scholarly journals Autonomy-Supportive Healthcare Climate and HIV-Related Stigma Predict Linkage to HIV Care in Men Who Have Sex With Men in Ghana, West Africa

2021 ◽  
Vol 20 ◽  
pp. 232595822097811
Author(s):  
Lily Y. Gu ◽  
Nanhua Zhang ◽  
Kenneth H. Mayer ◽  
James M. McMahon ◽  
Soohyun Nam ◽  
...  
Keyword(s):  
Gender Nonconformity ◽  
Hiv Stigma ◽  
Hiv Care ◽  
Sex Behavior ◽  
Related Stigma ◽  
And Gender ◽  
Sex With Men ◽  
Linkage To Hiv Care ◽  
Living With Hiv ◽  
The Impact

In Ghana, the HIV prevalence among MSM is more than 10 times greater than the general population of adults, and rates of engagement in HIV medical care are low among MSM diagnosed with HIV. Using structured surveys, we investigated the impact of HIV-related stigma, same-sex behavior stigma, and gender nonconformity stigma on linkage to HIV care (LTC) in MSM ( N = 225) living with HIV in Ghana. Autonomy-supportive healthcare climate ( OR = 1.63, p < .01), vicarious HIV stigma ( OR = 2.73, p < .01), and age ( OR = 1.06, p < .004) predicted LTC. Conversely, felt normative HIV stigma negatively predicted LTC ( OR = 0.65, p < .05). Finally, we identified regional disparities, with MSM from Takoradi being 4 times and 5 times more likely to be LTC compared to Kumasi and Accra, respectively. Our findings highlight the nuanced roles of stigmas in shaping the HIV care continuum among MSM living with HIV, while revealing potential gaps in current measures of HIV-related stigma.

scholarly journals An Exploratory Study of Resilience, HIV-Related Stigma, and HIV Care Outcomes Among Men who have Sex with Men (MSM) Living with HIV in Louisiana

2020 ◽  
Vol 24 (7) ◽  
pp. 2119-2129 ◽  
Author(s):  
Russell Brewer ◽  
Kristina B. Hood ◽  
Mary Moore ◽  
Andrew Spieldenner ◽  
Chris Daunis ◽  
...  
Keyword(s):  
Exploratory Study ◽  
Hiv Care ◽  
Related Stigma ◽  
Care Outcomes ◽  
Sex With Men ◽  
Living With Hiv

scholarly journals Psychosocial Determinants of HIV Stigma among Men Who Have Sex with Men in San Francisco, California

2021 ◽  
Vol 18 (15) ◽  
pp. 8031
Author(s):  
Dharma N. Bhatta ◽  
Jennifer Hecht ◽  
Shelley N. Facente
Keyword(s):  
Mental Health ◽  
San Francisco ◽  
Age Groups ◽  
Hiv Stigma ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
Adjusted Risk ◽  
Sex With Men ◽  
Living With Hiv

Background: Stigma and discrimination are major challenges faced by people living with HIV (PLWH), and stigma continues to be prevalent among PLWH. We conducted a cross-sectional study of 584 men who have sex with men (MSM) living with HIV between July 2018 and December 2020, designed to better understand which demographic and behavioral characteristics of MSM living with HIV in San Francisco, California are associated with experience of stigma, so that programs and initiatives can be tailored appropriately to minimize HIV stigma’s impacts. Methods: This analysis was conducted with data from San Francisco AIDS Foundation (SFAF) encompassing services from multiple different locations in San Francisco. Data about the level of HIV-related stigma experienced were collected through a single question incorporated into programmatic data collection forms at SFAF as part of the client record stored in SFAF’s electronic health record. We performed linear regression to determine the associations between self-reported experiences of HIV stigma and other characteristics among MSM living with HIV. Results: HIV stigma was low overall among MSM living with HIV who are actively engaged in HIV care in San Francisco; however, it was significantly higher for the age groups of 13–29 years (adjusted risk difference (ARD): 0.251, 95% CI: 0.012, 0.489) and 30–49 years (ARD: 0.205, 95% CI: 0.042, 0.367) when compared to the age group of 50 years and older, as well as people who were homeless (ARD: 0.844, 95% CI: 0.120, 1.568), unstably housed (ARD: 0.326, 95% CI: 0.109, 0.543) and/or having mental health concerns (ARD: 0.309, 95% CI: 0.075, 0.544), controlling for race, injection history, and viral load. Conclusions: These findings highlight an opportunity to develop culturally, socially, and racially appropriate interventions to reduce HIV stigma among MSM living with HIV, particularly for younger men and those struggling with housing stability and/or mental health.

