Stigma, Implicit Bias, and Long-Lasting Prevention Interventions to End the Domestic HIV/AIDS Epidemic

Andrasik, Michele P.; Broder, Gail; Oseso, Linda; Wallace, Stephaun E; Rentas, Francisco J.; Corey, Lawrence

doi:10.2105/ajph.2019.305454

Cited by 22 publications

(11 citation statements)

References 3 publications

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“…Efforts to end the HIV epidemic that center on accelerating implementation of treatment and prevention technology can do so more effectively by focusing on root social causes of these well-documented HIV-related disparities. These systemic barriers, which include systemic racism, poverty, homelessness, discrimination, homophobia, and transphobia, impede access to testing, treatment, and prevention services and drive inequity ( 9 ).…”

Section: Discussionmentioning

confidence: 99%

Estimated Annual Number of HIV Infections ─ United States, 1981–2019

Bosh¹,

Hall²,

Eastham³

et al. 2021

MMWR Morb. Mortal. Wkly. Rep.

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Section: Discussionmentioning

confidence: 99%

Estimated Annual Number of HIV Infections ─ United States, 1981–2019

Bosh¹,

Hall²,

Eastham³

et al. 2021

MMWR Morb. Mortal. Wkly. Rep.

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“…Rather than solely addressing individual-level biases among health care providers, these interventions should also address the sociocultural and structural factors that promote discrimination. 32 A promising approach would be to use mass media, social marketing interventions that inform HIV care providers of the need to provide culturally competent care to all PWH. 33 Other approaches could provide medical trainings on the value of delivering equitable treatment to all PWH, irrespective of their HIV status, race/ethnicity, gender, or sexual orientation.…”

Section: Discussionmentioning

confidence: 99%

Sociodemographic Correlates of Self-reported Discrimination in HIV Health Care Settings Among Persons With Diagnosed HIV in the United States, Medical Monitoring Project, 2018–2019

McCree

Beer

Jeffries

et al. 2021

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background: HIV-related discrimination in health care settings is associated with negative health outcomes among persons with HIV (PWH). This article describes and compares differences in the prevalence of self-reported experiences with discrimination in health care settings by sociodemographic and clinical care factors among persons with diagnosed HIV in the United States. Methods:We analyzed interview and medical record data collected during June 2018-May 2019 from 3850 PWH who had received HIV care in the past 12 months. We calculated weighted percentages and associated 95% confidence intervals and assessed the association between any experience of discrimination and selected sociodemographic and clinical characteristics using prevalence ratios with predicted marginal means.Results: Approximately 25% of PWH who had an HIV care visit in the past 12 months reported experiencing any discrimination. Experiences with discrimination were significantly more prevalent among persons aged 18-29 years (34%); transgender persons (41%); persons of gay (25%), bisexual (31%), or other (40%) sexual orientations; and persons who did not have a regular provider (39%), lived at/below poverty level (28%), were homeless (39%) or incarcerated (37%) in the past 12 months. PWH who experienced discrimination were more likely to have missed at least one HIV care visit, not be taking antiretroviral therapy, and have missed antiretroviral therapy doses. Recent and sustained viral suppression were not significantly associated with experiencing any discrimination.Conclusions: Interventions that address the sociocultural and structural factors associated with discrimination in all health care settings are needed to improve health outcomes among PWH and end the HIV epidemic in the United States.

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“…This is particularly true among BIPOC patients who may have experienced culturally insensitive care in the past. Providers must work to improve bedside manners, examine implicit biases (ie, provider health beliefs that may impact treatment recommendations, quality of care, diagnostic and treatment decisions, and patient outcomes 28 ), and provide culturally sensitive care devoid of prejudice and discrimination. For example, providers can work to reduce delays in initiating HIV care, never deny care to PLWH, and ensure patient linkage to care.…”

Section: Preventionmentioning

confidence: 99%