Loneliness, HIV-Related Stigma, and Condom Use Among a Predominantly Rural Sample of HIV-Positive Men Who Have Sex With Men (MSM)

Hubach, Randolph D.; Dodge, Brian; Li, Michael J.; Schick, Vanessa; Herbenick, Debby; Ramos, William D.; Cola, Thea; Reece, Michael

doi:10.1521/aeap.2015.27.1.72

Cited by 63 publications

(46 citation statements)

References 63 publications

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“…The original intervention brought together healthcare professionals (nurses) and patients (PLWH) from the same health facility for a 2-day workshop, facilitated by a representative from each target group, followed by a 1-day project evaluation workshop after a 1-month interval. The intervention included three key elements: (1) Sharing of information, (2) increasing contact between HW and PLWH, and (3) utilizing empowerment strategies to improve coping with HIV-related stigma. A full description of the original intervention is provided elsewhere.…”

Section: Original Interventionmentioning

confidence: 99%

“…H IV-related stigma presents a significant barrier for both the prevention and management of HIV. [1][2][3] Despite advances in the medical treatment of HIV, the persistence of HIV-related stigma within healthcare settings in the United States (US) 4 continues to be an obstacle to improving the health and well-being of people living with HIV (PLWH). [5][6][7] Whether experienced or anticipated, HIV-related stigma may adversely affect the health behaviors, and, hence, the treatment outcomes of PLWH in a number of ways.…”

Section: Introductionmentioning

confidence: 99%

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Adaptation and Implementation of an Intervention to Reduce HIV-Related Stigma Among Healthcare Workers in the United States: Piloting of the FRESH Workshop

Batey

Whitfield

Mulla

et al. 2016

AIDS Patient Care and STDs

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HIV-related stigma has been shown to have profound effects on people living with HIV (PLWH). When stigma is experienced in a healthcare setting, negative health outcomes are exacerbated. We sought to assess the feasibility and acceptability of a healthcare setting stigma-reduction intervention, the Finding Respect and Ending Stigma around HIV (FRESH) Workshop, in the United States. This intervention, adapted from a similar strategy implemented in Africa, brought together healthcare workers (HW) and PLWH to address HIV-related stigma. Two pilot workshops were conducted in Alabama and included 17 HW and 19 PLWH. Participants completed questionnaire measures pre- and post-workshop, including open-ended feedback items. Analytical methods included assessment of measures reliability, pre-post-test comparisons using paired t-tests, and qualitative content analysis. Overall satisfaction with the workshop experience was high, with 87% PLWH and 89% HW rating the workshop "excellent" and the majority agreeing that others like themselves would be interested in participating. Content analysis of open-ended items revealed that participants considered the workshop informative, interactive, well-organized, understandable, fun, and inclusive, while addressing real and prevalent issues. Most pre- and post-test measures had good-excellent internal consistency reliability (Cronbach's alphas ranging from 0.70 to 0.96) and, although sample sizes were small, positive trends were observed, reaching statistical significance for increased awareness of stigma in the health facility among HW (p = 0.047) and decreased uncertainty about HIV treatment among PLWH (p = 0.017). The FRESH intervention appears to be feasible and highly acceptable to HW and PLWH participants and shows great promise as a healthcare setting stigma-reduction intervention for US contexts.

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Section: Original Interventionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Adaptation and Implementation of an Intervention to Reduce HIV-Related Stigma Among Healthcare Workers in the United States: Piloting of the FRESH Workshop

Batey

Whitfield

Mulla

et al. 2016

AIDS Patient Care and STDs

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“…An association between homophobic stigma and risk-taking behaviors has been found [43]. Another study showed that as loneliness increased, condom use among MSM decreased [44]. Therefore, we chose self-esteem and loneliness as psychosocial factors in addition to anxiety, depression, and sexual compulsivity.…”

Section: Introductionmentioning

confidence: 99%

Association between a syndemic of psychosocial problems and unprotected anal intercourse among men who have sex with men in Shanghai, China

