scholarly journals Evaluation of a guideline developed to reduce HIV-related stigma and discrimination in healthcare settings and establishing consensus

PLoS ONE ◽  
2018 ◽  
Vol 13 (7) ◽  
pp. e0198781 ◽  
Author(s):  
Garumma Tolu Feyissa ◽  
Craig Lockwood ◽  
Mirkuzie Woldie ◽  
Zachary Munn
Keyword(s):  
Stigma And Discrimination ◽  
Healthcare Settings ◽  
Related Stigma

scholarly journals Reducing HIV-related stigma and discrimination in healthcare settings: A systematic review of quantitative evidence

PLoS ONE ◽  
2019 ◽  
Vol 14 (1) ◽  
pp. e0211298 ◽  
Author(s):  
Garumma Tolu Feyissa ◽  
Craig Lockwood ◽  
Mirkuzie Woldie ◽  
Zachary Munn
Keyword(s):  
Systematic Review ◽  
Quantitative Evidence ◽  
Stigma And Discrimination ◽  
Healthcare Settings ◽  
Related Stigma

scholarly journals Evaluation of a guideline developed to reduce HIV-related stigma and discrimination in healthcare settings and establishing consensus

2018 ◽  
Author(s):  
Garumma Tolu Feyissa ◽  
Craig Lockwood ◽  
Mirkuzie Woldie ◽  
Zachary Munn
Keyword(s):  
Delphi Technique ◽  
Expert Panel ◽  
Delphi Survey ◽  
General Domain ◽  
Stigma And Discrimination ◽  
Healthcare Settings ◽  
Related Stigma ◽  
And Training

AbstractBackgroundDeveloping guidelines and policies is critical to address HIV-related stigma and discrimination (SAD) in healthcare settings. To this end, a multidisciplinary panel developed a guideline to reduce SAD. This project evaluated the appropriateness of implementing the guideline in the Ethiopian context.MethodsA consensus of the expert panel was established through a Delphi technique which was followed by a panel meeting. Initial tentative recommendations were distributed to experts through e-mails to be evaluated using the modified guideline implementability appraisal (GLIA) v.2.0 checklist.ResultsIn the first round of the Delphi survey, all (13) panel members evaluated the guideline. The overall score for the general domain of the modified GLIA checklist was 96.56%. The scores for individual recommendations ranged from 68.33% to 92.76%. Maximum and minimum scores were attained for measurability (97.71%) and flexibility (59.77%) domains respectively. Percentages mean score lower than 75% was obtained for flexibility and validity domains. Participants suggested that additional tools and training should be added to the guideline. In the second round of the survey, all the recommendations received endorsement with scores above 75%. Maximum and minimum scores were attained for measurability (100%) and flexibility (86.88%) domains respectively. During the panel meeting, issues of responsibility for implementing the guideline were discussed.ConclusionThe project evaluated implementability of a guideline developed to reduce HIV-related SAD in healthcare settings. The Delphi survey was followed by a half-day meeting that helped in further clarification of points.

scholarly journals Addressing HIV-related stigma and discrimination in healthcare settings: development and contextualization of guideline recommendations

2019 ◽  
Author(s):  
Garumma Feyissa ◽  
Mirkuzie Woldie ◽  
Zachary Munn ◽  
Craig Lockwood
Keyword(s):  
Best Practice ◽  
Structural Information ◽  
Guideline Development ◽  
Local Health ◽  
Institutional Practices ◽  
Assessment Development ◽  
Stigma And Discrimination ◽  
Healthcare Settings ◽  
Biomedical Measurement ◽  
Related Stigma

Abstract Objective This objective of this project was to develop and contextualize guideline recommendations to reduce HIV-related stigma and discrimination (SAD) in Ethiopian healthcare settings. Results A multidisciplinary expert panel comprising 13 experts was established. The panel suggested that the guideline should target both healthcare worker behaviors and attitudes, and institutional practices and programs. A systematic review of systematic reviews and best practice documents was conducted. An initial list of 31 recommendations was drafted through a content analysis of the included documents. Strength and quality of evidence were assigned for each recommendation using Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. The initial recommendations were framed under the following themes: structural, information-based and skills building, contact and empowerment, biomedical, measurement of SAD, and steps to integrate SAD reduction into healthcare settings. The tentative recommendations were evaluated both internally and externally through a series of Delphi surveys using Guideline Implementability Appraisal (GLIA V2.0) checklist. Finally, we explored facilitators and barriers to implement the guideline using key informant interviews to develop a framework to guide dissemination, implementation, and evaluation of the guideline in the local health system of Ethiopia. Key words: Guideline development, guideline evaluation, HIV-related stigma and discrimination, Healthcare settings, Ethiopia

scholarly journals A quality improvement approach to the reduction of HIV-related stigma and discrimination in healthcare settings

