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Mokgatle M, Madiba S. Community Perceptions of HIV Stigma, Discriminatory Attitudes, and Disclosure Concerns: A Health Facility-Based Study in Selected Health Districts of South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6389. [PMID: 37510621 PMCID: PMC10379360 DOI: 10.3390/ijerph20146389] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 07/06/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023]
Abstract
Research data about HIV stigma perceptions and discriminatory attitudes among the general population are limited. Furthermore, the willingness of HIV-negative individuals to engage with HIV prevention and disclosure interventions has not been established in South Africa. The study investigated community perceptions of stigma as well as discriminatory attitudes towards HIV disclosure to understand if and how these perceptions might influence the uptake of disclosure interventions. This facility-based study used a validated questionnaire to measure the four constructs of HIV stigma among 670 adults recruited from health districts of two provinces of South Africa. Of these, 72% were female, 87% had ever been tested for HIV, and 31% knew someone who has HIV. Stigma towards people living with HIV (PLHIV) is widespread in the general population. A high proportion (75%) endorsed disclosure concerns, 75% perceived stigma to be common, and 56% endorsed negative statements indicating perceived stigma in communities. Fear, moral and social judgement, and rejection underlined their perceptions about PLHIV. Almost half (45.7%) were unwilling to care for family members sick with AIDS, suggesting negative distancing reactions and discriminatory attitudes towards PLHIV. The widespread discriminatory attitudes and the perceived stigma that is evident in the general population might heighten the disclosure concerns endorsed, promote non-disclosure, and increase HIV transmission. To design interventions, it is crucial to be cognisant of disclosure concerns, discriminatory attitudes, and perceived stigma evident in communities. Thus, the findings underscore the need to increase efforts to challenge and reduce community drivers of negative discriminatory attitudes and perceived stigma.
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Affiliation(s)
- Mathildah Mokgatle
- Department of Public Health, School of Health Care Sciences, Sefako Makgatho Health Sciences University, Pretoria 0204, South Africa
- School of Transdisciplinary Research and Graduate Studies, College of Graduate Studies, University of South Africa (UNISA), Muckleneuk, Pretoria 0001, South Africa
| | - Sphiwe Madiba
- Faculty of Health Sciences, Executive Deans Office, University of Limpopo, Polokwane 0700, South Africa
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Perngmark P, Sahawiriyasin O, Holroyd E. Experiences of Thai-Muslim patients regarding inconsistent antiretroviral therapy adherence: An exploratory descriptive qualitative study. BELITUNG NURSING JOURNAL 2023; 9:253-261. [PMID: 37492759 PMCID: PMC10363971 DOI: 10.33546/bnj.2426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/13/2022] [Accepted: 04/03/2023] [Indexed: 07/27/2023] Open
Abstract
Background Antiretroviral therapy (ART) has played a crucial role in saving countless lives of patients with HIV/AIDS across the world. However, despite its effectiveness, ART adherence still falls short globally, and non-adherence remains the primary cause of treatment failure. In the rural areas of southern Thailand, where the population is predominantly conservative Muslims, there has been an observed increase in ART non-adherence. Objective This study aimed to explore experiences of inconsistent ART adherence among Thai-Muslim patients with HIV/AIDS (PWHAs) in southern Thailand. In addition, the perspectives of healthcare providers were also sought. Methods Data were collected by conducting semi-structured in-depth interviews with ten Thai-Muslim PWHAs and five healthcare providers at a Voluntary Counseling-and-Testing Clinic. A content analysis approach was utilized to analyze the data. Results Inconsistent ART adherence was reported. Religion/spiritual imperatives, forgetfulness, inadequate knowledge (of drug side effects and drug regime), misunderstandings (about being symptom-free and feeling well), boredom from long-term drug-taking regimes, as well as poor transportation and lack of family support (arising from non-disclosure of one's HIV-serostatus due to HIV stigma) were emergent themes derived from the interviews with Thai-Muslim PWHAs. The healthcare providers' interview data revealed their need for the integration of Islamic beliefs to provide better care. Conclusion It is essential for healthcare teams to work collaboratively with patients' religious beliefs to enhance ART adherence. Clinical nurses can contribute to the promotion of HIV-care services by integrating Islamic beliefs and Muslim culture into their practice, thus increasing patients' knowledge and motivation for ART adherence. This could entail utilizing Islamic prayer rituals as drug reminders, elaborating on Islamic moral beliefs concerning sickness and healing, and integrating the cultural imperatives of self-care in the Muslim community into ongoing care delivery. Cross-cultural nursing education and specialized training in HIV care should incorporate knowledge about Islamic and Muslim cultural beliefs.
