1
|
Oliveros Gómez D, Machavariani E, Altice FL, Gálvez de León S, Earnshaw V, Montenegro-Idrogo JJ, Sánchez J, Seminario AL. Influence of Stigma on Engagement in HIV Care and Adherence to Antiretroviral Therapy in Specialized HIV Clinics Targeting Men Who Have Sex with Men and Transgender Women in Lima, Peru. AIDS Behav 2024; 28:2755-2768. [PMID: 38878137 DOI: 10.1007/s10461-024-04401-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2024] [Indexed: 07/30/2024]
Abstract
HIV stigma is a social determinant of health that can influence multiple health outcomes, including adherence to antiretroviral therapy (ART), engagement in HIV care, and viral suppression levels in people with HIV (PWH). In Peru, where the HIV epidemic is concentrated in men who have sex with men (MSM) and transgender women (TGW), stigma may play an important role in healthcare engagement. To understand the relationship between stigma and two outcome variables, ART adherence and engagement in HIV care in 400 MSM and TGW, we assessed factors from the Behavioral Model for Vulnerable Populations at two HIV clinics that tailor services for sexual and gender minorities. While some predisposing, need, and enabling resource factors were associated with optimal (≥ 90%) ART adherence or engagement in HIV care, none of the stigma subscales were correlated, suggesting that when LGBTQ-affirming care is provided to MSM/TGW, stigma may not influence HIV-related outcomes.
Collapse
Affiliation(s)
- David Oliveros Gómez
- Department of Social and Behavioral Sciences, Yale School of Public Health, Yale University, New Haven, CT, USA.
- Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, Yale University, 135 College Street, Suite 323, New Haven, CT, 06510, USA.
| | - Eteri Machavariani
- Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, Yale University, 135 College Street, Suite 323, New Haven, CT, 06510, USA
| | - Frederick L Altice
- Department of Social and Behavioral Sciences, Yale School of Public Health, Yale University, New Haven, CT, USA
- Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, Yale University, 135 College Street, Suite 323, New Haven, CT, 06510, USA
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale University, New Haven, CT, USA
| | - Samy Gálvez de León
- Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, Yale University, 135 College Street, Suite 323, New Haven, CT, 06510, USA
| | - Valerie Earnshaw
- Department of Human Development and Family Sciences, University of Delaware, Newark, DE, USA
| | - Juan José Montenegro-Idrogo
- Centro de Investigaciones Tecnológicas, Biomédicas y Medioambientales, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Jorge Sánchez
- Centro de Investigaciones Tecnológicas, Biomédicas y Medioambientales, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Ana Lucía Seminario
- Department of Global Health, University of Washington School of Public Health, University of Washington, Seattle, WA, USA
- Department of Pediatric Dentistry, University of Washington School of Dentistry, University of Washington, Seattle, WA, USA
- Facultad de Estomatología, Universidad Peruana Cayetano Heredia, Lima, Peru
| |
Collapse
|
2
|
Harmanci Seren AK, Eşkin Bacaksiz F, Çakir H, Yilmaz S, Sükut Ö, Turan S, Maghsoudi N. A Cross-Sectional Survey Study on Homophobia Among Medical, Nursing, Pharmacy, and Other Health Sciences Students. JOURNAL OF HOMOSEXUALITY 2023; 70:3108-3124. [PMID: 35759634 DOI: 10.1080/00918369.2022.2087480] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Since the lesbian, gay, bisexual, transgender, and intersex (LGBTI) community may be exposed to violence, discrimination, stigma, exclusion, and maltreatment due to their sexual orientation while accessing healthcare services, understanding, and improving the attitudes of future's health care professionals toward LGBTI individuals seem essential. This descriptive and cross-sectional study aimed to investigate the homophobia among medical, nursing, pharmacy, and healthcare sciences students and examine the related factors. The study included 2,531 students from medicine, nursing, pharmacy, and other health sciences (midwifery, nutrition and dietetics, physiotherapy, management of healthcare facilities) disciplines. Homophobia was measured with the Hudson and Ricketts Homophobia Scale. After getting ethical and institutional approvals, data were collected and analyzed using descriptive and inferential statistical tests. Medical students had the lowest homophobia score, and their mean score was significantly lower than other students. There was a significant difference between students' scores according to years of study, age, sex, acquaintance with LGBTI individuals, providing healthcare services to an LGBTI person, and opinions on providing care. Although homophobia scores of nursing, pharmacy, and other health sciences students were lower than the medical students', policies and expansive content regarding LGBTI should be in place in all health science educational institutes, including medical schools, to prevent students from holding homophobic and prejudicial attitudes against LGBTI individuals.
