24(1)

Published: May 20, 2024

Abstract Background With access to antiretroviral therapy (ART) HIV infection is a chronic manageable condition and non-sexually transmissible. Yet, many people living with still testify about experiencing HIV-related stigma discrimination. It well-documented that discrimination continue be critical barriers prevention, treatment, care quality of life. From an individual stigma-reduction intervention perspective, it essential identify interpersonal factors associated manifestations. To address this issue expand the literature, aim study was assess prevalence manifestations their among diverse sample in Sweden. Method Data from 1 096 participants were derived nationally representative, anonymous cross-sectional survey ”Living Sweden”. assessed using validated Swedish 12-item Stigma Scale encompassing four manifestations: personalised stigma, concerns public attitudes towards HIV, sharing status, internalized stigma. Variables potentially divided into categories: demographic characteristics, clinical factors, distress ART adherence, available emotional support. Four multivariable hierarchical linear regression analyses employed explore associations between multiple contributors Results The most dominating feature anticipation manifested high scores on status reported by 78% 54% participants. High around one third respectively. Between 23 31% variance explained mainly same pattern including female gender, shorter time since diagnosis, feelings hopelessness, non-sharing lack Conclusion Female support constituted potential vulnerability Our findings highlight vital necessity increase resilience its different forms. Exploring may give indication what circumstances risk burden amenable targeted interventions. As stigma-reductions interventions cannot performed isolated society, key challenge intensify anti-stigma also societal level.

Language: Английский

Citations

3
The Fight for an AIDS-Free World: Confronting the Stigma, Reaching the Marginalized DOI Creative Commons
Dorothy Serwaa Boakye, Emmanuel Kumah, Samuel Adjorlolo

et al.

Annals of Global Health, Journal Year: 2024, Volume and Issue: 90(1)

Published: Jan. 1, 2024

Annals of Global Health is a peer-reviewed, fully open access, online journal dedicated to publishing high quality articles all aspects global health. The journal's mission advance health, promote research, and foster the prevention treatment disease worldwide. Its goals are improve health well-being people, equity, wise stewardship earth's environment. latest impact factor 2.90. supported by Program for Public Common Good at Boston College. It was founded in 1934 Icahn School Medicine Mount Sinai as Journal Medicine. partner Consortium Universities Health. From time time, publishes Special Collections, series organized around common theme Recent Collections have included "Local evidence strategies addressing NCDs Non-Communicable Diseases Tanzania", "Universal Coverage through Integrated Care", "The Minderoo-Monaco Commission on Plastics Human Health". workers interested developing Collection strongly encouraged contact Managing Editor discuss project.

Language: Английский

Citations

3
HIV-Related Stigma, Social Support, and Symptoms of Mental Health Disorders Among People with HIV Initiating HIV Care in Cameroon DOI
Angela M. Parcesepe, Lindsey M. Filiatreau, Amanda Gomez

et al.

AIDS Patient Care and STDs, Journal Year: 2023, Volume and Issue: 37(3), P. 146 - 154

Published: Feb. 21, 2023

HIV-related stigma has been associated with poor mental health among people HIV (PWH). Social support is a potentially modifiable factor that may buffer negative sequelae of stigma. Little known about the extent to which modifying effect social differs across disorders. Interviews were conducted 426 PWH in Cameroon. Log binomial regression analyses used estimate association between high anticipated and low from family or friends symptoms depression, anxiety, post-traumatic stress disorder (PTSD), harmful alcohol use, separately. Anticipated was commonly endorsed ∼80% endorsing at least 1 12 stigma-related concerns. In multivariable analyses, greater prevalence depression {adjusted ratio (aPR) 1.6 [95% confidence interval (CI) 1.1-2.2]} anxiety [aPR 2.0 (95% CI 1.4-2.9)]. Low 1.5 1.1-2.2)], 1.7 1.2-2.5)], PTSD 1.0-2.4)]. However, did not meaningfully modify relationship any disorders explored. reported this group initiating care concerns related gossip losing greatest concern. Interventions focused on reducing strengthening systems be particularly beneficial have potential improve

Language: Английский

Citations

8
Policy recommendations to promote health and well‐being in sexual and gender minority populations in the United States DOI
Amelia E. Talley, Melisa Williams Ibora, Tran H. Le

et al.