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Affiliation(s)
| | | | - Eleanor Holroyd
- Faculty of Health and Environmental Sciences, Auckland University of Technology, New Zealand
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Chautrakarn S, Ong-Artborirak P, Naksen W, Thongprachum A, Wungrath J, Chariyalertsak S, Stonington S, Taneepanichskul S, Assanangkornchai S, Kessomboon P, Neelapaichit N, Aekplakorn W. Stigmatizing and discriminatory attitudes toward people living with HIV/AIDS (PLWHA) among general adult population: the results from the 6 th Thai National Health Examination Survey (NHES VI). J Glob Health 2023; 13:04006. [PMID: 36637802 PMCID: PMC9838688 DOI: 10.7189/jogh.13.04006] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Background Thailand has an ongoing action plan to reduce human immunodeficiency virus (HIV) discrimination and stigma. We aimed to monitor the level of stigmatizing and discriminatory attitudes toward people living with HIV/AIDS (PLWHA) among the general adult population and to investigate its related factors. Methods This study was based on data from the 6th Thai National Health Examination Survey, a large-scale country-wide survey in 2019-2020. We used a multistage sampling technique and included 11 843 adults aged 20 to 59. We collected data through face-to-face interviews which included six items related to HIV stigma domains. We weighted all analyses to account for the probability of sampling the Thai population aged 20 to 59 years. Results We found that anticipated stigma had the highest percentage of negative stigmatizing attitude responses (78.5%), followed by perceived stigma (66.6%), fear of HIV infection (54.4%), and social judgment (28.2%). Regarding the UNAIDS global indicator for discriminatory attitude, 48.6% of respondents had negative perceptions to questions about experienced stigma or discrimination. Multiple logistic regression showed that factors associated with discriminatory attitudes toward PLWHA were being aged 20-39 (adjusted odds ratio (aOR) = 1.32, 95% confidence interval (CI) = 1.18-1.47) or 50-59 (aOR = 1.23, 95% CI = 1.09-1.40) compared to being aged 40-49, being Muslim compared to Buddhist (aOR = 1.73, 95% CI = 1.46-2.06), being married compared to being single (aOR = 1.15, 95% CI = 1.04-1.28), holding certificate degree or higher compared to not studying or studying at a primary level (aOR = 0.81, 95% CI = 0.68-0.97), living in the Northeast (aOR = 1.27, 95% CI = 1.12-1.45) and Bangkok (aOR = 1.30, 95% CI = 1.12-1.51) compared to living in the North, having no HIV/AIDS infected relative or acquaintance compared to having an HIV/AIDS infected relative or acquaintance (aOR = 1.56, 95% CI = 1.41-1.73), and not obtaining an HIV test compared to obtaining it (aOR = 1.10, 95% CI = 1.02-1.19). Conclusions We found that HIV stigmatizing and discriminatory attitudes toward PLWHA decreased, but remained concerning among Thai adult people. A public education and awareness campaign, as well as an intervention to reduce HIV-related stigma and discrimination in the country's health care facilities, must still be maintained.
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Affiliation(s)
| | | | - Warangkana Naksen
- Faculty of Public Health, Chiang Mai University, Chiang Mai, Thailand
| | | | - Jukkrit Wungrath
- Faculty of Public Health, Chiang Mai University, Chiang Mai, Thailand
| | | | - Scott Stonington
- Departments of Internal Medicine and Anthropology, University of Michigan, Michigan, USA
| | | | | | | | | | - Wichai Aekplakorn
- Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand,National Health Examination Survey Office, Bangkok, Thailand
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Muluneh AG, Merid MW, Kassa GM, Bitew DA, Ferede MG. Hotspots and determinants of women's discriminatory attitude towards people living with HIV; evidence from ethiopian demographic and health survey data. BMC Womens Health 2022; 22:420. [PMID: 36271378 PMCID: PMC9587567 DOI: 10.1186/s12905-022-01997-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 10/04/2022] [Indexed: 11/05/2022] Open
Abstract
Background Human Immunodeficiency Virus (HIV) is the major public health concern in Ethiopia with more profound effect on women. Discriminatory attitude towards people living with HIV (PLWH) impose a significant impact on patient outcomes and related issues. Hence, this study aimed to investigate the hotspot areas and determinant factors of women’s discriminatory attitude towards people living with HIV. Methods An in-depth secondary data analysis was conducted based on Ethiopian demographic and health survey (EDHS) 2016. A total of weighed 13,822 reproductive-age women were included in the analysis. The non-spatial analysis was conducted using Stata 16. A mixed effect multi-level logistic regression model was fitted to identify determinant factors of discriminatory attitude towards PLWH. A p-value < 0.2 and 0.05 were used as a cut-off point to declare statistical significance for the bi- and multi-variable regression models, respectively. Four separate models i.e. the null, individual, community level model, and a fourth combined model were fitted. Model comparison was done using deviance. Random effect parameters such as correlation coefficient, median odds ratio, and proportional change in variance were used to explain the variation between and within clusters. Global and local level spatial analyses were conducted using Global Moran’s index, GetisOrd Gi* statistics, and Spatial scan statistics were conducted. Results The magnitude of women’s discriminatory attitude towards PLWH was 62.66% (95%CI: 60.12, 65.10). The discriminatory attitude of women towards PLWH was spatially clustered (Moran’s index = 0.41, P < 0.01). The hotspots of discriminatory attitude towards PLWH were detected in most parts of the Tigray region; Northern, and southeast borders of the Amhara region; Addis Ababa city; Central, Southern, and western Oromiya region; and East, south, and northeastern parts of South Nations, Nationalities and Peoples Region (SNNPR). Being rural resident, and having no media exposure were positively associated while better educational statuses, better wealth index, unmarried, having comprehensive HIV knowledge, Orthodox religion fellow, and ever being tested for HIV were negatively associated with women’s discriminatory attitude towards people living with HIV. Conclusion Discriminatory attitude of women towards PLWH was high in Ethiopia. Hotspots were detected in Amhara, Oromiya, SNNPR, Tigray regions, and Addis Ababa city. Socio-demographic, socio-economic, and HIV knowledge-related factors determine the women’s discriminatory attitude towards PLWH.
