Intersectional stigma and its impact on HIV prevention and care among MSM and WSW in sub-Saharan African countries: a protocol for a scoping review

Abubakari, Gamji M’Rabiu; Dada, Debbie; Nur, Jemal; Turner, DeAnne; Otchere, Amma; Tanis, Leonne; Ni, Zhao; Mashoud, Ibrahim Wunpini; Nyhan, Kate; Nyblade, Laura; Nelson, LaRon E.

doi:10.1136/bmjopen-2020-047280

Cited by 31 publications

(38 citation statements)

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“…We identified significant associations between HIV communication and HIV stigma, HIV communication, and other contextual factors on HIV testing. Several studies have highlighted the impact of stigma on HIV testing and linkage to care and the utility of sexual health communication in buffering HIV stigma and increasing HIV testing and linkage to care [ 18 , 26 , 27 , 28 , 29 ]. Our study provided significant insights about partner sexual health communication and HIV stigma and testing among YYA, necessary for intervention delivery that targets most at-risk populations in HIV science.…”

Section: Discussionmentioning

confidence: 99%

“…Stigma (internalized, perceived, and anticipated) has influenced YYA access and use of HIV testing [ 13 , 14 , 15 , 16 , 17 ]. Stigma refers to the occurrence of negative perceptions or associations of individual characteristics or phenomenon to rejection, unfair treatment, and/or discrimination [ 15 , 16 , 17 , 18 , 19 ]. Internalized stigma occurs when individuals attribute negative perceptions to their personal attributes and sometimes turn to undermine their self-value [ 15 , 16 , 17 , 18 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

“…Stigma refers to the occurrence of negative perceptions or associations of individual characteristics or phenomenon to rejection, unfair treatment, and/or discrimination [ 15 , 16 , 17 , 18 , 19 ]. Internalized stigma occurs when individuals attribute negative perceptions to their personal attributes and sometimes turn to undermine their self-value [ 15 , 16 , 17 , 18 , 19 ]. Perceived stigma occurs when one begins to question and build negative thoughts about what others may ascribe to them due to their stigmatized identities [ 15 , 16 , 17 , 18 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

“…Internalized stigma occurs when individuals attribute negative perceptions to their personal attributes and sometimes turn to undermine their self-value [ 15 , 16 , 17 , 18 , 19 ]. Perceived stigma occurs when one begins to question and build negative thoughts about what others may ascribe to them due to their stigmatized identities [ 15 , 16 , 17 , 18 , 19 ]. Anticipated stigma occurs when one expects to be stigmatized or rejected in a setting or by others.…”

Section: Introductionmentioning

confidence: 99%

“…Anticipated stigma occurs when one expects to be stigmatized or rejected in a setting or by others. Young Black and Latino MSM often deal with these kinds of stigma within themselves, friends, immediate family members, and the community [ 13 , 15 , 16 , 17 , 18 , 19 ]. Stigma has been correlated with increased HIV transmission rates, risk behaviors, and poorer health outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Assessing Different Types of HIV Communication and Sociocultural Factors on Perceived HIV Stigma and Testing among a National Sample of Youth and Young Adults

Abubakari

Smith

Boyd

et al. 2022

IJERPH

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In the United States, racial/ethnic and sexual youth and young adults (YYA) of color are disproportionately affected by HIV. Subsequently, YYA experience HIV stigma and engage in increased risk behaviors and reduced HIV testing. HIV communication has been identified as a potential buffer to HIV stigma, resulting in health-seeking behaviors, such as HIV testing. In this study, we respond to a meaningful gap in the literature by examining different types of HIV communication and their impact on HIV stigma and HIV testing in a diverse sample of YYA. We analyzed secondary data from the Kaiser Family Foundation National Survey of Teens and Young Adults on HIV/AIDS. A 40-question, web-based survey was conducted with 1437 youth (ages 15–24). Recruitment included a dual sampling method from households with: (1) listed phone numbers, (2) unlisted phone numbers, (3) telephones, (4) no telephone, and (5) only cell phone access. The purpose of the survey was to establish participants’ HIV knowledge, communication, experiences, and testing behaviors. Findings suggested an association between intimate-partner HIV communication, increased HIV testing, and reduced HIV stigma. We also identified differentials in HIV testing and stigma based on gender, income, age, and sexual minority status, explained by HIV communication. Further research is needed that examines ways to use intimate-partner HIV communication to reduce stigma and increase HIV testing among YYA of different sociodemographic characteristics and sexual orientations.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Assessing Different Types of HIV Communication and Sociocultural Factors on Perceived HIV Stigma and Testing among a National Sample of Youth and Young Adults