scholarly journals Stigma and HIV service access among transfeminine and gender diverse women in South Africa – a narrative analysis of longitudinal qualitative data from the HPTN 071 (PopART) trial

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Laing de Villiers ◽  
◽  
Angelique Thomas ◽  
Dionne Jivan ◽  
Graeme Hoddinott ◽  
...  
Keyword(s):  
South Africa ◽  
Gender Identity ◽  
Narrative Analysis ◽  
Service Access ◽  
Gender Diverse ◽  
Related Stigma ◽  
Male Sex ◽  
And Gender ◽  
Sex With Men ◽  
Living With Hiv

Abstract Background Transgender women have a disproportionately high HIV prevalence compared to cisgender women and men who have sex with men, which puts them at risk of HIV-related stigma (Baral SD et al., Lancet Infect Dis, 13;3, 2013). People whose gender identities are in tension with dominant social norms (including transgender women) often also experience gender identity-related stigma. There has been increasing attention to transgender people in HIV research and interventions. However, very little research has been done in sub-Saharan African countries. Methods We conducted a qualitative cohort study which included eight transfeminine and/or gender diverse women (four living with HIV) in Western Cape, South Africa, for a follow-up period of 12–18 months. Using a narrative analysis approach, we set out to understand how transfeminine and gender diverse participants in the cohort anticipated, experienced and internalised HIV stigma and gender identity stigma, and how these stigmas affected HIV service access. Result We found that participants reported anticipated, experienced, and internalised stigma relating both to their gender identity and to living with HIV. Participants reported inconsistent uptake of antiretroviral therapy (ART) services (including ART initiation and adherence) that they linked to stigma. We also found that gender diverse women and transfeminine women are challenged with other stigmatising social identities, like being a sex worker, drug user and/or a man (or assigned male sex at birth) who have sex with men (MSM). We use the terms ‘transfeminine’ and ‘gender diverse’ as terms that are inclusive of gender variant people who were all assigned male sex at birth and identify as women in some or all aspects of their lives. The persons in our study also showed gender identifications that were fluid and sometimes varied in different contexts and situations, therefore gender identity and sexual identity were often conflated for these individuals. Participants managed high levels of reported stigma by drawing on social support networks like families, friends and peers. Conclusion Our study provides exploratory work on how stigma may affect HIV services uptake amongst gender diverse women and transfeminine women in South Africa. We recommend future studies to further explore the unique HIV risks of gender diverse individuals. Trial registration DOH-27-0513-4253.

The impact of living with HIV: differences in experiences of stigma for heterosexual and homosexual people living with HIV in Australia

Sexual Health ◽  
2013 ◽  
Vol 10 (4) ◽  
pp. 316 ◽  
Author(s):  
Loren Brener ◽  
Hannah Wilson ◽  
Sean Slavin ◽  
John de Wit
Keyword(s):  
Hiv Treatment ◽  
Hiv Stigma ◽  
Heterosexual Transmission ◽  
People Living With Hiv ◽  
Hiv Status ◽  
Health And Wellbeing ◽  
Gay Community ◽  
Related Stigma ◽  
Living With Hiv ◽  
The Impact

Background HIV in Australia has been closely aligned with the gay community and continues to disproportionately affect members of this community. Although heterosexual transmission remains low, recently there has been an increase in new HIV diagnoses attributable to heterosexual sex. This highlights the need to address the health and social consequences for heterosexual people living with HIV (PLHIV). This subanalysis of a larger study compared the experiences of stigma, health and wellbeing of a sample of gay and heterosexual PLHIV. Methods: Data were drawn from a study of experiences of stigma among PLHIV in Australia. All 49 participants who reported being heterosexual were included, as were 49 participants randomly selected from the 611 gay participants. The samples were compared on perceived HIV stigma, HIV treatment-related stigma, perceived negative reactions of others, HIV status disclosure, and health and wellbeing measures. Results: The findings illustrate that heterosexual PLHIV have more negative experiences in terms of both general HIV stigma and treatment-related stigma than gay PLHIV. The heterosexual PLHIV also perceived greater negative reactions in relation to their HIV status by different people in their social environment and were less likely to access treatment than the gay PLHIV. There were no differences between the two groups in any of the health and wellbeing measures. Conclusions: This study shows that in the Australian context, heterosexual PLHIV may feel more stigmatised than gay PLHIV. In view of lower HIV treatment uptake in heterosexual PLHIV, addressing HIV-related stigma could contribute to increasing access to HIV treatment.