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Affiliation(s)
- Atalay Goshu Muluneh
- grid.59547.3a0000 0000 8539 4635Department of Epidemiology and Biostatistics, Institute of Public health, college of medicine and Health sciences, University of Gondar, Gondar, Ethiopia
| | - Mehari Woldemariam Merid
- grid.59547.3a0000 0000 8539 4635Department of Epidemiology and Biostatistics, Institute of Public health, college of medicine and Health sciences, University of Gondar, Gondar, Ethiopia
| | - Getahun Molla Kassa
- grid.59547.3a0000 0000 8539 4635Department of Epidemiology and Biostatistics, Institute of Public health, college of medicine and Health sciences, University of Gondar, Gondar, Ethiopia
| | - Desalegn Anmut Bitew
- grid.59547.3a0000 0000 8539 4635Department of Reproductive health, Institute of Public health, College of medicine and Health sciences, University of Gondar, Gondar, Ethiopia
| | - Menberesibhat Getie Ferede
- grid.59547.3a0000 0000 8539 4635Departments of Human Anatomy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Levels of HIV/AIDS stigma and associated factors among sexually active Ethiopians: analysis of 2016 Ethiopian Demographic and Health Survey Data. BMC Public Health 2022; 22:1080. [PMID: 35641915 PMCID: PMC9158254 DOI: 10.1186/s12889-022-13505-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 05/23/2022] [Indexed: 11/10/2022] Open
Abstract
Background Stigma and discrimination have fueled the transmission of the disease and dramatically increased its negative public health impact. Even though the disease has extremely ravaged human life, stigma, and discrimination attached to it are not well addressed in Ethiopia at the country level. The reduction of stigma and discrimination in a population are important indicators of the success of programs that target HIV prevention and control. This study aimed to assess the level of HIV-related stigma and its determinants among sexually active Ethiopians. Methods A public domain data were obtained from 2016 Ethiopian Demographic and Health Survey in which two-stage cross-sectional stratified cluster sampling was applied. A total of 28,371 sexually active Ethiopians were interviewed from both rural and urban parts of Ethiopia. Descriptive Statistics and multilevel ordinal logistic regression (proportional odds model) were used to summarize data and to investigate correlates of HIV-related stigma. Results Only 5.1% (95% CI: 4.5%, 5.8%) of sexually active Ethiopians did not have a stigmatizing attitude, whereas, 59.2% (95% CI: 57.3%, 61.1%) and 35.65% (95% CI: 33.5%, 37.9%) of them had a moderate and high level of stigma respectively. Regression results show that residence (AOR = 1.82, 95% CI:1.46, 2.27), education (AOR = 0.65,95% CI: 0.50,0.84), owning mobile (AOR = 0.63,95% CI:0.55,0.72), HIV-testing (AOR = 0.77, 95% CI:0.70,0.84), age (AOR = 0.81, 95% CI: 0.73, 0.91), religion (AOR = 1.53,95% CI:1.33,1.76), and marital status (AOR = 1.38, 95% CI:1.19, 1.61) were significantly associated with HIV-related stigma (p < 0.0001). Conclusion Regardless of all efforts put in a place to prevent and control HIV, a significant proportion of sexually active Ethiopians have stigmatizing attitudes. Residence, educational level, owning mobile, HIV test uptake, age, religion, and marital status were determinants of HIV-related stigma. Expanding mobile coverage, promoting HIV counseling and tests, promoting HIV education, and working with religious leaders, among other strategies could be used to minimize the stigma attached to the disease to best prevent and control it.
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Arifin H, Ibrahim K, Rahayuwati L, Herliani YK, Kurniawati Y, Pradipta RO, Sari GM, Ko NY, Wiratama BS. HIV-related knowledge, information, and their contribution to stigmatization attitudes among females aged 15-24 years: regional disparities in Indonesia. BMC Public Health 2022; 22:637. [PMID: 35365099 PMCID: PMC8976340 DOI: 10.1186/s12889-022-13046-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 03/21/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Stigmatization attitudes among youths toward people living with HIV (PLWH) is still an issue and concern in Indonesia. The purpose of this study was to determine the regional disparities, levels of HIV-related knowledge, information, and contributions related to stigmatization attitudes among females aged 15-24 years in Indonesia. METHODS A cross-sectional study with The 2017 Indonesian Demographic Health Survey (IDHS) was used. A total of 12,691individual records of females aged 15-24 years were recruited through two-stage stratified cluster sampling. The endpoint was stigmatization attitude. Then, bivariate and multivariate binary logistics were performed. RESULTS The findings showed that female youths who have no HIV-related knowledge (62.15%) and some source of information (52.39%). The highest prevalence of stigmatizing attitude was 59.82%, on Java Island. Multivariate analysis showed that females living in Sulawesi and Kalimantan; those living in a rural area; and those with more HIV-related knowledge were less likely to have a stigmatizing attitude. Conversely, females with the middle- to richest-wealth index and had some HIV-related information were more likely to have a stigmatizing attitude. CONCLUSION An understanding of stigmatizing attitudes should be considered through demographic factors, knowledge, and source of HIV-related information. The Indonesian government should pay more attention to indicators of HIV-related knowledge and information. Moreover, we suggest that the government collaborates with youths to disseminate information and restructure and reanalyze policies about HIV.
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Affiliation(s)
- Hidayat Arifin
- Department of Medical and Surgical Nursing, Faculty of Nursing, Universitas Padjadjaran, Jl. Raya Bandung, KM. 21, Jatinangor, Sumedang, 45363, West Java, Indonesia.
