Public health services and intersectional stigma: a social sciences perspective with implications for HIV service design and delivery.

IF 4.5 3区 医学 Q2 IMMUNOLOGY Current Opinion in HIV and AIDS Pub Date : 2023-01-01 DOI:10.1097/COH.0000000000000769
Rayner Kay Jin Tan, Weiming Tang, Joseph D Tucker
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引用次数: 3

Abstract

Purpose of review: Understanding stigma is important for improving HIV care services and gaps in HIV service delivery have been attributed to stigma. This review article synthesizes recent evidence on stigma and its implications for HIV service design and delivery. Given the intersectional nature of stigma, we will focus on HIV stigma as well as related forms of stigma based on one's race, sexual identity, gender identity and other identities.

Recent findings: Stigma remains a barrier to achieving equity in HIV services. Individualistic measures of stigma remain influential and are associated with barriers to accessing HIV health services. Recent work also highlights stigma measured at a structural level and its impact on HIV services contexts. Individuals situated at intersections of marginalized identities continue to face greatest injustices, and although intersectional approaches have been adapted to design services at a micro level, few focus on structural change. Recent evidence for mitigating stigma indicates some success for psychosocial interventions that target internalized stigma. Furthermore, community-led approaches show promise in addressing stigma that manifests in HIV health services settings.

Summary: Interventions that address individual-level stigma and structural stigma are needed. Theoretical and applied antistigma research is needed to make HIV services more equitable.

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公共卫生服务和交叉污名:对艾滋病毒服务设计和提供的影响的社会科学观点。
综述目的:了解耻辱感对改善艾滋病毒护理服务很重要,而艾滋病毒服务提供方面的差距归因于耻辱感。这篇综述文章综合了最近关于耻辱及其对艾滋病毒服务设计和提供的影响的证据。鉴于耻辱的交叉性质,我们将重点关注艾滋病毒耻辱以及基于种族,性身份,性别身份和其他身份的相关形式的耻辱。最近的发现:耻辱仍然是实现艾滋病毒服务公平的障碍。个人主义的污名措施仍然具有影响力,并与获得艾滋病毒保健服务的障碍有关。最近的工作还强调了在结构层面衡量的耻辱及其对艾滋病毒服务环境的影响。处于边缘身份交叉点的个人继续面临着最大的不公正,尽管交叉点的方法已经适应了微观层面的设计服务,但很少有人关注结构变化。最近关于减轻耻辱感的证据表明,针对内化耻辱感的社会心理干预取得了一些成功。此外,社区主导的方法有望解决在艾滋病毒卫生服务环境中表现出来的耻辱。总结:需要采取干预措施,解决个人层面的耻辱感和结构性的耻辱感。为了使艾滋病毒服务更加公平,需要进行理论和应用的反污名研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Current Opinion in HIV and AIDS
Current Opinion in HIV and AIDS IMMUNOLOGY-INFECTIOUS DISEASES
CiteScore
7.40
自引率
7.30%
发文量
115
审稿时长
6-12 weeks
期刊介绍: Published bimonthly and offering a unique and wide ranging perspective on the key developments in the field, each issue of Current Opinion in HIV and AIDS features hand-picked review articles from our team of expert editors. With six disciplines published across the year – including HIV and ageing, a HIV vaccine, and epidemiology – every issue also contains annotated reference detailing the merits of the most important papers.
期刊最新文献
Recent data on the role of antiretroviral therapy in weight gain and obesity in persons living with HIV. Anticipating HIV viral escape - resistance to active and passive immunization. Accelerating HIV vaccine development through meaningful engagement of local scientists and communities. Guiding HIV-1 vaccine development with preclinical nonhuman primate research. Discovery medicine - the HVTN's iterative approach to developing an HIV-1 broadly neutralizing vaccine.
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