HIV-Related Stigma Among Youth Living With HIV in Western Uganda

2021 ◽  
pp. 104973232110123
Author(s):  
Emmanuel Kimera ◽  
Sofie Vindevogel ◽  
Anne-Mie Engelen ◽  
Jessica De Maeyer ◽  
Didier Reynaert ◽  
...  
Keyword(s):  
Process Model ◽  
Comparative Method ◽  
Core Category ◽  
Textual Data ◽  
Related Stigma ◽  
And Behaviors ◽  
Context Specific ◽  
Youth Living With Hiv ◽  
Living With Hiv ◽  
Western Uganda

We present an explanatory theory for HIV-related stigma from the perspectives of youth living with HIV/AIDS (YLWHA) in Western Uganda, on which the fight against this relentless stigma in this age group and locality can be founded. A constant comparative method was used to analyze textual data from in-depth interviews with 35 YLWHA, selected from three health facilities. A stigma process model for YLWHA was developed with the stigmatizing feelings and behaviors as the core category. Concepts delineating causes, consequences, and moderators of HIV-related stigma emerged from the data to complete the stigma process. The specific focus on YLWHA and contextual characteristics adds new dimensions to the understanding of HIV-related stigma that are scant in existing HIV-related stigma models. In light of our findings, research is necessary to identify context-specific strategies to overcome the deep-rooted causes of stigmatizing views and behaviors in all social spheres of YLWHA within Western Uganda.

scholarly journals Experiences and effects of HIV-related stigma among youth living with HIV/AIDS in Western Uganda: A photovoice study

PLoS ONE ◽  
2020 ◽  
Vol 15 (4) ◽  
pp. e0232359 ◽  
Author(s):  
Emmanuel Kimera ◽  
Sofie Vindevogel ◽  
Didier Reynaert ◽  
Kintu Mugenyi Justice ◽  
John Rubaihayo ◽  
...  
Keyword(s):  
Related Stigma ◽  
Youth Living With Hiv ◽  
Living With Hiv ◽  
Western Uganda ◽  
Hiv Aids

scholarly journals Care and support for youth living with HIV/AIDS in secondary schools: perspectives of school stakeholders in western Uganda

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Emmanuel Kimera ◽  
Sofie Vindevogel ◽  
Didier Reynaert ◽  
Anne-Mie Engelen ◽  
Kintu Mugenyi Justice ◽  
...  
Keyword(s):  
Secondary Schools ◽  
Qualitative Inquiry ◽  
Resource Limited ◽  
Care And Support ◽  
Gradual Process ◽  
Youth Living With Hiv ◽  
Living With Hiv ◽  
Western Uganda ◽  
Hiv Aids ◽  
School Stakeholders

Abstract Background Although schools have been identified as significant settings in the response to the HIV/AIDS pandemic, limited research is available on how they can accommodate Youth Living with HIV/AIDS (YLWHA), especially in resource limited countries. In this study, we explored strategies by school stakeholders (school staff, parents/caretakers, and students) in western Uganda to care for and support YLWHA in their schools. Methods The article utilizes data collected between May and October, 2019 from a qualitative inquiry based on focus group discussions and interviews with 88 school stakeholders purposively selected from 3 secondary schools in western Uganda. Textual data was analyzed thematically involving both inductive and deductive coding. Results We identified 7 overarching interrelated themes in which participants reported strategies to care for and support YLWHA: counselling and guidance; social support networks and linkages; knowledge and skills; anti-stigma and anti-discrimination measures; disclosure of HIV status; treatment and management of HIV/AIDS; and affirmative actions for YLWHA. Stakeholders’ strategies often differed regarding what was considered appropriate, the approach and who to take lead in supporting YLWHA. Conclusions Despite the limited care and support strategies specific for YLWHA currently available in schools, our study points to optimism and high potential given stakeholders’ identified avenues for improvement. We posit that promoting HIV/AIDS-care and support in schools is a gradual process requiring each school to develop a strong knowledge base about HIV/AIDS and support needs of YLWHA, develop a coherent and school-wide approach, and collaborate extensively with external stakeholders who are significant in supporting YLWHA.

scholarly journals Youth living with HIV/AIDS in secondary schools: perspectives of peer educators and patron teachers in Western Uganda on stressors and supports

2019 ◽  
Vol 16 (1) ◽  
pp. 51-61 ◽  
Author(s):  
Emmanuel Kimera ◽  
Sofie Vindevogel ◽  
John Rubaihayo ◽  
Didier Reynaert ◽  
Jessica De Maeyer ◽  
...  
Keyword(s):  
Secondary Schools ◽  
Peer Educators ◽  
Youth Living With Hiv ◽  
Living With Hiv ◽  
Western Uganda ◽  
Hiv Aids

scholarly journals Qualitative Comparison of Barriers to Antiretroviral Medication Adherence Among Perinatally and Behaviorally HIV-Infected Youth