| | - Kusman Ibrahim
- Department of Medical and Surgical Nursing, Faculty of Nursing, Universitas Padjadjaran, Jl. Raya Bandung, KM. 21, Jatinangor, Sumedang, 45363, West Java, Indonesia
| | - Laili Rahayuwati
- Department of Community Health Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, Indonesia
| | - Yusshy Kurnia Herliani
- Department of Medical and Surgical Nursing, Faculty of Nursing, Universitas Padjadjaran, Jl. Raya Bandung, KM. 21, Jatinangor, Sumedang, 45363, West Java, Indonesia
| | - Yulia Kurniawati
- Department of Medical and Surgical Nursing, Faculty of Nursing, Universitas Jember, Jember, Indonesia
| | - Rifky Octavia Pradipta
- Department of Fundamental Nursing, Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
| | - Gevi Melliya Sari
- Department of Medical and Surgical Nursing, Stikes Husada Jombang, Jombang, Indonesia
| | - Nai-Ying Ko
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Bayu Satria Wiratama
- Department of Biostatistics, Epidemiology, and Population Health, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
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Boah M, Yeboah D, Kpordoxah MR, Adokiya MN. Frequency of exposure to the media is associated with levels of HIV-related knowledge and stigmatising attitudes among adults in Ghana. AFRICAN JOURNAL OF AIDS RESEARCH : AJAR 2022; 21:49-57. [PMID: 35361064 DOI: 10.2989/16085906.2022.2040549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 02/01/2022] [Accepted: 02/01/2022] [Indexed: 06/14/2023]
Abstract
Studies show that increased knowledge of the human immunodeficiency virus (HIV) is achieved through exposure to mass media, which then contributes to positive attitudes and behaviours towards people living with HIV and acquired immune deficiency syndrome (AIDS). This study examined the relationship between the frequency of exposure to the media and the level of HIV-related knowledge and stigmatising attitudes towards HIV and AIDS among adults in Ghana. A weighted sample of 13 484 men and women 15 to 59 years old took part in the study. The main outcome variable was the HIV-related knowledge score, calculated based on responses to eight questions about general HIV concepts and HIV transmission modes. The frequency of exposure to the media was the primary explanatory variable. The relationship between the frequency of media exposure and the level of HIV-related knowledge was investigated using Poisson regression methods in Stata 13.0. Of the 13 484 respondents analysed, 25%, 88.2% and 79.7% reported reading print media, listening to the radio and watching TV at least once a week respectively. The average HIV-related knowledge score was 4.9 (SD 1.6), with 22.9% of respondents correctly answering five questions and about 2.0% correctly answering all eight questions. The frequency of exposure to the media, particularly print media and television, was associated with an increase in the level of HIV-related knowledge. When compared to having a low level of HIV-related knowledge, having a moderate and high level of HIV-related knowledge reduced the score of stigmatising attitude by 0.065 and 0.277 points, respectively. The adult population in Ghana has a very low level of HIV or AIDS knowledge, as well as a significant level of stigma associated with HIV or AIDS, which could stymie HIV prevention efforts. The media, on the other hand, provide a platform for these issues to be addressed.
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Affiliation(s)
- Michael Boah
- Department of Epidemiology, Biostatistics & Disease Control, School of Public Health, University for Development Studies, Tamale, Ghana
| | - Daudi Yeboah
- Department of Epidemiology, Biostatistics & Disease Control, School of Public Health, University for Development Studies, Tamale, Ghana
| | - Mary Rachael Kpordoxah
- Department of Global and International Health, School of Public Health, University for Development Studies, Tamale, Ghana
| | - Martin Nyaaba Adokiya
- Department of Epidemiology, Biostatistics & Disease Control, School of Public Health, University for Development Studies, Tamale, Ghana
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Armoon B, Higgs P, Fleury MJ, Bayat AH, Moghaddam LF, Bayani A, Fakhri Y. Socio-demographic, clinical and service use determinants associated with HIV related stigma among people living with HIV/AIDS: a systematic review and meta-analysis. BMC Health Serv Res 2021; 21:1004. [PMID: 34551772 PMCID: PMC8459487 DOI: 10.1186/s12913-021-06980-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 09/02/2021] [Indexed: 01/11/2023] Open
Abstract
Background Defining HIV-related stigma (HRS) can be problematic due to structural inequalities, cultural differences, discrimination by health care providers and the limitations of tools measuring stigma for people living with HIV (PLWH). This meta-analysis aimed to determine self-reported HRS and its association with socio-demographic and clinical determinants. Methods PubMed, Scopus, Web of Science, PsycInfo, SciELO and Cochrane electronic databases were searched and after reviewing for study duplicates, the full-text of selected articles were assessed for eligibility using Population, Intervention, Comparator, Outcomes criteria. We used fixed and random-effects meta-analysis models to estimate the pooled prevalence, pooled odds ratio (OR) and 95% confidence intervals. Results Thirty-one studies containing 10,475 participants met the eligibility criteria. Among the potential risk factors: age > 30 years (OR = 0.93, 95%CI = 0.86, 1), living with a spouse (OR = 0.07, 95%CI = 0.02, 0.17), CD4 count < 200 (OR = 0.5, 95% CI = 0.31, 0.68), medication adherence (OR = 0.96, 95%CI = 0.94, 0.99), poor access to care (OR = 0.79, 95%CI = 0.65, 0.93), time since diagnosis, and accessibility to care (OR = 0.37, 95%CI = 0.11, 0.86) were all significantly associated with self-reported HIV stigma among PWLH. Conclusion Stigma is correlated with numerous negative consequences in marginalised populations including PLWH. Considering the negative association that stigma has on HIV prevention and treatment targeted evidence-based stigma reduction interventions are recommended. Interventions that are focused on a particular group, such as healthcare professionals are warranted. Rigorously designed studies with specific and validated outcome measures associated with targeted interventions may help to improve the reduction of HRS for PLWH.
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Affiliation(s)
- Bahram Armoon
- Research Center, Douglas Mental Health University Institute, 6875 LaSalle Blvd, Montreal, QC, H4H 1R3, Canada. .,Department of Psychiatry, McGill University, 1033, Pine Avenue West, Montreal, QC, H3A 1A1, Canada.
