HIV-Related Stigma by Healthcare Providers in the United States: A Systematic Review

Geter, Angelica; Herron, Adrienne R.; Sutton, Madeline Y.

doi:10.1089/apc.2018.0114

Cited by 180 publications

(156 citation statements)

References 15 publications

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“…Educational intervention had a signi cant effect on improving HIV/AIDS knowledge, changing HIV attitudes and reducing the proportion of workers with extra-partners, and could also change premarital and paid sexual behavior when combined with community intervention. A recent systematic review showed that educational intervention combined with community intervention could also change the public stigma of HIV [51]. In the future, more attention should be paid to HIV education combined with community intervention [52].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of HIV interventions among factory workers in low- and middle-income countries: a systematic review

Chen¹,

Luo²,

Meng

et al. 2020

Preprint

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Background: Factory workers in low- and middle-income countries (LMICs) are vulnerable to HIV transmission. Interventions are needed to prevent HIV in this population. We systematically reviewed published literature on the efficacy of various HIV interventions in reducing stigma, risk behaviors and HIV transmission among factory workers.Methods: A systematic review was performed using predefined inclusion and exclusion criteria. Four databases (PubMed, PsycINFO, Scopus and EMBASE) were searched for relevant publications between January 1, 1990 and December 31, 2018. Two independent reviewers assessed the methodological quality of studies.Results: Thirteen articles were included, with 2 randomized controlled trials and 11 cohort studies. Five interventions and their combinations were summarized. Educational intervention increased condom use and reduced the use of recreational drugs and alcohol before sex. Community intervention that proactively provide HIV counselling and testing (HCT) services could increase the detection rate of HIV and other sexually transmitted diseases (STDs). Lottery intervention increased HCT uptake and decreased HIV public stigma. Education combined with community intervention reduced the proportion of workers with casual sex and enhanced HIV knowledge. Peer education combined with community intervention increased the proportion of workers who were willing to take their partners to HCT. Policy intervention combined with peer education enhanced HIV knowledge, perceived condom accessibility and condom use with regular partners.Conclusions: Various interventions improved HIV knowledge, decreased HIV stigma and reduced HIV-related risk behaviors among factory workers in LMICs. The combination of multiple interventions tended to achieve better efficacy than a single intervention. Persistent combination interventions are essential to address HIV in this population.

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Section: Discussionmentioning

confidence: 99%

Efficacy of HIV interventions among factory workers in low- and middle-income countries: a systematic review

Chen¹,

Luo²,

Meng

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…They are also uniquely situated to educate patients on the risks and benefits of PrEP and have the ability to reach a large number of high-risk individuals. Two prior reviews have highlighted the substantial breadth of research on barriers to PrEP use among populations with higher rates of HIV, 19,20 and two other reviews have incorporated health care provider barriers to PrEP service delivery, 21,22 but a comprehensive and systematic review on provider-level barriers to PrEP prescription was needed.…”

Section: Introductionmentioning

confidence: 99%

Health Care Provider Barriers to HIV Pre-Exposure Prophylaxis in the United States: A Systematic Review

Pleuhs

Quinn

Walsh

et al. 2020

AIDS Patient Care and STDs

169

128

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Increasing prescription of pre-exposure prophylaxis (PrEP) is imperative to ending the HIV epidemic in the United States. The objective of this review was to identify health care provider barriers to PrEP implementation. A systematic review was conducted in February 2019 using PubMed to identify barriers to PrEP prescribing practices in the United States. Targeted search terms surrounding PrEP and providers resulted in 222 original studies, 28 of which were ultimately included in our review, with data collected between 2011 and 2018. Six themes were identified across reviewed studies: (i) a lack of PrEP knowledge, (ii) the presence of the Purview Paradox, which refers to discordance in beliefs between HIV specialists and primary care providers on who should prescribe PrEP, (iii) concerns about PrEP costs, (iv) concerns about behavioral and health consequences, (v) interpersonal stigma, and (vi) concerns about patient adherence. A majority of providers were lacking knowledge regarding PrEP, resulting in discomfort in prescribing PrEP, or limited awareness and understanding of PrEP clinical guidelines. Discrepant opinions were identified regarding whether PrEP was best managed within primary care or specialty clinics. Other barriers included concerns about cost, patient adherence, and follow-up maintenance care. Finally, concerns about risk compensation and discomfort discussing sexual activities with patients who would benefit most from PrEP were apparent. Additional work is needed to prepare providers to prescribe and manage patients on PrEP, optimize PrEP delivery, and reduce provider bias. Future research is needed to identify providers' attitudes and beliefs regarding innovations in PrEP dosing, task shifting, and novel strategies for PrEP care.

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“…HIV-related stigma exhibited by health care workers in the South is prevalent, and provider characteristics such as race, religion, and clinic type may predict stigmatizing attitudes. [26][27][28] Research has also shown that personal values held by providers may interfere with discussing sexual behaviors with their patients, 25 and patient anticipated stigma in health care settings has been correlated with lower adherence to ART. 29 This underscores that targeted educational and stigma reduction efforts with providers in the southern United States, like those who participated in this study, are warranted.…”

Section: Geographic Information System Results/analysismentioning

confidence: 99%

Perceptions of Patient HIV Risk by Primary Care Providers in High-HIV Prevalence Areas in the Southern United States

Drumhiller

Geter

Elmore

et al. 2020

AIDS Patient Care and STDs

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The southern United States accounted for 52% of new HIV diagnoses in 2015. Visits to primary care providers (PCPs) offer opportunities for routine HIV screening. However, of at-risk persons in the United States who visited a health care provider within the previous year, >75% were not offered a test for HIV. Perceptions of patient population risk by PCPs could offer insight into these missed opportunities, and inform development of HIV testing interventions for PCPs to increase routine screening. During April-October 2017, we conducted online surveys regarding PCP's perceptions of patient HIV risk in six areas of the South with high-HIV prevalence. Surveys queried HIV-related knowledge, beliefs, attitudes, and practices. Free-text responses to the question ''Are there any unique or special risk factors relating to HIV infection in your patient population?'' were analyzed using NVivo for applied thematic analysis. Of 526 respondents, the mean age was 47 years with 65% white, 13% Asian/other, 13% black, 6% Hispanic/Latino; 71% female; 93% straight/heterosexual; and 35% offered HIV screening correctly based on standard of care. Main themes revealed were as follows: (1) provider perceptions of patient risk factors (e.g., ''injection drug use is rampant''), (2) provider perceptions of patient barriers to access and care (e.g., ''concern for parental notification and cost for treatment''), and (3) provider misconceptions of HIV risk and patient stigmatization (e.g., ''I have a low-risk population''). Our findings suggest that PCPs in the South may warrant education regarding local HIV prevalence and routine HIV screening and prevention practices.

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HIV-Related Stigma by Healthcare Providers in the United States: A Systematic Review

Cited by 180 publications

References 15 publications

Efficacy of HIV interventions among factory workers in low- and middle-income countries: a systematic review

Efficacy of HIV interventions among factory workers in low- and middle-income countries: a systematic review

Health Care Provider Barriers to HIV Pre-Exposure Prophylaxis in the United States: A Systematic Review

Perceptions of Patient HIV Risk by Primary Care Providers in High-HIV Prevalence Areas in the Southern United States

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