Adapting an Evidence-Based Intervention Targeting HIV-Infected Prisoners in Malaysia

HIV-infected prisoners in Malaysia represent a critical target population for secondary HIV risk reduction interventions and care. We report on the process and outcome of our formative research aimed at systematically selecting and adapting an EBI designed to reduce secondary HIV risk and improve adherence to antiretroviral therapy among soon-to-be-released HIV-infected prisoners. Our formative work involved a critical examination of established EBIs and associated published reports complemented by data elicited through structured interviews and focus groups with key stakeholders, members of the target population, and their family members. Based on all information, we adapted the Holistic Health Recovery Program targeting people living with HIV (HHRP+), an EBI, to consist of eight 2-hour sessions that cover a range of specified topics so that participants may individually apply intervention content as needed to accommodate their particular substance abuse, HIV risk, and antiretroviral adherence issues. This study provides a complete example of the process of selecting and adapting an EBI—taking into account both empirical evidence and input from target organization stakeholders and target population members and their families—for use in real world prison settings where high-risk populations are concentrated.

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HIV Vulnerabilities and Risk Perception of Justice-Involved Women

Critical Social Work ◽

10.22329/csw.v15i1.5911 ◽

2019 ◽

Vol 15 (1) ◽

Author(s):

Lisa De Saxe Zerdena ◽

Anna Scheyett ◽

Catherine I. Fogelc

Keyword(s):

Risk Perception ◽

Qualitative Study ◽

Hiv Risk ◽

Justice System ◽

Hiv Positive ◽

Structured Interviews ◽

Formerly Incarcerated ◽

Hiv Risks ◽

Prevention Interventions ◽

Hiv Risk Reduction Interventions

Women with histories of justice involvement are not only more likely to enter prison with a diagnosis of HIV infection, but also are up to 15 times more likely to be HIV positive than women in the general U.S. population. Given the growing prevalence of both women affected by HIV and women in the criminal justice system, an urgent need exists for prevention interventions tailored for justice-involved women. This formative qualitative study uses semi-structured interviews to examine formerly incarcerated women’s perspectives on their HIV risks and behaviors. Findings inform future HIV-risk reduction interventions for justice-involved women.

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The Lived Experiences of Stigmatization in the Process of HIV Status Disclosure among People Living with HIV in Taiwan

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18105089 ◽

2021 ◽

Vol 18 (10) ◽

pp. 5089

Author(s):

Chia-Hui Yu ◽

Chu-Yu Huang ◽

Nai-Ying Ko ◽

Heng-Hsin Tung ◽

Hui-Man Huang ◽

...

Keyword(s):

Lived Experiences ◽

Healthcare Professionals ◽

Social Stigma ◽

People Living With Hiv ◽

Hiv Status ◽

Structured Interviews ◽

Two Phases ◽

Hiv Status Disclosure ◽

Living With Hiv ◽

Status Disclosure

People living with HIV (PLWH) face social stigma which makes disclosure of HIV status difficult. The purpose of this descriptive qualitative study was to understand the lived experiences of stigmatization in the process of disease disclosure among PLWH in Taiwan. Analysis of the semi-structured interviews from 19 PLWH in Taiwan revealed two phases and six themes. Phase one “experiences before disclosure” involved three themes: “Struggles under the pressure of concealing the HIV Status,” “Torn between fear of unemployment/isolation and desire to protect closed ones,” and “Being forced to disclose the HIV status.” Phase two “experiences after disclosure” included three themes: “Receiving special considerations and requirements from school or work,” “Receiving differential treatments in life and when seeking medical care,” and “Stress relief and restart.” Healthcare professionals need to assess stigmatization in PLWH and develop individualized approaches to assist with the disease disclosure process.

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HIV-related stigma in the UK then and now: to what extent are we on track to eliminate stigma? A qualitative investigation

BMC Public Health ◽

10.1186/s12889-021-11000-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Barbara Hedge ◽

Karrish Devan ◽

Jose Catalan ◽

Anna Cheshire ◽

Damien Ridge

Keyword(s):