| | - Peter Higgs
- Department of Public Health, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Marie-Josée Fleury
- Research Center, Douglas Mental Health University Institute, 6875 LaSalle Blvd, Montreal, QC, H4H 1R3, Canada.,Department of Psychiatry, McGill University, 1033, Pine Avenue West, Montreal, QC, H3A 1A1, Canada.,Management, Evaluation and Health Policies Department, School of Public Health, Université de Montréal, 7101 av. du Parc, Montreal, QC, H3X1X9, Canada
| | - Amir-Hossien Bayat
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Ladan Fattah Moghaddam
- Department of nursing, faculty of nursing and midwifery, Tehran medical sciences, Islamic Azad University, Tehran, Iran
| | - Azadeh Bayani
- Student Research Committee, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Yadollah Fakhri
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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Henderson GE, Rennie S, Corneli A, Peay HL. Cohorts as collections of bodies and communities of persons: insights from the SEARCH010/RV254 research cohort. Int Health 2021; 12:584-590. [PMID: 33165552 PMCID: PMC7650957 DOI: 10.1093/inthealth/ihaa060] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 07/28/2020] [Accepted: 08/20/2020] [Indexed: 12/11/2022] Open
Abstract
Longitudinal research cohorts are uniquely suited to answer research questions about morbidity and mortality. Cohorts may be comprised of individuals identified by specific conditions or other shared traits. We argue that research cohorts are more than simply aggregations of individuals and their associated data to meet research objectives. They are social communities comprised of members, investigators and organizations whose own interests, identities and cultures interact and evolve over time. The literature describes a range of scientific and ethical challenges and opportunities associated with cohorts. To advance these deliberations, we report examples from the literature and our own research on the Thai SEARCH010/RV254 cohort, comprising individuals diagnosed with human immunodeficiency virus (HIV) during acute infection. We reflect on the impact of cohort experiences and identity, and specifically how people incorporate cohort participation into meaning making associated with their diagnosis, the influence of cohort participation on decision making for early-phase clinical trials recruited from within the cohort, and the impact of the relationships that exist between researchers and participants. These data support the concept of cohorts as communities of persons, where identity is shaped, in part, through cohort experiences. The social meanings associated with cohorts have implications for the ethics of cohort-based research, as social contexts inevitably affect the ways that ethical concerns manifest.
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Affiliation(s)
- Gail E Henderson
- Department of Social Medicine, University of North Carolina School of Medicine, 347A MacNider, 333 South Columbia Street, Chapel Hill, NC 27599-7240, USA
| | - Stuart Rennie
- Department of Social Medicine, University of North Carolina School of Medicine, 347A MacNider, 333 South Columbia Street, Chapel Hill, NC 27599-7240, USA
| | - Amy Corneli
- Departments of Population Health Sciences and Medicine, School of Medicine, Duke Clinical Research Institute, Duke University, 215 Morris Street, Durham, NC 27701
| | - Holly L Peay
- RTI International, 3040 E Cornwallis Rd, Research Triangle Park, NC 27709
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Peay HL, Ormsby NQ, Henderson GE, Jupimai T, Rennie S, Siripassorn K, Kanchawee K, Isaacson S, Cadigan RJ, Kuczynski K, Likhitwonnawut U. Recommendations from Thai stakeholders about protecting HIV remission ('cure') trial participants: report from a participatory workshop. Int Health 2021; 12:567-574. [PMID: 33165551 PMCID: PMC7650909 DOI: 10.1093/inthealth/ihaa067] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 07/28/2020] [Accepted: 09/02/2020] [Indexed: 12/02/2022] Open
Abstract
Background The social/behavioral HIV Decision-Making Study (DMS) assesses informed consent and trial experiences of individuals in HIV remission trials in Thailand. We convened a 1-d multi-stakeholder participatory workshop in Bangkok. We provide a meeting summary and reactions from DMS investigators. Methods Workshop members viewed de-identified interview excerpts from DMS participants. They deliberated on the findings and made recommendations regarding informed choice for remission trials. Notes and recordings were used to create a summary report, which was reviewed by members and refined. Results Workshop members’ recommendations included HIV education and psychosocial support to establish the basis for informed choice, key trial information to be provided in everyday language, supportive decision-making processes and psychosocial care during and after the trial. Concerns included participant willingness to restart antiretrovirals after trial-mandated treatment interruption, unintended influence of the research team on decision-making and seemingly altruistic motivations for trial participation that may signal attempts to atone for stigmatized behavior. Conclusions The workshop highlighted community perspectives and resulted in recommendations for supporting informed choice and psychosocial and physical health. These are the first such recommendations arising from a deliberative process. Although some elements are rooted in the Thai context, most are applicable across remission trials.
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Affiliation(s)
| | - Nuchanart Q Ormsby
- University of North Carolina at Chapel Hill, Department of Social Medicine, USA
| | - Gail E Henderson
- University of North Carolina at Chapel Hill, Department of Social Medicine, USA
| | - Thidarat Jupimai
- Center of Excellence in Pediatric Infectious Diseases and Vaccines Faculty of Medicine, Chulalongkorn University, Thailand
| | - Stuart Rennie
- University of North Carolina at Chapel Hill, Department of Social Medicine, USA.,University of North Carolina at Chapel Hill, Center for Bioethics, USA
| | | | - Kunakorn Kanchawee
- Center of Excellence in Research on Gender, Sexuality and Health, Faculty of Social Sciences and Humanities, Mahidol University, Thailand
| | - Sinéad Isaacson
- University of North Carolina at Chapel Hill, Department of Social Medicine, USA.,University of North Carolina at Chapel Hill, Department of Epidemiology, USA
| | - R Jean Cadigan
- University of North Carolina at Chapel Hill, Department of Social Medicine, USA.,University of North Carolina at Chapel Hill, Center for Bioethics, USA
| | - Kriste Kuczynski
- University of North Carolina at Chapel Hill, Department of Social Medicine, USA
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11
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Awareness and Attitudes Toward HIV Self-Testing in Northern Thailand. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18030852. [PMID: 33498211 PMCID: PMC7908521 DOI: 10.3390/ijerph18030852] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 01/15/2021] [Accepted: 01/17/2021] [Indexed: 11/25/2022]
Abstract
Human Immunodeficiency Virus self-testing (HIVST) was recently introduced in Thailand, but little is known about receptivity among its residents. Because Human Immunodeficiency Virus (HIV) testing is a critical component of HIV prevention, it is important to understand how HIVST is perceived among potential users. The purpose of this study was to examine awareness and attitudes toward HIVST among adults in Northern Thailand. A convenience sample of 403 adult residents of the Sanpatong district, Chiang Mai Province, was interviewed using a structured questionnaire in 2019. Awareness of HIVST was low (14%), as was the overall HIVST negative attitude score (6.44; possible range of 0–14). The odds of being aware of HIVST were more than twice as high for those with more education compared to those with less (AOR = 2.29, 95% CI: 1.22–4.30), and roughly half as high for those who expressed HIV stigma compared to those who did not (AOR = 0.49, 95% CI: 0.26–0.91). Holding negative attitudes towards HIVST also was associated with lower education and expressing HIV stigma, but these relationships disappeared in multivariate analysis. Findings may be used by local health organizations to tailor HIVST education efforts.
