Developing a community-level anti-HIV/AIDS stigma and homophobia intervention in new York city: The project CHHANGE model

Frye, Victoria; Paige, Mark Q.; Gordon, Steven B.; Matthews, D. W.; Musgrave, Geneva; Kornegay, Mark; Greene, Emily; Phelan, Jo C.; Koblin, Beryl A.; Taylor-Akutagawa, Vaughn

doi:10.1016/j.evalprogplan.2017.03.004

Cited by 44 publications

(28 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Poverty is a fundamental cause of HIV-related health and other social inequities ▪ Provide universal basic income▪ Reduce barriers that prevent eligible individuals from accessing benefits [68]▪ Increase entitlement levels, as current sub-poverty benefit levels ensure continued hardship [68]▪ Entitlements and health benefits are generally subject to strict low-income guidelines, which precludes employment for many PLWH who need to retain benefits. Changing these policies could increase employment rates [69]▪ Provide job training programs in health care and social service settings, as employment can increase knowledge, money, power, prestige, and beneficial social connections and reduce the fundamental causes of disparities [70] Stigma is a fundamental cause of HIV inequities ▪ Address community-level stigma within its broader structural context (e.g., CHHANGE study) [71]▪ Implement symbolic violence and stigma-reduction training and intervention efforts at the levels of health care systems, providers, and PLWH Substance use is chronic and recurring ▪ Provide interventions to health care settings to reduce substance use-related stigma▪ Locate specialized retention clinics within HIV clinics to support persons who use substances [72]▪ Ground services in harm reduction, emphasizing support for individual autonomy and decisions▪ Locate evidencebased substance use treatment in HIV care settings…”

Section: Resultsmentioning

confidence: 99%

Understanding long-term HIV survivorship among African American/Black and Latinx persons living with HIV in the United States: a qualitative exploration through the lens of symbolic violence

Freeman¹,

Gwadz

Wilton

et al. 2020

Int J Equity Health

View full text Add to dashboard Cite

Background: Persons living with HIV (PLWH) are living longer, although racial/ethnic and socioeconomic status (SES) disparities persist. Yet, little is known about the experience of living with and managing HIV over decades. The present study took a qualitative approach and used the lens of symbolic violence, a type of internalized, nonphysical violence manifested in the power differential between social groups. We focused on adult African American/Black and Latinx (AABL) PLWH from low-SES backgrounds. Methods: Data were drawn from two studies with AABL PLWH in New York City (N = 59). After providing signed informed consent, participants engaged in in-depth semi-structured interviews on aspects of HIV management. Interviews were audio-recorded and professionally transcribed verbatim, and data were analyzed using directed qualitative content analysis. Results: Participants in the two studies were comparable on sociodemographic and background characteristics. They had lived with HIV for 20 years, on average (range 3-33 years). All were from low-SES backgrounds and most were African American/Black and men. Participants experienced a convergence of multiple social exclusions, harms, and stigmas, consistent with symbolic violence, which contributed to disengagement from HIV care and discontinuation of HIV medications. We organized results into five sub-themes: (1) participants were "ground down" over time by material, social, and emotional challenges and this diminished self-worth and, at times, the will to live; (2) social isolation and self-isolation, based in part on feeling devalued and dehumanized, served as stigma-avoidance strategies and mechanisms of social exclusion; (3) stigmatizing aspects of patient-provider interactions, both experienced and anticipated, along with (4) restricted autonomy in HIV care and other settings (e.g., parole) reduced engagement; and (5) poor HIV management was internalized as a personal failure. Importantly, resilience was evident throughout the five sub-themes.

show abstract

Section: Resultsmentioning

confidence: 99%

Understanding long-term HIV survivorship among African American/Black and Latinx persons living with HIV in the United States: a qualitative exploration through the lens of symbolic violence

Freeman¹,

Gwadz

Wilton

et al. 2020

Int J Equity Health

View full text Add to dashboard Cite

show abstract

“…These negative attitudes towards patients with HIV/AIDS were identifi ed in all the countries examined including Nigeria [6], Australia [7], Russia [3], and the US [8]. One of the causes for US and Indian nurses' reluctance to care and negative attitudes toward people with HIV/AIDS was recognized as a lack of education [8,9]. HIV-stigma is a major reason why HIV continues to be a global epidemic.…”