2017 ◽  
Vol 27 (8) ◽  
pp. 1177-1189 ◽  
Author(s):  
Errol L. Fields ◽  
Laura M. Bogart ◽  
Idia B. Thurston ◽  
Caroline H. Hu ◽  
Margie R. Skeer ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Comparative Method ◽  
Qualitative Comparison ◽  
Antiretroviral Medication ◽  
Antiretroviral Medication Adherence ◽  
Constant Comparative Method ◽  
Perinatally Infected ◽  
Youth Living With Hiv ◽  
Living With Hiv ◽  
Common Barriers

Medication adherence among youth living with HIV (28%–69%) is often insufficient for viral suppression. The psychosocial context of adherence barriers is complex. We sought to qualitatively understand adherence barriers among behaviorally infected and perinatally infected youth and develop an intervention specific to their needs. We conducted in-depth interviews with 30 youth living with HIV (aged 14–24 years) and analyzed transcripts using the constant comparative method. Barriers were influenced by clinical and psychosocial factors. Perinatally infected youth barriers included reactance, complicated regimens, HIV fatigue, and difficulty transitioning to autonomous care. Behaviorally infected youth barriers included HIV-related shame and difficulty initiating medication. Both groups reported low risk perception, medication as a reminder of HIV, and nondisclosure, but described different contexts to these common barriers. Common and unique barriers emerged for behaviorally infected and perinatally infected youth reflecting varying HIV experiences and psychosocial contexts. We developed a customizable intervention addressing identified barriers and their psychosocial antecedents.

scholarly journals Experiences and perceptions of youth living with HIV in Western Uganda on school attendance: barriers and facilitators

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Emmanuel Kimera ◽  
Sofie Vindevogel ◽  
Mugenyi Justuce Kintu ◽  
John Rubaihayo ◽  
Jessica De Maeyer ◽  
...  
Keyword(s):  
School Attendance ◽  
Barriers And Facilitators ◽  
Youth Living With Hiv ◽  
Living With Hiv ◽  
Western Uganda

Adolescent Trials Network for HIV-AIDS Scale It Up Program: Protocol for a Rational and Overview (Preprint)

2018 ◽  
Author(s):  
Sylvie Naar ◽  
Jeffrey T Parsons ◽  
Bonita F Stanton
Keyword(s):  
Implementation Science ◽  
Large Body ◽  
Hiv Infections ◽  
Self Management ◽  
Management Interventions ◽  
Hiv Research ◽  
The Individual ◽  
Youth Living With Hiv ◽  
Living With Hiv ◽  
Hiv Aids

BACKGROUND The past 30 years have witnessed such significant progress in the prevention and treatment of HIV/AIDS that an AIDS-free generation and the end to the global AIDS epidemic are ambitious, but achievable, national and global goals. Despite growing optimism, globally, youth living with HIV are markedly less likely to receive antiretroviral therapy than adults (23% vs 38%). Furthermore, marked health disparities exist regarding HIV infection risk, with young men of color who have sex with men disproportionately affected. A large body of research has identified highly impactful facilitators of and barriers to behavior change. Several efficacious interventions have been created that decrease the rate of new HIV infections among youth and reduce morbidity among youth living with HIV. However, full benefits that should be possible based on the tools and interventions currently available are yet to be realized in youth, in large part, because efficacious interventions have not been implemented in real-world settings. Scale It Up (SIU) primarily aims to assemble research teams that will ultimately bring to practice evidence-based interventions that positively impact the youth HIV prevention and care cascades, and in turn, advance the fields of implementation science and self-management science. OBJECTIVE This paper aims to describe the structure of the U19-SIU and the effectiveness-implementation hybrid trials, as well as other center-wide protocols and initiatives, implemented within SIU. METHODS SIU will achieve its aims through 4 individual primary protocols, 2 center-wide protocols, and 3 cross-project initiatives. RESULTS SIU was funded by National Institute for Child Health and Human Development (U19HD089875) and began in October 2016. As of November 2018, 6 SIU protocols have launched at least the first phase of work (ATN 144 SMART: Sequential Multiple Assignment Randomized Trial; ATN 145 YMHP: Young Men’s Health Project; ATN 146 TMI: Tailored Motivational Interviewing Intervention; ATN 153 EPIS: Exploration, Preparation, Implementation, Sustainment model; ATN 154 CM: Cascade Monitoring; ATN 156 We Test: Couples' Communication and HIV Testing). Further details can be found in the individual protocol papers. CONCLUSIONS To date, the youth HIV research portfolio has not adequately advanced the important care area of self-management. SIU protocols and initiatives address this broad issue by focusing on evaluating the effectiveness and implementation of self-management interventions. SIU is highly innovative for 5 primary reasons: (1) our research framework expands the application of “self-management”; (2) the 4 primary protocols utilize innovative hybrid designs; (3) our Analytic Core will conduct cost-effectiveness analyses of each intervention; (4) across all 4 primary protocols, our Implementation Science Core will apply implementation scales designed to assess inner and outer context factors; and (5) we shall advance understanding of the dynamics between provider and patient through analysis of recorded interactions. INTERNATIONAL REGISTERED REPOR DERR1-10.2196/11204

scholarly journals The role of unintended pregnancy in internalized stigma among women living with HIV in Kenya