scholarly journals The Impact of Intersectional Identities on Older People With HIV

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 723-723
Author(s):  
Mark Brennan-Ing ◽  
Charles Emlet
Keyword(s):  
Older People ◽  
African American Women ◽  
Well Being ◽  
Hiv Stigma ◽  
Neurocognitive Functioning ◽  
Bisexual Men ◽  
And Bisexual ◽  
And Gender ◽  
The Impact ◽  
Racial Ethnic

Abstract Kimberlé Crenshaw introduced the term “intersectionality” in the late 1980s to highlight the experience discrimination and marginalization of Black and African-American women originating from the confluence of their racial/ethnic and gender identities. Since that time the focus on intersectionality has broadened to consider other communities and individuals who may have multiple stigmatized and discredited identities, including older people with HIV (PWH). For example, Porter and Brennan-Ing described the “Five Corners” model as the intersection of ageism, racism, classism, sexism, and HIV stigma for older transgender and gender non-conforming PWH. HIV disproportionately affects marginalized communities (e.g., racial/ethnic and sexual minorities). Thus, for older PWH it is important to consider how HIV stigma may intersect with other marginalized identities and impact physical and psychological well-being. The first paper in this session examines how the intersection of HIV serostatus, gay identity, and age complicates identity disclosure, leading to social isolation and interference with care planning. The second paper describes how intersectional identities among older PWH interfere with access to mental health services in a population that is disproportionately affected by depression and PTSD. Our third paper examines the role of race, education, and behavioral health in neurocognitive functioning among a diverse sample of older HIV+ gay and bisexual men. Our last paper examines neurocognitive functioning among older Latinx PWH, finding that sexual and gender minorities were at greater risk for impairment. Implications of these findings for research and programming that accounts for the effects of intersectionality among older PWH will be discussed.

scholarly journals Salud y Orgullo Mexicano: Development of a Culturally Specific Transnational Linkage and Retention in Care Intervention for Mexican Men Who Have Sex with Men Living with HIV in Chicago

2021 ◽  
Author(s):  
Amy K. Johnson ◽  
Román Buenrostro ◽  
Gilberto Soberanis ◽  
Banita McCarn ◽  
Bridget Magner ◽  
...  
Keyword(s):  
Intervention Mapping ◽  
Retention In Care ◽  
Hiv Care ◽  
Individual Level ◽  
Expert Advisory ◽  
Mapping Process ◽  
Sex With Men ◽  
Peer Navigation ◽  
Living With Hiv ◽  
Mexican Men

AbstractThis manuscript documents the development of an innovative individual-level peer navigation intervention “Salud y Orgullo Mexicano” (SOM) designed to increase linkage and retention to HIV care for Mexican men who have sex with men (MSM) in Chicago, Illinois. The intervention was developed via a modified intervention mapping process. Elements of two existing interventions were combined and refined with input from the Mexican MSM community, including informant interviews, an expert advisory board, and a design team. A manualized transnational intervention was developed via intervention mapping. A peer health navigation intervention “SOM” was created using intervention mapping and input from the focus community. Next steps include implementing and evaluating the intervention to determine acceptability and efficacy.

scholarly journals Free access to antiretroviral treatment and protection against the risk of catastrophic health expenditure in people living with HIV: evidence from Cameroon

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Marwân-al-Qays Bousmah ◽  
Marie Libérée Nishimwe ◽  
Christopher Kuaban ◽  
Sylvie Boyer
Keyword(s):  
Socioeconomic Status ◽  
Health Expenditure ◽  
Antiretroviral Treatment ◽  
Catastrophic Health Expenditure ◽  
Hiv Care ◽  
Free Access ◽  
People Living With Hiv ◽  
Art Policy ◽  
Living With Hiv ◽  
The Impact