2019 ◽  
Vol 4 (3) ◽  
pp. e001587 ◽  
Author(s):  
Daniel J Ikeda ◽  
Laura Nyblade ◽  
Kriengkrai Srithanaviboonchai ◽  
Bruce D Agins
Keyword(s):  
Quality Improvement ◽  
Southeast Asia ◽  
National Level ◽  
Scale Up ◽  
Lessons Learned ◽  
Routine Practice ◽  
People Living With Hiv ◽  
Stigma And Discrimination ◽  
Healthcare Settings ◽  
Related Stigma

HIV-related stigma and discrimination (S&D) in healthcare settings represents a potent barrier to achieving global aims to end the HIV epidemic, particularly in Southeast Asia (Cambodia, Lao People’s Democratic Republic, Thailand and Vietnam). Evidence-based approaches for measuring and reducing S&D in healthcare settings exist, but their incorporation into routine practice remains limited, in part due to a lack of attention to how unique organisational practices—beyond the knowledge and attitudes of individuals—may abet and reinforce S&D. Application of a quality improvement (QI) approach in which facilities leverage routine measurement of S&D among healthcare workers and people living with HIV, team-based learning, root cause analysis, and tests of change offers a novel means through which to address S&D in local contexts and develop interventions to address individual-level and organisation-level drivers of S&D. To support the adoption of a QI approach to S&D reduction, the Southeast Asia Stigma Reduction QI Learning Network was launched with Ministries of Health from Cambodia, Lao PDR, Thailand and Vietnam, to co-develop strategies for implementing QI activities in participating facilities. Since the inception of Network activities in 2017, Ministry-led QI activities to address S&D have been implemented in 83 facilities and 29 provinces across participating countries. Moreover, 27 strategies and interventions have been tested to date and are being evaluated for scale up by participating facilities, spanning multiple drivers and organisational domains. Lessons learned through Network activities offer national-level and facility-level HIV programmes best practices for implementing a QI approach to S&D reduction.

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.

Key and general population HIV-related stigma and discrimination in HIV-specific health care settings: results from the Stigma Index Brazil

AIDS Care ◽  
2021 ◽  
pp. 1-5
Author(s):  
Angelo Brandelli Costa ◽  
Jair B. de Moura Filho ◽  
Josineide M. Silva ◽  
Jorge A. Beloqui ◽  
Yura Espindola ◽  
...  
Keyword(s):  
Health Care ◽  
General Population ◽  
Health Care Settings ◽  
Stigma And Discrimination ◽  
Related Stigma ◽  
Specific Health

scholarly journals Is socio-economic status a determinant of HIV-related stigma attitudes in Zimbabwe? Findings from Project Accept

2016 ◽  
Author(s):  
Kudzanai Mateveke ◽  
Basant Singh ◽  
Alfred Chingono ◽  
E. Sibanda ◽  
Ian Machingura
Keyword(s):  
Social Isolation ◽  
Assessment Tool ◽  
Economic Status ◽  
Target Population ◽  
Low Ses ◽  
Voluntary Counseling And Testing ◽  
Socio Economic Status ◽  
Stigma And Discrimination ◽  
Related Stigma ◽  
The Impact

HIV related stigma and discrimination is a known barrier for HIV prevention and care. We aimed to assess the relationship between socio-economic status (SES) and HIV related stigma in Zimbabwe. This paper uses data from Project Accept, which examined the impact of community-based voluntary counseling and testing intervention on HIV incidence and stigma. Total of 2522 eligible participants responded to a psychometric assessment tool, which assessed HIV related stigma and discrimination attitudes on 4 point Likert scale. The tool measured three components of HIVrelated stigma: shame, blame and social isolation, perceived discrimination, and equity. Participants’ ownership of basic assets was used to assess the socio-economic status. Shame, blame and social isolation component of HIV related stigma was found to be significantly associated with medium [odds ratio (OR)=1.73, P<0.01] and low SES (OR=1.97, P<0.01), indicating more stigmatizing attitudes by participants belonging to medium and low SES in comparison to high SES. For HIV related stigma and discrimination programs to be effective, they should take into account the socio-economic context of target population.

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