Assessing associations between stigma and mental health among preexposure prophylaxis users in Guatemala.

Bartels, Sophia M.; Galíndo, César; Ángeles, Gustavo; Barrington, Clare

doi:10.1037/sah0000429

Cited by 5 publications

(4 citation statements)

References 47 publications

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“…Most studies on stigma in Guatemala focus on how HIV/AIDS stigma intersects with preexisting stigma around sexual orientation, gender identity, sex work, migrant status, and social class within larger structures of inequality (Bartels et al, 2023; Infante et al, 2009; Rocha-Jiménez et al, 2018). These studies demonstrate how anticipated, enacted, and internalized stigmas contribute to the loss of family and social support, isolation from religious communities, discrimination in health care settings, and mental distress (Boyce et al, 2012; Miller et al, 2020; Orrego Dunleavy et al, 2018; Rhodes et al, 2015).…”

Section: Mental Health In Guatemalamentioning

confidence: 99%

Cultural concepts of distress, psychiatric disorders, and social distance: Measuring mental health stigma in Guatemala.

Maupin,

Driese,

Pezzia

2024

Stigma and Health

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Stigma toward psychiatric disorders is documented worldwide. While the extent of stigma may vary within and between contexts, stigma toward psychiatric conditions is frequently driven by labeling, perceptions of violence, notions of causation, and behaviors associated with different conditions. However, as stigma attacks "what matters most," interpretations of mental health may depend on sociocultural values and structures which require attention to cultural concepts of distress (CCDs). Most ethnographic studies argue that CCDs are not as stigmatized as psychiatric disorders as they represent culturally recognized and acceptable mechanisms for individuals to express experiences of suffering, critique social structures and relations, and call for social support. Yet, few studies systematically analyze stigma toward CCDs, or compare it to stigma toward psychiatric disorders. In this article, we examine factors that influence stigma toward three psychiatric disorders (alcohol use disorder [AUD], major depression, and schizophrenia) and three CCDs (ataque de nervios, nervios, and susto) among a sample of women in a Highland Guatemalan town. Using a survey design, we evaluate the impact of different factors on preferences for social distance relating to standardized vignettes for each condition. Results suggest that there is greater stigma toward AUD and schizophrenia while ataque de nervios and nervios are less stigmatized compared to a "troubled person" baseline. Notions of labeling, causation, and violence influence the significance of these differences. This study emphasizes the need to understand how CCDs and psychiatric disorders are differentiated in public perception and how sociocultural values, norms, and structures shape expressions of stigma. Clinical Impact StatementIn this study, we test the hypothesis that cultural concepts of distress are less stigmatized in Latin America than psychiatric disorders. Using a series of standardized vignettes for different conditions, we measure the factors influencing preferences for social distance. We find that some CCDs, like ataque de nervios and nervios, are less stigmatized and that factors including labeling something a mental disorder, notions of causation, and perceptions of violence influence participants' willingness for social interaction. This study contributes to the understanding of how cultural values, norms, and structure shape expressions of mental health stigma.

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Section: Mental Health In Guatemalamentioning

confidence: 99%

Cultural concepts of distress, psychiatric disorders, and social distance: Measuring mental health stigma in Guatemala.

Maupin,

Driese,

Pezzia

2024

Stigma and Health

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“…Las investigaciones en esta línea, estudian y focalizan en el impacto de la identidad de género y la orientación sexual en la salud mental de las personas LGBT+. Dentro de este grupo es posible nombrar estudios sobre personas LGBT+ y salud mental en general o tema específico como adicción, conductas autolesivas, consumo de sustancias (Radusky et al, 2023), depresión (Zegarra-López et al, 2023) (Barrington et al, 2023;Bartels et al, 2023;Reisner et al, 2023), violencia (Ceballos y Zúñiga, 2023; Radusky et al, 2023;Zea et al, 2022), entre otros. En general, los estudios sobre salud mental en personas LGBT+ en esta región concluyen que hay mayor prevalencia de malestar y psicopatología producto de los estresores psicosociales nombrados en apartados anteriores.…”

