Can COVID-19 changes reduce stigma in African HIV clinics?

Lofgren, Sarah M; Kigozi, Joanita; Natala, Nakita G; Tsui, Sharon; Arinda, Anita; Akinyange, Vanessa; Sebuliba, Raymond; Boulware, David R.; Castelnuovo, Barbara

doi:10.1016/s2352-3018(22)00045-5

Cited by 2 publications

(3 citation statements)

References 9 publications

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“…Patient-centric healthcare approaches, such as telehealth and self-testing at home, which have been used to reduce the risk of COVID-19 transmission and promote privacy, can be utilized for HIV care. These approaches will likely reduce avoidance of HIV services because of anticipated HIV stigma in healthcare settings [ 65 ].…”

Section: Discussionmentioning

confidence: 99%

Addressing HIV stigma in healthcare, community, and legislative settings in Central and Eastern Europe

Schweitzer,

Dišković,

Krongauz

et al. 2023

AIDS Res Ther

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Introduction Surging HIV prevalence across countries of Central and Eastern Europe (CEE) is largely a result of poor HIV care engagement and a lack of comprehensive support for key populations. This is fostered by widespread stigma across healthcare, community, and legislative settings. Discussion Throughout CEE, HIV stigma and intersectional stigma are serious obstacles to providing adequate medical care to people living with HIV. Anticipated and enacted (experienced) stigma from healthcare professionals, and fears of breaches in confidentiality, deter individuals from having an HIV test and engaging in HIV care. Furthermore, negative connotations surrounding HIV infection can lead to discrimination from family, friends, colleagues, and the public, leading to internalized stigma and depression. Key populations that have higher HIV prevalence, such as men who have sex with men, people who inject drugs, transgender individuals, and sex workers, experience additional stigma and discrimination based on their behaviour and identities. This contributes to the concentrated HIV epidemics seen in these populations in many CEE countries. The stigma is exacerbated by punitive legislation that criminalizes HIV transmission and penalizes sexual orientation, drug use, gender identities, and sex work. Despite high levels of HIV stigma and intersectional stigma, there are many evidence-based interventions that have reduced stigma in other parts of the world. Here, we discuss the interventions that are currently being enacted in various countries of CEE, and we suggest additional effective, evidence-based interventions that will tackle stigma and lead to increased HIV care engagement and higher rates of viral suppression. We cover the promotion of the undetectable = untransmittable (U = U) message, stigma-reduction education and training for healthcare professionals, patient-centric approaches for testing and treatment, and advocacy for non-discriminatory legislation, policies, and practices. We also consider targeted stigma-reduction interventions that acknowledge the wider challenges faced by marginalized populations. Conclusions HIV stigma and intersectional stigma in CEE drive poor engagement with HIV testing services and care. Widespread adoption of evidence-based interventions to tackle stigma highlighted in this review will improve the quality of life of people living with HIV, improve HIV care engagement, and ultimately slow the surging HIV prevalence and concentrated epidemics occurring throughout CEE.

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Section: Discussionmentioning

confidence: 99%

Addressing HIV stigma in healthcare, community, and legislative settings in Central and Eastern Europe

Schweitzer,

Dišković,

Krongauz

et al. 2023

AIDS Res Ther

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“…As compared to other therapies, the efficacy of Antiretroviral therapy depends on strict adherence to the regimen. This poses the greatest challenges ever to many clients who initiated the therapy [14][15][16][17][18][19][20]. HIV is a pandemic infection that affects every part of the globe.…”

Section: Adherencementioning

confidence: 99%

“…However, stigmatization and discrimination are found to be obstacles to effective ART adherence [19][20][21].…”

Section: Adherencementioning

confidence: 99%

Evaluation of the factors influencing adherence to ART in HIV/AIDS patients at Kampala International University Teaching Hospital Bushenyi District

Claire¹

2023

IDOSR JST

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Globally, there were an estimated 33 million people living with HIV by the end of 2007, and more than 25 million people since 1981 have died from AIDS. In 2007 there were 2.7 million new infections and 2 million HIV-related deaths. All these facts are attributed to the compromise of adherence to ART. Currently, there are an estimated 940,000 people (adults and children) living with HIV in Uganda but the adherence levels are hence posing a great challenge in the fight against the scourge. To assess factors influencing adherence to ART among HIV/AIDS clients at Kampala International University Teaching Hospital, a descriptive cross-sectional study design quantitative in nature was used to recruit 52 respondents for the study out of whom 52 questionnaires thus giving a response rate of 100%. 75% of the respondents strongly agreed that level of income may influence adherence to ART, 57% of the respondents agreed that drug hypersensitivity and side effects affect adherence to ART and 63.5% of the respondents agreed that clinic characteristics can impact adherence. The researcher concluded that client-related factors influencing adherence to ART include the client’s age, level of education, level of income, social support, co-morbidities, and patient’s belief about the effectiveness of ART. Therapy-related factors affecting adherence to ART include; polypharmacy, hypersensitivity, pill burden, and regimen complexity. Health system-related factors affecting adherence to ART include; clinic characteristics, selfmedication, lengthy wait before the next clinic visit, and the patient-provider relationship. Keywords: HIV/AIDS, ART, Adherence, Uganda, Hypersensitivity.

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Can COVID-19 changes reduce stigma in African HIV clinics?

Cited by 2 publications

References 9 publications

Addressing HIV stigma in healthcare, community, and legislative settings in Central and Eastern Europe

Addressing HIV stigma in healthcare, community, and legislative settings in Central and Eastern Europe

Evaluation of the factors influencing adherence to ART in HIV/AIDS patients at Kampala International University Teaching Hospital Bushenyi District

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