Abstract Background To foster access to care and reduce the burden of health expenditures on people living with HIV (PLHIV), several sub-Saharan African countries, including Cameroon, have adopted a policy of removing HIV-related fees, especially for antiretroviral treatment (ART). We investigate the impact of Cameroon’s free antiretroviral treatment (ART) policy, enacted in May 2007, on catastrophic health expenditure (CHE) risk according to socioeconomic status, in PLHIV enrolled in the country’s treatment access program. Methods Based on primary data from two cross-sectional surveys of PLHIV outpatients in 2006–2007 and 2014 (i.e., before and after the policy’s implementation, respectively), we used inverse propensity score weighting to reduce covariate imbalances between participants in both surveys, combined with probit regressions of CHE incidence. The analysis included participants treated with ART in one of the 11 HIV services common to both surveys (n = 1275). Results The free ART policy was associated with a significantly lower risk of CHE only in the poorest PLHIV while no significant effect was found in lower-middle or upper socioeconomic status PLHIV. Unexpectedly, the risk of CHE was higher in those with middle socioeconomic status after the policy’s implementation. Conclusions Our findings suggest that Cameroon’s free ART policy is pro-poor. As it only benefitted PLHIV with the lowest socioeconomic status, increased comprehensive HIV care coverage is needed to substantially reduce the risk of CHE and the associated risk of impoverishment for all PLHIV.

scholarly journals Who Is Not Linking to HIV Care in Tennessee — the Benefits of an Intersectional Approach

2021 ◽  
Author(s):  
Leslie J. Pierce ◽  
Peter Rebeiro ◽  
Meredith Brantley ◽  
Errol L. Fields ◽  
Cathy A. Jenkins ◽  
...  
Keyword(s):  
Black Males ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Hiv Care ◽  
Older Individuals ◽  
Hiv Diagnosis ◽  
Race And Gender ◽  
Targeted Interventions ◽  
And Gender ◽  
Linkage To Hiv Care

Abstract Introduction Guided by an intersectional approach, we assessed the association between social categories (individual and combined) on time to linkage to HIV care in Tennessee. Methods Tennessee residents diagnosed with HIV from 2012-2016 were included in the analysis (n=3750). Linkage was defined by the first CD4 or HIV RNA test date after HIV diagnosis. We used Cox proportional hazards models to assess the association of time to linkage with individual-level variables. We modeled interactions between race, age, gender, and HIV acquisition risk factor (RF), to understand how these variables jointly influence linkage to care. Results Age, race, and gender/RF weAima A. Ahonkhaire strong individual (p < 0.001 for each) and joint predictors of time to linkage to HIV care (p < 0.001 for interaction). Older individuals were more likely to link to care (aHR comparing 40 vs. 30 years, 1.20, 95%CI 1.11-1.29). Blacks were less likely to link to care than Whites (aHR= 0.73, 95% CI: 0.67-0.79). Men who have sex with men (MSM) (aHR = 1.18, 95%CI: 1.03-1.34) and heterosexually active females (females) (aHR = 1.32, 95%CI: 1.14-1.53) were more likely to link to care than heterosexually active males. The three-way interaction between age, race, and gender/RF showed that Black males overall and young, heterosexually active Black males in particular were least likely to establish care. Conclusions Racial disparities persist in establishing HIV care in Tennessee, but data highlighting the combined influence of age, race, gender, and sexual orientation suggest that heterosexually active Black males should be an important focus of targeted interventions for linkage to HIV care.

Quality of Life in People Living With HIV: An Exploratory Cross-Sectional Survey in Belgium

2021 ◽  
Vol 33 (3) ◽  
pp. 249-264
Author(s):  
Gert Scheerder ◽  
Sandra Van den Eynde ◽  
Patrick Reyntiens ◽  
Ria Koeck ◽  
Jessika Deblonde ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Negative Impact ◽  
Sexual Life ◽  
People Living With Hiv ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Related Stigma ◽  
Living With Hiv ◽  
The Impact

This cross-sectional survey explored the quality of life in 505 people living with HIV in Belgium. Several domains of quality of life were impaired: 26% had been diagnosed with depression and 43% had weak social support. HIV-related stigma is still widespread, with 49% believing most people with HIV are rejected and 65% having experienced discrimination due to HIV. The impact of HIV was limited on professional life, but 40% experienced a negative impact on life satisfaction and 41% a negative impact on sexual life. For several domains, people with a recent diagnosis of HIV and long-term survivors had significantly worse scores. This survey also uncovered strengths of people living with HIV, such as positive coping and HIV self-image. Expanding the scope of quality of life in people living with HIV may provide a more complete picture of relevant life domains that may be impacted by living with HIV, but this needs further validation.

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