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sara Chace Dwyer ◽  
Aparna Jain ◽  
Wilson Liambila ◽  
Charlotte E. Warren
Keyword(s):  
Unintended Pregnancy ◽  
Hiv Treatment ◽  
Outcome Variable ◽  
Internalized Stigma ◽  
Health Seeking ◽  
Logistic Regression Models ◽  
Stigma And Discrimination ◽  
Women Living With Hiv ◽  
Related Stigma ◽  
Living With Hiv

Abstract Background Kenya has successfully expanded HIV treatment, but HIV-related stigma and discrimination, and unintended pregnancy remain issues for many Kenyan women living with HIV. While HIV-related stigma can influence the health seeking behaviors of those living with HIV, less is known about how reproductive health outcomes influence internalized stigma among women living with HIV. Methods Baseline data only were used in this analysis and came from an implementation science study conducted in Kenya from 2015 to 2017. The analytic sample was limited to 1116 women who are living with HIV, between 18 to 44 years old, and have ever experienced a pregnancy. The outcome variable was constructed from 7 internalized stigma statements and agreement with at least 3 statements was categorized as medium/high levels of internalized stigma. Unintended pregnancy, categorized as unintended if the last pregnancy was mistimed or unwanted, was the key independent variable. Univariate and multivariate logistic regression models were used to assess the association between unintended pregnancy and internalized stigma. Associations between internalized stigma and HIV-related discrimination and violence/abuse were also explored. Results About 48% agreed with at least one internalized stigma statement and 19% agreed with at least three. Over half of women reported that their last pregnancy was unintended (59%). Within the year preceding the survey, 52% reported experiencing discrimination and 41% reported experiencing violence or abuse due to their HIV status. Women whose last pregnancy was unintended were 1.6 times (95% CI 1.2–2.3) more likely to have medium/high levels of internalized stigma compared to those whose pregnancy was wanted at the time, adjusting for respondents’ characteristics, experiences of discrimination, and experiences of violence and abuse. Women who experienced HIV-related discrimination in the past 12 months were 1.8 times (95% CI 1.3–2.6) more likely to have medium/high levels of internalized stigma compared to those who experienced no discrimination. Conclusions Results suggest that unintended pregnancy is associated with internalized stigma. Integrated HIV and FP programs in Kenya should continue to address stigma and discrimination while increasing access to comprehensive voluntary family planning services for women living with HIV.

scholarly journals Stigma mastery in people living with HIV: gender similarities and theory

2021 ◽  
Author(s):  
Charles Patrick Namisi ◽  
John C. Munene ◽  
Rhoda K. Wanyenze ◽  
Anne R. Katahoire ◽  
Rosalinda M. Parkes-Ratanshi ◽  
...  
Keyword(s):  
Older Women ◽  
Social Exclusion ◽  
Theoretical Framework ◽  
People Living With Hiv ◽  
Negative Effects ◽  
Hiv Diagnosis ◽  
Cross Sectional ◽  
Age Related ◽  
Related Stigma ◽  
Living With Hiv

Abstract Aims This study aimed to determine the prevalence of, factors associated with, and to build a theoretical framework for understanding Internalsed HIV-related Stigma Mastery (IHSM). Methods A cross-sectional study nested within a 2014 Stigma Reduction Cohort in Uganda was used. The PLHIV Stigma Index version 2008, was used to collect data from a random sample of 666 people living with HIV (PLHIV) stratified by gender and age. SPSS24 with Amos27 softwares were used to build a sequential-mediation model. Results The majority of participants were women (65%), aged ≥ 40 years (57%). Overall, IHSM was 45.5% among PLHIV, that increased with age. Specifically, higher IHSM correlated with men and older women “masculine identities” self-disclosure of HIV-diagnosis to family, sharing experiences with peers. However, lower IHSM correlated with feminine gender, the experience of social exclusion stress, fear of future rejection, and fear of social intimacy. Thus, IHSM social exclusion with its negative effects and age-related cognition are integrated into a multidimensional IHSM theoretical framework with a good model-to-data fit. Conclusion Internalised HIV-related Stigma Mastery is common among men and older women. Specificially, “masculine identities” self-disclose their own HIV-positive diagnosis to their family, share experiences with peers to create good relationships for actualising or empowerment in stigma mastery. However, social exclusion exacerbates series of negative effects that finally undermine stigma mastery by young feminine identities. Thus, stigma mastery is best explained by an integrated empowerment framework, that has implications for future practice, policy, and stigma-related research that we discuss.

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