Abubakari

Smith

Boyd

et al. 2022

IJERPH

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Using a mixed‐methods approach to adapt an HIV stigma reduction intervention to address intersectional stigma faced by men who have sex with men in Ghana

et al. 2022

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Introduction In Ghana, men who have sex with men (MSM) are estimated to be 11 times more likely to be living with HIV than the general population. Stigmas at the intersection of HIV, same‐sex and gender non‐conformity are potential key drivers behind this outsized HIV disease burden. Healthcare workers (HCWs) are essential to HIV prevention, care and treatment and can also be sources of stigma for people living with HIV and MSM. This article describes the process and results of adapting an evidence‐based HIV stigma‐reduction HCW training curriculum to address HIV, same‐sex and gender non‐conformity stigma among HCWs in the Greater Accra and Ashanti regions, Ghana. Methods Six steps were implemented from March 2020 to September 2021: formative research (in‐depth interviews with stigma‐reduction trainers [n = 8] and MSM living with HIV [n = 10], and focus group discussions with HCWs [n = 8] and MSM [n = 8]); rapid data analysis to inform a first‐draft adapted curriculum; a stakeholder adaptation workshop; triangulation of adaptation with HCW baseline survey data (N = 200) and deeper analysis of formative data; iterative discussions with partner organizations for further refinement; external expert review; and final adaptation with the teams of HCWs and MSM being trained to deliver the curriculum. Results Key themes emerging under four immediately actionable drivers of health facility intersectional stigma (awareness, fear, attitudes and facility environment) informed the adaptation of the HIV training curriculum. Based on the findings, existing curriculum exercises were placed in one of four categories: (1) Expand—existing exercises that needed modifications to incorporate deeper MSM and gender non‐conformity stigma content; (2) Generate—new exercises to fill gaps; (3) Maintain—exercises to keep with no modifications; and (4) Eliminate—exercises that could be dropped given training time constraints. New exercises were developed to address gender norms, the belief that being MSM is a mental illness and stigmatizing attitudes towards MSM. Conclusions Getting to the “heart of stigma” requires understanding and responding to both HIV and other intersecting stigma targeting sexual and gender diversity. Findings from this study can inform health facility stigma reduction programming not only for MSM, but also for other populations affected by HIV‐related and intersectional stigma in Ghana and beyond.

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Problematizing empowerment in global health: Disrupting universalisms and challenging power inequities

Tucker,

Odhiambo,

Jadwin‐Cakmak

et al. 2024

World Med & Health Policy

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This commentary is a call for problematizing the concept of “empowerment” as it is often used in global health. The authors urge that scholars and policymakers use the concept as it is defined in specific contexts, particularly within communities in low to middle‐income countries. The authors also interrogate universalized assumptions about the use of “empowerment” as a political concept, as well as the use of social categories such as “women”. Finally, the authors challenge and complicate the notion that empowerment is a concept which can be delivered from donors in high‐income countries to so‐called disempowered recipients in low‐income contexts.

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Intersectional stigma and its impact on HIV prevention and care among MSM and WSW in sub-Saharan African countries: a protocol for a scoping review

Cited by 31 publications

References 31 publications

Assessing Different Types of HIV Communication and Sociocultural Factors on Perceived HIV Stigma and Testing among a National Sample of Youth and Young Adults

Assessing Different Types of HIV Communication and Sociocultural Factors on Perceived HIV Stigma and Testing among a National Sample of Youth and Young Adults

Using a mixed‐methods approach to adapt an HIV stigma reduction intervention to address intersectional stigma faced by men who have sex with men in Ghana

Problematizing empowerment in global health: Disrupting universalisms and challenging power inequities

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