Antiretroviral Treatment ◽

Hiv Transmission ◽

Minority Groups ◽

Physical Violence ◽

Hiv Care ◽

People Living With Hiv ◽

Structured Interviews ◽

Health And Social Care ◽

Related Stigma ◽

Engagement In Hiv Care

Abstract Background The introduction of effective antiretroviral treatment in the late 1990s led to the perception that HIV was a chronic but manageable condition. Nevertheless, stigma remains one of the major hurdles for people living with HIV (PLWH) to accessing healthcare and biomedical preventions. Thus, Fast Track Cities has set a target of zero HIV discrimination by 2030 as part of its strategy to end HIV transmission. Methods Fifty-three participants from the United Kingdom, including PLWH (n = 21, 40%), health and social care workers (n = 24, 45%), and charity workers and activists (n = 13, 25%), were recruited. Semi-structured interviews investigated stigma and discrimination, focusing on both before and after the widespread use of effective antiretroviral treatment in the late 1990s. Data were analysed using a thematic approach. Results Before effective antiretroviral treatment narratives were shaped by two main themes: 1) the media’s role in influencing public opinion and contributing to misunderstandings of HIV transmission; and 2) personal experiences of HIV-related stigma, which for PLWH included incidents of physical violence and aggression, as well as fears of their HIV status being publicised. Contemporary narratives on stigma experiences were organised around four themes: 1) discrimination in healthcare settings; 2) stigma amongst men who have sex with men (MSM); 3) stigma towards African and Afro-Caribbean PLWH; and 4) the limits of change in public HIV-related knowledge and attitudes. Contemporary narratives indicated a reduction in enacted stigma, but continued anticipation of discrimination and self-reported shame, particularly in MSM and African and Afro-Caribbean PLWH. Conclusion The nature of stigma against those with HIV has evolved. The intersection of PLWH and minority groups (e.g. MSM and African and Afro-Caribbean persons) may enhance anticipatory and internalised stigma, with some suggestion that this may contribute to reduced engagement in HIV care and prevention services. Our findings indicate the need for further research in this area, as well as proactive interventions with community groups to enhance knowledge of HIV.

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Positive Prevention: HIV Risk Reduction for People Living with HIV/AIDS

HIV/AIDS in South Africa 25 Years On ◽

10.1007/978-1-4419-0306-8_18 ◽

2009 ◽

pp. 273-286

Author(s):

Seth C. Kalichman ◽

Leickness C. Simbayi

Keyword(s):

Risk Reduction ◽

Hiv Risk ◽

People Living With Hiv ◽

Hiv Risk Reduction ◽

Positive Prevention ◽

Living With Hiv ◽

Hiv Aids

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The Impact of Stigma and Discrimination on Adherence to Medication amongst People Living with HIV in Tiv Land, North Central Nigeria

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2019/v30i130165 ◽

2019 ◽

pp. 1-9

Author(s):

Godwin Aondohemba Timiun ◽

Timothy J. Scrase

Keyword(s):

People Living With Hiv ◽

Structured Interviews ◽

Hiv Patients ◽

Stigma And Discrimination ◽

Treatment Services ◽

Adherence To Medication ◽

Multi Stage ◽

Living With Hiv ◽

And Control ◽

The Impact

In spite the identification of stigma as a factor impeding public utilisation of HIV counselling, testing, and treatment services in Nigeria, gaps still exist in knowledge on the impact of stigma, and discrimination on adherence to medication amongst people living with HIV (PLWH). This study adopted mixed methods to examine the impact of stigma and discrimination on adherence to medication amongst PLWH in Nigeria. A sample of 1,621 respondents was collected using multi-stage and purposive sampling methods. Structured interviews using questionnaires and in-depth interviews (using a guide) were utilised for data collection. SPSS (version 21) was used for quantitative data analysis while the qualitative data was analysed thematically. There are 46.3% men and 53.7% women respondents. Generally, their income is low, 70.7% are earning less than N25, 000 (approximately $125 USD) per month. Some of the HIV patients are stigmatised. In reaction, they avoid public places, travel long distances away from their immediate community to collect drugs and to avoid been noticed around the centers. They sometimes miss taking drugs regularly as prescribed, suffer depression and die. Stigma and discrimination impede adherence to medication amongst PLHW in Nigeria. More efforts should be made to create awareness to reduce stigma and discrimination of HIV patients, while augmenting their income to meet up with the challenges of adherence to medication. The overall benefits would be enhanced mechanism of HIV prevention, treatment and control in the study area.

