Stigma reduction interventions in people living with HIV to improve health-related quality of life

Abstract

As UNAIDS 90-90-90 targets for people living with HIV are increasingly being reached in many contexts, health-related quality of life (HRQoL), the "fourth 90", warrants special attention. HIV-related stigma and discrimination remain major barriers for overall HRQoL despite impressive clinical and virological improvements in HIV care. We reviewed original publications examining the impact of interventions to reduce stigma as experienced by people living with HIV in all income settings between 2010-2018. Our search identified a lack of welldesigned intervention studies that documented stigma reduction and few studies that specifically assessed the impact of stigma on HRQoL. Further, few interventions targeted discrimination from providers outside HIV-specific care or involved people living with HIV in both the design and implementation. Lastly, evidence on methods to reduce stigma among several underrepresented key populations and geographic regions was limited and research on intersectional stigma, i.e. the convergence of multiple stigmatized identities, needs further attention.

Codesigning care improvements for women living with HIV: a patient-oriented deliberative dialogue workshop in Montréal, Quebec

“…There is limited published literature on codesigned HIVspecific care recommendations. However, our findings are consistent with the HIV literature that emphasizes the need to address HIV-related stigma, 44,46 promote peer-navigation OPEN Research Especially with age, there are certain situations that we did not see 10 years ago -for example, joint pains, back pains -so we talk to the doctor and he refers you to a physiotherapist, etc., but often those are professionals that you have to pay out of pocket for. If you don't have private health insurance, then you get stuck paying for it, or stuck with the pain.…”

Impact of ‘HIV-related stigma-reduction workshops’ on knowledge and attitude of healthcare providers and students in Central India: a pre-test and post-test intervention study

“…Our study is based on the call for new research that promotes the development of knowledge-building and stigma-reduction interventions to target a broad range of HCPs that PLWHA will encounter in their healthcare journeys 38 39. The scaling-up of HIV stigma-reduction efforts lacks focus throughout the world, and especially in countries with a high HIV prevalence like India.…”

“…The number and duration of educational sessions does not necessarily correspond to greater increases in knowledge, and shorter interventions may suffice to bring participants to an adequate level of knowledge 38 39. Researchers have used various time lengths to assess their intervention designs, and thus it is not appropriate to conclude there is a relationship between the length and number of workshops and the level of change 22 24 36 40.…”

Social and behavioral health responses to COVID-19: lessons learned from four decades of an HIV pandemic

“…Approaches to addressing stigma in the context of promoting well-being and disease prevention exist and likely provide relevant tools applicable to addressing COVID-19. Interventions to address stigma have been developed that target individuals, health care workers, communities, and social figures, which will likely find new purpose in COVID-19 (Andersson et al, 2020;Rao et al, 2019;Stangl et al, 2013).…”