Strengthening the US Health Workforce to End the HIV Epidemic: Lessons Learned From 11 Ending the HIV Epidemic Jurisdictions

JAIDS Journal of Acquired Immune Deficiency Syndromes, Год журнала: 2025, Номер 98(5S), С. e181 - e191

Опубликована: Март 31, 2025

Background: Supplements were awarded under the National Institutes of Health, ending HIV epidemic (EHE) initiative to foster implementation science through community-engaged research. The objective this study was synthesize lessons learned, identify areas research sufficiently studied, and present an agenda for future on health workforce development from a collaboration across 9 EHE projects in 11 jurisdictions United States. Methods: supplement recipients completed semistructured questionnaire shared learned about common themes using Consolidated Framework Implementation Research Expert Recommendation Implementing Change frameworks. Data synthesized topic no longer need research, next steps. Results: Project teams emphasized several strategies including clarifying roles responsibilities, dynamic training, stigma mitigation as enhance prevention treatment services. Strengthening organizational support supportive supervision structures, ensuring sustainable funding, preventing turnover, addressing salary constraints, establishing clear promotion educational pathways identified useful workplace strategies. deploying community engagement ensure communities aware Several studied that can be deprioritized discussed. Conclusion: A moving forward is discussed with recommendations improve programs.

Язык: Английский

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What Has Been Studied About Attitudes and Social Stigma Towards HIV/AIDS? A Global Bibliometric Study with Correlations on Global Health HIV-Related Indicators

Healthcare, Год журнала: 2025, Номер 13(8), С. 891 - 891

Опубликована: Апрель 13, 2025

Introduction: This study aimed to assess, through health metrics and bibliometric analysis, the global research on attitudes social stigma of people living with HIV/AIDS identify findings, gaps, future directions. Methods: A cross-sectional was conducted a structured search in different databases. Fifteen thousand four hundred ninety-six documents were found between 1981 2024. Results: 83.5% original articles, international co-authorship 30.66%. Since 2000, there has been an increase stigma. The United States is most prolific country worldwide (n = 7837 publications; 50.5%), highest number institutions 4/5), as well greatest influence relevance (h-index 170). studied topics are support psychology concerning homosexuality, middle age, youth HIV/AIDS. There no significant correlation volume publications, countries’ income levels, geographic regions adult HIV prevalence, overall incidence or antiretroviral therapy coverage (p > 0.05 for all cases). Conclusions: Over past two decades, shifted from human rights, legal ethics toward healthcare, recent interest pre-exposure prophylaxis, gender minorities, intersectional absence strong correlations publications HIV-related indicators underscores necessity translating evidence into actionable strategies reduce improve outcomes.

Язык: Английский

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Interventions for stigma reduction in HIV treatment and prevention designed to enhance antiretroviral uptake and adherence: A systematic review

PLOS Global Public Health, Год журнала: 2025, Номер 5(5), С. e0004604 - e0004604

Опубликована: Май 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.

Язык: Английский

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Current Status of HIV-Stigma Reduction Interventions: A Need to Address the Root Causes at Multiple Levels

Current HIV/AIDS Reports, Год журнала: 2025, Номер 22(1)

Опубликована: Май 29, 2025

Язык: Английский

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HIV-Related Stigma, Social Support, and Symptoms of Mental Health Disorders Among People with HIV Initiating HIV Care in Cameroon

AIDS Patient Care and STDs, Год журнала: 2023, Номер 37(3), С. 146 - 154

Опубликована: Фев. 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

Язык: Английский

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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

Annals of Behavioral Medicine, Год журнала: 2023, Номер 57(10), С. 801 - 816

Опубликована: Июнь 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.

Язык: Английский

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

BMC Public Health, Год журнала: 2024, Номер 24(1)

Опубликована: Май 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.

Язык: Английский

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Policy recommendations to promote health and well‐being in sexual and gender minority populations in the United States

Social Issues and Policy Review, Год журнала: 2023, Номер 17(1), С. 3 - 33

Опубликована: Янв. 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.

Язык: Английский

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“I felt special!”: a qualitative study of peer‐delivered HIV self‐tests, STI self‐sampling kits and PrEP for transgender women in Uganda

Journal of the International AIDS Society, Год журнала: 2023, Номер 26(12)

Опубликована: Дек. 1, 2023

Abstract Introduction Peer delivery is a client‐centred approach that could maximize the coverage and impact of HIV services for transgender women (TGW). We conducted qualitative interviews to examine how peer‐delivered self‐testing (HIVST), sexually transmitted infection self‐sampling (STISS) oral pre‐exposure prophylaxis (PrEP) influenced prevention choices among TGW their intimate partners in Uganda. Methods Within cluster randomized trial HIVST, STISS PrEP HIV‐negative (NCT04328025), we 55 with 30 TGW, 15 10 peers (August 2021–February 2022). explored: (1) self‐test experiences; (2) HIVST partners; (3) descriptions STI testing. Partner covered: experiences HIVST; disclosure status partner; sexual behaviours after interview topics included: intervention recommendations including psychological support coping strategies. Qualitative data were analysed using an inductive content analytic approach. Results Peer‐delivered combination was valued by this group partners. extended beyond delivering HIV/STI kits refills caring individual health wellbeing providing stigma psychosocial empowered research participants become “HIVST ambassadors,” teach non‐study about PrEP, encourage linkage care. mutual strengthened partnered relationships. use both tested negative implied infidelity. Self‐sampling enabled take control testing avoid embarrassment exposing bodies. Privacy confidentiality motivated uptake treatment. Conclusions In sample from Uganda, peer benefitted efforts new not engaged Integrating into differentiated increase test vulnerable population.

Язык: Английский

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Biopsychosocial Health Outcomes and Experienced Intersectional Stigma in a Mixed HIV Serostatus Longitudinal Cohort of Aging Sexual Minority Men, United States, 2008‒2019

American Journal of Public Health, Год журнала: 2022, Номер 112(S4), С. S452 - S462

Опубликована: Июнь 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 )

Язык: Английский

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