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12
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Gedela K, Wirawan DN, Wignall FS, Luis H, Merati TP, Sukmaningrum E, Irwanto I. Getting Indonesia's HIV epidemic to zero? One size does not fit all. Int J STD AIDS 2020; 32:290-299. [PMID: 33226314 DOI: 10.1177/0956462420966838] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Indonesia has one of the fastest growing HIV epidemics in the world. AIDS related deaths in Indonesia have not fallen and have increased significantly since 2010. HIV infection rates remain high and rising in key affected populations. We provide an on the ground, evidence-based perspective of the challenges Indonesia faces. We discuss what is required to adopt tailored public health approaches that address context specific challenges, confront structural barriers and the heterogeneity of the current evolving HIV epidemic.
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Affiliation(s)
- Keerti Gedela
- Chelsea & Westminster NHS Foundation Trust, London, UK
| | - Dewa Nyoman Wirawan
- Faculty of Medicine, Udayana University, Denpasar, Indonesia.,Yayasan Kerti Praja, Denpasar, Indonesia
| | | | | | - Tuti Parwati Merati
- Faculty of Medicine, Udayana University, Denpasar, Indonesia.,Department of Infectious Diseases, Sanglah General Hospital, Denpasar, Indonesia
| | - Evi Sukmaningrum
- AIDS Research Centre and Department of Psychology, Atma Jaya Catholic University, Jakarta, Indonesia
| | - Irwanto Irwanto
- AIDS Research Centre and Department of Psychology, Atma Jaya Catholic University, Jakarta, Indonesia
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13
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Integration and scale-up of efforts to measure and reduce HIV-related stigma: the experience of Thailand. AIDS 2020; 34 Suppl 1:S103-S114. [PMID: 32881799 DOI: 10.1097/qad.0000000000002586] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE(S) To share Thailand's journey to develop and implement a national response to measure and tackle HIV-related stigma and discrimination and key implementation lessons learned. DESIGN A national response to stigma and discrimination including policy, measurement, and interventions. Intervention activities began in health facilities because of their key role in achieving health outcomes. METHODS Three building blocks were implemented: policy and its translation into a roadmap for action; measurement development and routinization to inform intervention design and track progress; and intervention development and implementation. RESULTS Thailand has successfully integrated a response to stigma and discrimination into its national HIV response. Stigma and discrimination-reduction was included as a key strategic goal for the first time in the 2014-2016 National AIDS Strategic Plan. A costed national stigma and discrimination-reduction roadmap incorporated into the operational plan provided clear strategic direction on how to move forward. The development of HIV-related stigma and discrimination measures and their incorporation into the national HIV monitoring and evaluation framework has led to routine data collection to monitor stigma and discrimination in health facilities, key populations, and the general population. Development and successful piloting of a health facility stigma-reduction package - the 3 × 4 approach - has led to national scale-up of the approach through a modified approach. Thailand continues to evolve and innovate the program, including developing new activities to tackle stigma and discrimination beyond the health system. CONCLUSION Thailand's experience demonstrates the key elements needed to make addressing stigma and discrimination a priority in the national HIV response.
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14
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Zhang Q, Yang H, Fan J, Duan L, Chen D, Feng X, Li X. Older people living with human immunodeficiency virus/acquired immune deficiency syndrome in Chinese rural areas: perceived stigma and associated factors. Trans R Soc Trop Med Hyg 2020; 113:477-482. [PMID: 31111936 DOI: 10.1093/trstmh/trz033] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 01/22/2019] [Accepted: 04/03/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Perceived stigma is a common problem among people living with human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) (PLWHA). In recent years, the number of older adults with HIV/AIDS has rapidly increased in China. However, HIV/AIDS-related perceived stigma and associated factors in older PLWHA remain unknown. METHODS A cross-sectional study was conducted in Yongzhou. Participants were recruited via the Hunan HIV/AIDS Registry system. All participants were ≥50 y of age at the time of their HIV diagnosis. Sowell's HIV Stigma Scale was used to measure perceived stigma. RESULTS A total of 193 participants were interviewed, of which 132 (68.4%) were male. The ages of the participants ranged from 50 to 82 y and the average age was 61.1±5.95 y. Eighteen (9.3%) subjects were ethnic minorities. Older PLWHA reported a relatively high level of perceived stigma, especially individuals of Han ethnicity having high annual incomes. The individuals who had disclosed their HIV-positive status to all their family had higher scores on the dimension related to blame. Regression analysis showed that ethnicity, annual income, living arrangement and disclosure patterns were the main associated factors of perceived stigma. CONCLUSIONS Perceived stigma is common in older Chinese PLWHA. Individuals of ethnic minorities or with higher economic status have higher levels of stigma. Family relationships have a deep influence on perceived stigma.