Collapse
Affiliation(s)
| | - Feride Eşkin Bacaksiz
- Department of Nursing Management, Hamidiye Faculty of Nursing, University of Health Sciences Turkey, Istanbul, Turkey
| | - Hanife Çakir
- Bakırkoy Prof. Dr. Mazhar Osman Mental and Neurological Diseases Training and Research Hospital, University of Health Sciences Turkey, Istanbul, Turkey
| | - Sevil Yilmaz
- Department of Psychiatric Nursing, Florence Nightingale Faculty of Nursing, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Özge Sükut
- Department of Psychiatric Nursing, Florence Nightingale Faculty of Nursing, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Suzan Turan
- Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, University of Health Sciences Turkey, Istanbul, Turkey
| | - Nurten Maghsoudi
- Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences Turkey, Istanbul, Turkey
| |
Collapse
|
3
|
Oyarce-Vildósola O, Rodríguez-Fernández A, Maury-Sintjago E. Association between Homophobia and Sociodemographic Characteristics in Health Workers in Southern Chile. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192113749. [PMID: 36360632 PMCID: PMC9654434 DOI: 10.3390/ijerph192113749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/15/2022] [Accepted: 10/20/2022] [Indexed: 05/25/2023]
Abstract
Homophobic attitude in health workers is a social determinant in the health of the homosexual population because it affects healthcare and its access and equity. The objective was to determine the relationship between the level of homophobia and sociodemographic characteristics of primary health workers in southern Chile. This was an analytical cross-sectional study. The sample consisted of 491 public servants from health centers in southern Chile. The attitudes toward lesbians and gay men (ATLG) scale was applied, and a binary logistic regression model was performed to evaluate the association. The study participants were predominantly women (76.0%), under 40 years of age (63.5%), heterosexuals (93.5%), and unpartnered (68.2%) but with children (61.7%), and they also had an educational attainment ≥ 12 years (66.6%). About 87.6% of the participants held healthcare positions, and the majority were religious believers (74.3%) and had a centrist political affiliation (51.0%). Results indicated that 34% of the participants exhibited homophobic attitudes; there were statistically significant differences with respect to age, number of children, educational attainment, religion, and political affiliation (p < 0.01). These were higher in individuals ≥40 years of age, with ≥3 children, with educational attainment ≥ 12 years, holding a healthcare position, who were religious believers, and who had right-wing political affiliation.
Collapse
Affiliation(s)
- Oscar Oyarce-Vildósola
- Master’s Degree Program in Public Health, Faculty of Health and Food Sciences, Universidad del Bío-Bío, Chillan 3780000, Chile
| | - Alejandra Rodríguez-Fernández
- Department of Nutrition and Public Health, Universidad del Bío-Bío, Chillan 3780000, Chile
- Auxology, Bioanthropology, and Ontogeny Research Group (GABO), Universidad del Bío-Bío, Chillan 3780000, Chile
| | - Eduard Maury-Sintjago
- Department of Nutrition and Public Health, Universidad del Bío-Bío, Chillan 3780000, Chile
- Auxology, Bioanthropology, and Ontogeny Research Group (GABO), Universidad del Bío-Bío, Chillan 3780000, Chile
| |
Collapse
|
4
|
Westwood S. Religious-based negative attitudes towards LGBTQ people among healthcare, social care and social work students and professionals: A review of the international literature. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e1449-e1470. [PMID: 35396881 PMCID: PMC9543796 DOI: 10.1111/hsc.13812] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 03/07/2022] [Accepted: 03/29/2022] [Indexed: 05/27/2023]
Abstract
There is a dearth of research on how negative religious attitudes towards LGBTQ people inform professional practice. This paper reports on a scoping review of 70 selected studies from 25 different countries. It explores key issues and knowledge gaps regarding the delivery of services to LGBTQ adults by religious healthcare, social care and social work organisations and/or practitioners with faith-based objections to LGBTQ people and their lives. The review identified four main themes: (1) a close connection between religious affiliation and negative attitudes towards LGBTQ people, among both students and professionals; (2) a heightening effect of religiosity, particularly among Christian and Muslim practitioners/students; (3) educators' religious attitudes informing curriculum design and delivery, and some highly religious students resisting and/or feeling oppressed by LGBTQ-inclusivity, if present; (4) examples of practice concerns raised by professionals and lay LGBTQ people. The article considers the ethical, practical, educational and professional standards implications, highlighting the need for further research in this area.
Collapse
|