Section: Identidad De Género Orientación Sexual Y Salud Mentalunclassified

Investigación en Psicoterapia LGBT+ en Iberoamérica: Avances y Desafíos

Tomicic,

Martínez,

Concha

2024

rdp

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Tradicionalmente, la investigación en psicoterapia se ha focalizado en pacientes típicos y estandarizados de acuerdo a algún diagnóstico predeterminado. Aunque es evidente para clínicos/as que los y las pacientes tienen identidades culturales y experiencias únicas de enfermedad y sufrimiento, ha sido menos abordado en este campo de estudios. Sin embargo, en los últimos años se ha puesto énfasis en la necesidad de una investigación en psicoterapia contextualizada con pacientes con identidades no-hegemónicas. A partir de estos estudios se han desarrollado conocimiento e intervenciones culturalmente sensibles y competentes en distintas poblaciones, como es el caso de pacientes de identidad sexual y de género diverso. El propósito de este trabajo es hacer una revisión narrativa actualizada de la investigación en salud mental y psicoterapia en población LGBT+, desarrollada en el contexto Iberoamericano. Presentamos las líneas de investigación que son posibles de reconocer en la región, ordenadas en las dimensiones de Determinantes, Constituyentes y Consecuencias de la psicoterapia del Modelo Genérico de Psicoterapia desarrollado por Orlinski y Howard. Finalizamos con una discusión acerca de la manera como estas líneas de investigación ofrecen en conjunto una comprensión y propuesta de abordaje de los desafíos específicos que enfrenta la población LGBT+ en materia de salud mental e intervención psicoterapéutica, contribuyendo a la mejora de la calidad de vida y el bienestar psicológico de estas poblaciones en Iberoamérica.

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“…Finally, PrEP stigma, a longstanding concern in other settings (22), can come in many forms, most commonly including anticipated stigma (the threat of being stigmatized); enacted stigma (the act of being discriminated against); or internalized stigma (ascribing negative beliefs to self) (23,24). In other contexts, PrEP stigma has manifested as negative stereotypes ascribed to PrEP users including promiscuity, mistaking PrEP users as HIV positive, and associating PrEP exclusively with stigmatized identities (e.g., MSM) -resulting in intersectional stigmas (24).…”

Section: Introductionmentioning

confidence: 99%

Barriers and Facilitators to Uptake and Persistence on PrEP among Key Populations in Southern Province, Zambia: A Thematic Analysis

Stoebenau,

Muchanga,

Ahmad

et al. 2024

Preprint

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Background: Especially in high HV prevalence contexts, such as Zambia, effective biomedical prevention tools are needed for priority populations (PPs), including key populations (KPs), who are at higher risk. HIV pre-exposure prophylaxis (PrEP) has been scaled up nationally in Zambia, but little is known about barriers to PrEP use among specific PPs to date. Methods: To understand barriers and facilitators to PrEP use in Zambia, we conducted a qualitative case study of PrEP services to PPs including sero-discordant couples (SDCs), female sex workers (FSWs), and men who have sex with men (MSM) in Livingstone. The study conducted in 2021 included in-depth interviews (n=43) guided by the socio-ecological model, and focus group discussions (n=4) with clinic and community-based providers and PrEP-eligible clients including users and non-users across PP groups. We used thematic analysis to analyze data using codes derived both deductively and inductively. Results: We found multilevel barriers and facilitators to PrEP use. Cross-cutting barriers shared across PP groups included anticipated stigma resulting from PrEP being mistaken for antiretroviral drugs used to treat HIV and concerns about side-effects based on both misinformation and experience. PrEP stigma in this setting differed from studies in other regions; for example, there was little concern about PrEP being associated with promiscuity. The fear of being mislabeled as having HIV was of greatest concern for FSWs. Facilitators to PrEP use primarily included the importance of confidential, KP-sensitive services, and the role of informed, supportive family, friends, and peers. Participants across all PP groups urged expanded education efforts to increase awareness of PrEP within the general population toward mitigating concerns of being mislabeled as living with HIV. Conclusion: To our knowledge, this is the first qualitative study of the PrEP cascade among PPs in Zambia. This study provides important explanation for the low rates of PrEP continuation found in earlier demonstration trials among KPs in Zambia. The study also offers recommendations for programming efforts going forward such as inclusive PrEP awareness campaigns, expanded KP sensitivity training, and related efforts to thwart PrEP stigma while expanding access.

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Assessing associations between stigma and mental health among preexposure prophylaxis users in Guatemala.

Cited by 5 publications

References 47 publications

Cultural concepts of distress, psychiatric disorders, and social distance: Measuring mental health stigma in Guatemala.

Cultural concepts of distress, psychiatric disorders, and social distance: Measuring mental health stigma in Guatemala.

Investigación en Psicoterapia LGBT+ en Iberoamérica: Avances y Desafíos

Barriers and Facilitators to Uptake and Persistence on PrEP among Key Populations in Southern Province, Zambia: A Thematic Analysis

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