Wang

Jia

et al. 2017

BMC Infect Dis

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BackgroundPrevious studies have discussed the overlapping and reinforcing effects (defined as a syndemic) of psychosocial problems on high-risk sexual behaviors among men who have sex with men (MSM). The present study aimed to apply the syndemic theory to verify the reinforcing effects of psychosocial problems on unprotected anal intercourse (UAI) among MSM in Shanghai, and determine if other important psychosocial factors fit into the syndemic theory.MethodsData were collected from 547 MSM in Shanghai, China, through face-to-face interviews. The measures for psychosocial problems included the Rosenberg Self-Esteem Scale; the Generalized Anxiety Disorder-7; the Center for Epidemiological Studies Depression Scale; the University of California, Los Angeles Loneliness Scale; and the Sexual Compulsivity Scale. We used multivariate analysis and binary logistic regression to investigate the associations between psychosocial problems and high-risk sexual behaviors.ResultsThe prevalence of UAI among MSM in the past 6 months was 54.5%. Education (graduate from college vs. high school) served as a protective factor against UAI (OR 0.59, 95% CI: 0.38–0.94). There was a high prevalence of psychosocial problems, and at least one-third of participants reported experiencing more than two psychosocial symptoms. Of these psychosocial factors that we investigated, lower self-esteem was associated with UAI in both univariate and multivariate regression model (P = 0.009). Result suggests that overlapping and reinforcing effects of psychosocial problems may increase high risk sexual behaviors among MSM in Shanghai, China (OR 1.65, 95% CI: 1.09–2.50; P = 0.018).ConclusionsWe found further evidence for a syndemic of psychosocial problems among MSM in Shanghai, China. This syndemic may also increase high risk sexual behaviors among MSM. Most HIV prevention interventions are focused on behavior change and only have moderate effects; our findings suggest that a shift from behavior-focused interventions to a more comprehensive strategy that addresses psychosocial factors may be necessary.

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“…A substantial body of research has documented the physical and mental health consequences of HIV-related stigma, both in China and globally (Hua et al, 2014; Kalichman, 2014; Karamouzian, Akbari, Haghdoost, Setayesh, & Zolala, 2015; Peitzmeier, Grosso, Bowes, Ceesay, & Baral, 2015). Negative consequences include non-adherence to antiretroviral therapy (ART) (Dlamini et al, 2009), irregular patterns of accessing health care (Evangeli, Newell, Richter, & McGrath, 2014), increased HIV symptoms (Earnshaw, Lang, Lippitt, Jin, & Chaudoir, 2015), loneliness (Hubach et al, 2015), and decreased quality of life (Slater et al, 2015; Wu et al, 2014). Stigma can be divided into perceived stigma , defined as negative beliefs, views, and feelings toward oneself arising from self-identification with a stigmatized condition (Logie & Gadalla, 2009), and enacted stigma , which refers to the experiences of prejudice, discrimination, and exclusion directed towards individuals from an external source because of specific attributes or conditions that characterize them (Brown, Macintyre, & Trujillo, 2003).…”

Section: Introductionmentioning

confidence: 99%

Exploring HIV-related stigma among HIV-infected men who have sex with men in Beijing, China: a correlation study

et al. 2016

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HIV-related stigma among HIV-infected men who have sex with men (MSM) has been associated with adverse health outcomes, including poor adherence to antiretroviral therapy (ART) and care, and increased participation in behaviours linked to higher rates of HIV transmission. In China, the incidence of HIV is growing more rapidly among MSM than among other subgroups. This study characterizes and quantifies HIV stigma among HIV-infected (MSM) in Beijing, China, which arguably may be driving this epidemic. A cross-sectional survey study was performed among 266 HIV-positive MSM in Beijing, China in 2014. The Berger HIV Stigma Scale was used to measure levels of HIV-related stigma. Participants additionally answered questions regarding socio-demographic characteristics and HIV-associated risk factors; previously validated Mandarin-language scales assessed depression, coping style, and social support networks. Multivariable linear regression models were used to identify variables significantly associated with HIV stigma. The mean overall HIV stigma score among the study population was 112.78±18.11 (score range: 40–160). Higher HIV stigma scores were positively associated with depression (β=7.99, 95% CI:3.69, 12.29,p<0.001) and negative coping skills (β=0.64, 95% CI:0.21,1.08,p<0.01), and was negatively associated with disclosed HIV status (β=−6.45, 95%CI:−11.80,−1.11,p<0.05), and availability of social support networks (β=−0.12, 95%CI:−0.22,−0.02,p<0.05). Other variables such as poor self-rated health status and presence of opportunistic infections were positively associated with individual dimensions of HIV-related stigma. The results of this study can inform the development of culturally sensitive interventions to reduce HIV-related stigma among MSM with HIV in China, with the overarching goal of reducing HIV transmission in this vulnerable population.

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Loneliness, HIV-Related Stigma, and Condom Use Among a Predominantly Rural Sample of HIV-Positive Men Who Have Sex With Men (MSM)

Cited by 63 publications

References 63 publications

Adaptation and Implementation of an Intervention to Reduce HIV-Related Stigma Among Healthcare Workers in the United States: Piloting of the FRESH Workshop

Adaptation and Implementation of an Intervention to Reduce HIV-Related Stigma Among Healthcare Workers in the United States: Piloting of the FRESH Workshop

Association between a syndemic of psychosocial problems and unprotected anal intercourse among men who have sex with men in Shanghai, China

Exploring HIV-related stigma among HIV-infected men who have sex with men in Beijing, China: a correlation study

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