Social Issues and Policy Review, Journal Year: 2023, Volume and Issue: 17(1), P. 3 - 33

Published: Jan. 1, 2023

Abstract This narrative review examines literature informing policy and laws relevant to the health well‐being of lesbian, gay, bisexual, transgender, queer (LGBTQ+) adult populations. Empirical factors related structural stigma, specifically law, were examined. studies examining stigma health‐related outcomes in LGBTQ+ populations have proliferated since publication Institute Medicine's The Health Lesbian, Gay, Bisexual Transgender People (2010) Hatzenbuehler's theoretical work on stigma‐related influences health. Databases searched using a priori terms. Over 2,100 articles identified that included original data from United States 2010. Studies for inclusion ( n = 78) roughly evenly split according whether results influence federal‐, state‐, or local‐level policies adults’ Policy recommendations center around expansion anti‐discrimination law policy, abolishment restricts access rights adults, supplemental training cultural competencies, provision additional resources vulnerable subpopulations adults.

Language: Английский

Citations

7
A Systematic Review of Intervention Studies That Address HIV-Related Stigmas Among US Healthcare Workers and Health Systems: Applying a Theory-Based Ontology to Link Intervention Types, Techniques, and Mechanisms of Action to Potential Effectiveness DOI
Bryan A. Kutner, Michael Vaughn, Rebecca Giguere

et al.

Annals of Behavioral Medicine, Journal Year: 2023, Volume and Issue: 57(10), P. 801 - 816

Published: June 15, 2023

Abstract Background To end the HIV epidemic, we need to better understand how address HIV-related stigmas in healthcare settings, specifically common theoretical bases across interventions so that can generalize about their potential effectiveness. Purpose We describe theory-based components of stigma by identifying functions/types, techniques, and purported mechanisms change. Methods This systematic review examined studies published April 2021. applied a transtheoretical ontology developed Human Behaviour Change Project, consisting 9 intervention types (ITs), 93 behavior change techniques (BCTs), 26 action (MOAs). coded frequency calculated effectiveness each IT, BCT, MOA. evaluated study quality with 10-item adapted tool. Results Among nine highest studies, indicated use an experimental design, potentially effective IT was “Persuasion” (i.e. using communication induce emotions and/or stimulate action; 66.7%, 4/6 studies). The BCTs were “Behavioral practice/rehearsal” increase habit skill) “Salience consequences” make consequences more memorable; 100%, 3/3 MOAs “Knowledge” awareness) “Beliefs capabilities” self-efficacy; 67%, 2/3 Conclusions By applying synthesized findings on interventions. Interventions typically combined than one Practitioners researchers our select interventions, including areas for further evaluation, expedite ending epidemic.

Language: Английский

Citations

7
Unmasking Individual and Institutional HIV Stigma in Hospitals: Perspectives of Dutch Healthcare Providers DOI Creative Commons
Carlijn Jordans, Klaske Vliegenthart-Jongbloed,

A. W. van Bruggen

et al.

AIDS and Behavior, Journal Year: 2024, Volume and Issue: 28(9), P. 3184 - 3195

Published: June 13, 2024

Abstract People with HIV continue to experience stigma. Quantitative data on stigma perpetrated by healthcare providers of hospitals providing care in high-income countries are limited. The aim this study is investigate factors associated Dutch settings from the providers’ perspective. We conducted a cross-sectional using questionnaire ‘Measuring Stigma and Discrimination Among Health Facility Staff – Monitoring Tool for Global Indicators’ assess among (n = 405) two academic hospitals. Healthcare licensed provide medical were eligible inclusion. primary outcome was self-reported prevalence at least one manifestation measured six indicators (four individual, institutional). Secondary outcomes per indicator, occupation, department, individual indicators. prevalent 88.1% (95%CI 84.5% − 91.2%) participants. mostly driven negative attitudes towards people worry acquire HIV. Multivariate analysis showed that several stigma, including younger age, male sex, working surgical departments, as nurse. Having received any training and/or discrimination less all In conclusion, highly providers. Targeted approaches, discrimination, needed reduce should, others, focus

Language: Английский

Citations

2
Biopsychosocial Health Outcomes and Experienced Intersectional Stigma in a Mixed HIV Serostatus Longitudinal Cohort of Aging Sexual Minority Men, United States, 2008‒2019 DOI
M. Reuel Friedman, Qimin Liu, Steven Meanley

et al.