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Affiliation(s)
- Qiang Zhang
- Xiang Ya School of Public Health, Central South University, No. 110 Xiangya Road, Changsha, Hunan, People's Republic of China
| | - Haixia Yang
- Yongzhou Center for Disease Control and prevention, Yongzhou, China
| | - Jinyu Fan
- Tangshan Maternal and Child Health Hospital, Tangshan, China
| | - Luxi Duan
- Xiang Ya School of Public Health, Central South University, No. 110 Xiangya Road, Changsha, Hunan, People's Republic of China
| | - Dan Chen
- Xiang Ya School of Public Health, Central South University, No. 110 Xiangya Road, Changsha, Hunan, People's Republic of China
| | - Xiangling Feng
- Xiang Ya School of Public Health, Central South University, No. 110 Xiangya Road, Changsha, Hunan, People's Republic of China
| | - Xingli Li
- Xiang Ya School of Public Health, Central South University, No. 110 Xiangya Road, Changsha, Hunan, People's Republic of China
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15
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Thaweesit S, Sciortino R. The invisible intersectionality of female gender in Thailand's response to the HIV epidemic. CULTURE, HEALTH & SEXUALITY 2020; 22:762-777. [PMID: 32463325 DOI: 10.1080/13691058.2020.1751881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 04/01/2020] [Indexed: 06/11/2023]
Abstract
This article uses feminist perspectives to analyse Thailand's response to the HIV epidemic from its inception in 1984 until today. In particular, it applies the WHO Gender Responsiveness Assessment Scale to explain how and to what degree gender considerations have been integrated into successive HIV policies and programmes. Findings show that, from 1984 to 1996, HIV prevention policies were generally insensitive to gender and only started to pay limited attention to women's needs between 1997 and 2011. Gender sensitivity increased in the 2012-2019 period, but the focus then was more on 'men who have sex with men' and the transgender communities than on women. In general, Thailand's HIV responses has overlooked gender power relations and the adverse effects of the intersection between women's gender and their other disadvantaged social statuses.
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Affiliation(s)
- Suchada Thaweesit
- Institute for Population and Social Research (IPSR), Mahidol University, Nakorn Pathom, Thailand
| | - Rosalia Sciortino
- Institute for Population and Social Research (IPSR), Mahidol University, Nakorn Pathom, Thailand
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16
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Shah S, Elgalib A, Al-Wahaibi A, Al-Fori M, Raju P, Al-Skaiti M, Al-Mashani HN, Duthade K, Omaar I, Muqeetullah M, Mitra N, Shah P, Amin M, Morkos E, Vaidya V, Al-Habsi Z, Al-Abaidani I, Al-Abri SS. Knowledge, Attitudes and Practices Related to HIV Stigma and Discrimination Among Healthcare Workers in Oman. Sultan Qaboos Univ Med J 2020; 20:e29-e36. [PMID: 32190367 DOI: 10.18295/squmj.2020.20.01.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 07/07/2019] [Accepted: 10/07/2019] [Indexed: 11/16/2022] Open
Abstract
Objectives Stigma and discrimination undermine the quality of life of people with HIV and their access to health services. This study aimed to assess HIV-related knowledge, attitudes and practices among healthcare workers (HCWs) in Oman. Methods This cross-sectional study took place between July and November 2016. A questionnaire was distributed to 1,400 government HCWs to determine HIV-related knowledge, attitudes and practices. Results A total of 1,281 HCWs participated (response rate = 92%). Routine tasks, such as dressing wounds, drawing blood and touching clothes, were a cause of concern for 24-52% of HCWs. Only 69% correctly answered questions regarding the transmission of HIV via eating/drinking and mosquito bites. Compared to other HCWs, doctors had significantly higher knowledge (mean = 0.46, 95% confidence interval [CI]: 0.19 to 0.73; P <0.001), attitude (mean = 0.77, 95% CI: 0.31 to 1.24; P = 0.001) and practice (mean = 2.07, 95% CI: 1.59 to 2.55; P <0.001) scores. Expatriates also scored significantly higher in knowledge (mean = 1.08, 95% CI: 0.93 to 1.23; P <0.001), attitude (mean = 1.23, 95% CI: 0.98 to 1.48; P <0.001) and practice (mean = 1.08, 95% CI: 0.82 to 1.34; P <0.001) compared to Omani nationals. Finally, those with >15 years' work experience scored significantly higher on knowledge (mean = -0.60, 95% CI: -1.12 to -0.08; P = 0.025) and attitude (mean = -0.99, 95% CI: -1.87 to -0.10; P = 0.029) compared to those with less experience. Conclusion The high rate of HIV-related stigma among HCWs in Oman should be rectified in order to achieve the 90-90-90 target set by the Joint United Nations Programme on HIV/AIDS.