Section: Introductionmentioning

confidence: 99%

Comparison of perceptions of HIV/AIDS between Cameroonian, Honduran and American nursing students after Peerled Education

Diesel¹

2017

Arch Nursing Pract Care

View full text Add to dashboard Cite

The study examined changes in HIV/AIDS-related knowledge, attitudes, and beliefs between cohorts of Cameroonian, Honduran, and American nursing students across iterations of a train-the-trainer program. Following a didactic course on HIV/AIDS, two subsets of American students led an educational workshop in Cameroon and Honduras. Fifty-three Cameroonian, 31 Honduran, and 33 American nursing students were evaluated prior to the course or workshop, at the program's conclusion, and 60 days later. Students responded to surveys that measured stigma, willingness to provide care, attitude, and knowledge. Questionnaire scale scores differed signifi cantly by country at each of the three assessment periods. All cohorts demonstrated an improvement in knowledge with varying levels of success. The workshop helped the American subset sustain a willingness to provide care and increased obstetrical-related HIV/AIDS knowledge more than the didactic course for American students or workshop for Cameroonian students. The American subset showed the greatest improvement in knowledge. Cross-cultural peer interaction is a constructive and valuable strategy for improving comprehension and perceptions of HIV/AIDS among student nurses and should be tailored to meet the personal and professional experiences of the students.

show abstract

“…Mburu et al (95) also found that seeking HIV prevention services, or any type of health care, meant that they publicly accepted the stigmatized sick role. Community-level interventions that fostered contact or visibility with the disaffected groups and targeted negative stereotypes have proved effective in reducing HIV stigma and homophobia (98).…”

Section: Societal-level Factorsmentioning

confidence: 99%

Intersectional Stigma and Multi-Level Barriers to HIV Testing Among Foreign-Born Black Men From the Caribbean

Taylor

DeHovitz

Hirshfield

2020

Front. Public Health

View full text Add to dashboard Cite

Testing is the entry point into the HIV care continuum that includes linkage to and retention in prevention services, and adherence to prevention strategies, including repeat HIV testing. Despite US policy approaches to expand HIV testing to diverse clinical care and community settings, disparities in HIV testing among Black populations persist. Foreign-born (FB) Black persons from the Caribbean have higher annual rates of HIV diagnosis and a higher percentage of late-stage HIV diagnosis, compared with US-born Black persons; and most HIV infections among FB Blacks are among men. In this article, we provide an overview of HIV testing barriers among FB Black men who engage in HIV risk-taking behaviors (e.g., condomless sex with male and/or female partners of unknown HIV serostatus). Barriers to HIV testing for both FB and US-born Black men, include HIV stigma (anticipated, perceived, internalized), low perceived HIV risk, medical or government mistrust, and perceived low access to testing resources. We examine beliefs about masculinity and gender roles that may perpetuate heteronormative stereotypes associated with perceptions of low HIV risk and barriers to HIV testing. We also discuss the impact of recent immigration policies on accessing HIV testing and treatment services and how intersectional stigmas and structural forms of oppression, such as racism, prejudice against select immigrant groups, and homophobia that may further amplify barriers to HIV testing among FB Black men. Finally, we review comprehensive prevention approaches, and suggest innovative approaches, that may improve the uptake of HIV testing among FB Black men.

show abstract

Developing a community-level anti-HIV/AIDS stigma and homophobia intervention in new York city: The project CHHANGE model

Cited by 44 publications

References 46 publications

Understanding long-term HIV survivorship among African American/Black and Latinx persons living with HIV in the United States: a qualitative exploration through the lens of symbolic violence

Understanding long-term HIV survivorship among African American/Black and Latinx persons living with HIV in the United States: a qualitative exploration through the lens of symbolic violence

Comparison of perceptions of HIV/AIDS between Cameroonian, Honduran and American nursing students after Peerled Education

Intersectional Stigma and Multi-Level Barriers to HIV Testing Among Foreign-Born Black Men From the Caribbean

Contact Info

Product

Resources

About