American Journal of Public Health, Journal Year: 2022, Volume and Issue: 112(S4), P. S452 - S462

Published: June 1, 2022

Objectives. To determine whether intersectional stigma is longitudinally associated with biopsychosocial outcomes. Methods. We measured experienced (EIS; ≥ 2 identity-related attributions) among sexual minority men (SMM) in the United States participating Multicenter AIDS Cohort Study. assessed longitudinal associations between EIS (2008‒2009) and concurrent future hypertension, diabetes, dyslipidemia, antiretroviral therapy adherence, HIV viremia, health care underutilization, depression symptoms (2008‒2019). conducted causal mediation to assess contribution of relationship self-identified Black race persistently uncontrolled Results. The mean age (n = 1806) was 51.8 years (range 22–84 years). Of participants, 23.1% as Black; 48.3% were living HIV. Participants reporting (30.8%) had higher odds symptoms, suboptimal adherence compared participants who did not report EIS. mediated Conclusions. Our findings demonstrate that a durable driver outcomes over life course. Public Health Implications. There critical need for interventions reduce stigma, help SMM cope enact policies protecting minoritized people from discriminatory acts. (Am J Health. 2022;112(S4):S452–S462. https://doi.org/10.2105/AJPH.2022.306735 )

Language: Английский

Citations

11
Socio-ecological Barriers to Viral Suppression Among Transgender Women Living with HIV in San Francisco and Los Angeles, California DOI
Jennifer Jain, Miranda Hill, Kristi E. Gamarel

et al.

AIDS and Behavior, Journal Year: 2023, Volume and Issue: 27(8), P. 2523 - 2534

Published: Jan. 22, 2023

Language: Английский

Citations

6
Supporting Adolescents With HIV in South Africa Through an Adherence-Supporting App: Mixed Methods Beta-Testing Study DOI Creative Commons
Marta I. Mulawa, Bulelwa Mtukushe, Elizabeth T. Knippler

et al.

JMIR Formative Research, Journal Year: 2023, Volume and Issue: 7, P. e47575 - e47575

Published: June 1, 2023

Novel smartphone app-delivered interventions have the potential to improve HIV treatment adherence among adolescents with HIV, although such are limited. Our team has developed Masakhane Siphucule Impilo Yethu (MASI; Xhosa for "Let's empower each other and our health"), a intervention in South Africa. MASI was adapted African cultural context using HealthMpowerment platform, an evidence-based digital health youth United States.We conducted this beta-testing study (1) explore initial usability of MASI, (2) examine engagement experiences features, (3) inform refinements app implementation plan prior subsequent pilot randomized controlled trial (RCT).This from August 2021 December Cape Town, Beta-testing participants received access 3 weeks. A mixed methods approach used, brief questionnaires semistructured in-depth interviews installation after 1 week 2 weeks testing. Engagement measured through analysis back-end paradata, follow-up interview guides were tailored participant based on their use.Participants (6 male participants, 6 female participants; ages 16-19 years) collectively spent 4.3 hours averaging 21.4 minutes per over 3-week period (range 1-51.8 minutes). Participants logged into average 24.1 10-75) times during period. The mean System Usability Scale score 69.5 (SD 18), which is considered slightly above apps. Thematic qualitative results revealed generally positive across opportunities refine delivery identified.Initial high, described having experience features. Systematically analyzing paradata findings allowed us gain richer insights patterns engagement, enabling further enhance MASI. led few technological user experience. Enhancements also made preparation RCT. Lessons learned conduct may development, implementation, evaluation similar future.

Language: Английский

Citations

6