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Affiliation(s)
- Samir Shah
- Department of Communicable Diseases, Ministry of Health, Oman
| | - Ali Elgalib
- Department of Communicable Diseases, Ministry of Health, Oman
| | - Adil Al-Wahaibi
- Directorate General for Disease Surveillance & Control, Ministry of Health, Oman
| | - Maha Al-Fori
- Department of Communicable Diseases, Ministry of Health, Oman
| | - Prasanna Raju
- Department of Communicable Diseases, Ministry of Health, Oman
| | | | | | - Kishor Duthade
- Directorate General of Health Services, Ministry of Health, Oman
| | - Iyad Omaar
- Directorate General of Health Services, Ministry of Health, Oman
| | | | - Nilanjan Mitra
- Directorate General of Health Services, Ministry of Health, Oman
| | - Parag Shah
- Directorate General of Health Services, Ministry of Health, Oman
| | - Mohammed Amin
- Directorate General of Health Services, Ministry of Health, Oman
| | - Essam Morkos
- Directorate General of Health Services, Ministry of Health, Oman
| | - Vidyanand Vaidya
- Directorate General of Health Services, Ministry of Health, Oman
| | - Zeyana Al-Habsi
- Department of Communicable Diseases, Ministry of Health, Oman
| | | | - Seif S Al-Abri
- Directorate General for Disease Surveillance & Control, Ministry of Health, Oman
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17
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Seekaew P, Pengnonyang S, Jantarapakde J, Meksena R, Sungsing T, Lujintanon S, Mingkwanrungruangkit P, Sirisakyot W, Tongmuang S, Panpet P, Sumalu S, Potasin P, Kantasaw S, Patpeerapong P, Mills S, Avery M, Chareonying S, Phanuphak P, Vannaki R, Phanuphak N. Discordance between self-perceived and actual risk of HIV infection among men who have sex with men and transgender women in Thailand: a cross-sectional assessment. J Int AIDS Soc 2019; 22:e25430. [PMID: 31855324 PMCID: PMC6922021 DOI: 10.1002/jia2.25430] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 11/14/2019] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Low uptake of HIV testing and services, including pre-exposure prophylaxis (PrEP), in Thai men who have sex with men (MSM) and transgender women (TGW) may be due to the inaccuracy in self-risk assessment. This study investigated the discordance between self-perceived HIV risk and actual risk. METHODS Data were obtained between May 2015 and October 2016 from MSM and TGW enrolled in key population-led Test and Treat study in six community health centres in Thailand. Eligible participants were at least 18 years old, Thai national, had sex with men, had unprotected sex with a man in the past six months or had at least three male sex partners in the past six months, and were not known to be HIV positive. Baseline demographic behavioural characteristics questionnaires, including self-perceived HIV risk, were self-administered. Participants received HIV/STI (syphilis/gonorrhoea/chlamydia) testing at baseline. Participants who self-perceived to have low risk, but engaged in HIV-susceptible practices were categorized as having risk discordance (RD). Regression was conducted to assess factors associated with RD among MSM and TGW separately. RESULTS Of the 882 MSM and 406 TGW participants who perceived themselves as having low HIV risk, over 80% reported at least one of the following: tested HIV positive, engaged in condomless sex, tested positive for a sexually transmitted infection sexually transmitted infection (STI; or used amphetamine-type stimulants. Logistic regression found that living with a male partner (p = 0.005), having never tested for HIV (p = 0.045), and living in Bangkok (p = 0.01) and Chiang Mai (p < 0.001) were associated with increased risk discordance among MSM. Living with a male partner (p = 0.002), being less than 17 years old at sexual debut (p = 0.001), and having a low knowledge score about HIV transmission (p < 0.001) were associated with increased risk discordance among TGW. However, for TGW, being a sex worker decreased the chance of risk discordance (p = 0.034). CONCLUSIONS Future HIV prevention messages need to fill in the gap between self-perceived risk and actual risk in order to help HIV-vulnerable populations understand their risk better and proactively seek HIV prevention services.
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Affiliation(s)
- Pich Seekaew
- PREVENTIONThai Red Cross AIDS Research CentreBangkokThailand
- Department of EpidemiologyMailman School of Public HealthColumbia UniversityNew YorkNYUSA
| | | | | | | | | | - Sita Lujintanon
- PREVENTIONThai Red Cross AIDS Research CentreBangkokThailand
| | | | | | | | | | - Saman Sumalu
- The Service Workers in Group FoundationBangkokThailand
| | | | | | | | | | | | | | | | - Ravipa Vannaki
- Office of Public HealthU.S. Agency for International Development Regional Development Mission AsiaBangkokThailand
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18
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Mathew RS, Boonsuk P, Dandu M, Sohn AH. Experiences with stigma and discrimination among adolescents and young adults living with HIV in Bangkok, Thailand. AIDS Care 2019; 32:530-535. [PMID: 31625417 DOI: 10.1080/09540121.2019.1679707] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Thailand has identified stigma and discrimination as barriers to controlling their HIV epidemic. We aimed to explore the perspectives of young adults living with HIV in Bangkok regarding the influence of stigma and discrimination in education, employment, health care, personal relationships, and perceptions of self. Participants aged 15-24 years were conveniently and purposively sampled from local HIV clinics in Bangkok. Twenty-three individuals (14 female, 9 male; median age 20) were enrolled into the study between May and June 2017. Semi-structured qualitative interviews were conducted in Thai. Interview transcripts were translated into English and analyzed with Dedoose software (v7.6.12) using a framework analysis approach. Participants reported varied experiences with and beliefs about HIV-related stigma as they related to family, employment, education, and society. While few experienced discrimination, such as losing opportunities at work or school, all reported anticipating potential stigma and fearing negative repercussions from disclosure. Many participants reported that fear of disclosure negatively impacted their medication adherence. For the individuals interviewed, fear of stigma was a daily consideration. Many experienced HIV-related stigma in school, at work, within their communities, and in their inter-personal relationships. Anti-stigma efforts should include strategies that address the needs of young adults.
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Affiliation(s)
- Rhea S Mathew
- San Francisco Global Health Sciences, University of California, San Francisco, CA, USA.,Current affiliation: Drexel University College of Medicine: 2900 W. Queen Lane Philadelphia, PA 19129
| | - Phiangjai Boonsuk
- TREAT Asia/amfAR - The Foundation for AIDS Research, Bangkok, Thailand
| | - Madhavi Dandu
- San Francisco Global Health Sciences, University of California, San Francisco, CA, USA
| | - Annette H Sohn
- TREAT Asia/amfAR - The Foundation for AIDS Research, Bangkok, Thailand
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19
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Sohn AH, Ross J, Wainberg ML. Barriers to mental healthcare and treatment for people living with HIV in the Asia-Pacific. J Int AIDS Soc 2018; 21:e25189. [PMID: 30289626 PMCID: PMC6173277 DOI: 10.1002/jia2.25189] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 09/14/2018] [Indexed: 11/05/2022] Open
Affiliation(s)
- Annette H Sohn
- TREAT Asia, amfAR - The Foundation for AIDS Research, Bangkok, Thailand
| | - Jeremy Ross
- TREAT Asia, amfAR - The Foundation for AIDS Research, Bangkok, Thailand
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