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Counting, Coping, and Navigating the Flux: A Focused Ethnographic Study of HIV and Diabetes Self-Management

Qualitative Health Research ◽

10.1177/10497323211064231 ◽

2021 ◽

pp. 104973232110642

Author(s):

Chelsi W Ohueri ◽

Alexandra A. García ◽

Julie A. Zuñiga

Keyword(s):

Management Practices ◽

Participant Observation ◽

Ethnographic Study ◽

Self Management ◽

People Living With Hiv ◽

Structured Interviews ◽

Familial Support ◽

Multiple Observations ◽

Dual Diagnoses ◽

Living With Hiv

Approximately 10–15% of people living with HIV are also diagnosed with diabetes. To manage their two chronic conditions, people must undertake certain activities and adopt behaviors. Due to overlapping symptoms, complex medication regimens, and heavy patient workloads, implementing these self-management practices can be difficult. In this focused ethnography, data were collected from semi-structured interviews and limited participant-observation with a selected subset of participants to gain insight into self-management challenges and facilitators. We conducted interviews and multiple observations with 22 participants with HIV+T2DM over the period of 9 months. Participants experienced numerous barriers to self-management in the areas of diet, medication adherence, and mental health. Social and familial support, as well as consistent access to care, were facilitators for optimal self-management. At the same time participants’ lives were in a unique flux shaped by the dual diagnoses, and therefore, required constant mental and physical adjustments, thus illustrating challenges of managing chronicity.

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Discrimination Against People With HIV and AIDS in the Workplace

10.4018/978-1-6684-2405-6.ch064 ◽

2022 ◽

pp. 1255-1275

Author(s):

Chinwe Rosabelle Nwanna

Keyword(s):

Urban Areas ◽

Secondary Data ◽

Hiv And Aids ◽

Rural Setting ◽

Primary Data ◽

People Living With Hiv ◽

Structured Interviews ◽

Rural And Urban Areas ◽

Rural And Urban ◽

Lagos State

The main thrust of the chapter was to explore the discrimination experienced by people living with HIV and AIDS (PLHIV) in the workplace in Lagos State. A purposive sample of 80 PLHIV was selected from two local government areas (LGAs) of Lagos state: Epe, a rural setting, and Lagos Mainland, an urban one. Secondary data were obtained from internet sources while primary data were collected through structured interviews September 2005–April 2006. Data were analyzed using SPSS versions 11 and 13. Data between and within the rural and urban areas were also analyzed comparatively. The results indicate that PLHIV experienced instant dismissal from offices, mandatory HIV tests, alienation, denial of promotion, and exclusion from insurance schemes. This indicates that PLHIV's rights were violated. The study recommends intensive HIV education and enforcement of national HIV policy and international legal instruments in the workplace to protect PLHIV's rights.

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Agents of change among people living with HIV and their social networks: stepped-wedge randomised controlled trial of the NAMWEZA intervention in Dar es Salaam, Tanzania

BMJ Global Health ◽

10.1136/bmjgh-2018-000946 ◽

2019 ◽

Vol 4 (3) ◽

pp. e000946 ◽

Cited By ~ 5

Author(s):

Mary C Smith Fawzi ◽

Hellen Siril ◽

Yuanyuan Liu ◽

Keith McAdam ◽

Donald Ainebyona ◽

...

Keyword(s):

Social Networks ◽

Randomised Controlled Trial ◽

Hiv Risk ◽

Controlled Trial ◽

Risk Behaviour ◽

Dar Es Salaam ◽

People Living With Hiv ◽

Stepped Wedge ◽

Randomised Controlled ◽

Living With Hiv

IntroductionNAMWEZA is a novel intervention that focuses on preventing HIV and promoting sexual and reproductive health and rights by addressing underlying factors related to vulnerability of acquiring HIV, such as depression, intimate partner violence (IPV) and stigma. The goal of the study was to evaluate the effect of the NAMWEZA intervention on risk behaviour as well as factors potentially contributing to this vulnerability for people living with HIV and their network members.MethodsA stepped-wedge randomised controlled trial was conducted from November 2010 to January 2014 among people living with HIV and their network members in Dar es Salaam, Tanzania. 458 people living with HIV were randomised within age/sex-specific strata to participate in the NAMWEZA intervention at three points in time. In addition, 602 members of their social networks completed the baseline interview. Intention-to-treat analysis was performed, including primary outcomes of uptake of HIV services, self-efficacy, self-esteem, HIV risk behaviour and IPV.ResultsFor people living with HIV, a number of outcomes improved with the NAMWEZA intervention, including higher self-efficacy and related factors, as well as lower levels of depression and stigma. IPV reduced by 40% among women. Although reductions in HIV risk behaviour were not observed, an increase in access to HIV treatment was reported for network members (72% vs 94%, p=0.002).ConclusionThese results demonstrate the complexity of behavioural interventions in reducing the vulnerability of acquiring HIV, since it is possible to observe a broad range of different outcomes. This study indicates the importance of formally evaluating interventions so that policymakers can build on evidence-based approaches to advance the effectiveness of HIV prevention interventions.Trial registration numberNCT01693458.

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