Intersectional stigmas and HIV-related outcomes among a cohort of key populations enrolled in stigma mitigation interventions in Senegal
| Autor: | Benjamin Liestman, Fatou Maria Drame, Oluwasolape Olawore, Cheikh Tidiane Ndour, Nguissali Turpin, Carrie Lyons, Daouda Diouf, Delivette Castor, Souleymane Mboup, Gnilane Turpin, Sidy Mokhtar Ndiaye, Karleen Coly, Stefan Baral, Coumba Toure-Kane, Nafissatou Leye-Diouf, Sosthenes Ketende, Ibrahima Ba |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male 0301 basic medicine Adolescent Social stigma Social Stigma Immunology Psychological intervention Stigma (botany) HIV Infections Health Services Accessibility Article Sexual and Gender Minorities Young Adult 03 medical and health sciences 0302 clinical medicine Surveys and Questionnaires Prevalence Humans Immunology and Allergy Medicine Longitudinal Studies Prospective Studies 030212 general & internal medicine Young adult Prospective cohort study Sex Workers business.industry Incidence (epidemiology) Odds ratio Senegal 030104 developmental biology Infectious Diseases Cohort Female business Demography |
| Zdroj: | AIDS |
| ISSN: | 1473-5571 0269-9370 |
| DOI: | 10.1097/qad.0000000000002641 |
| Popis: | OBJECTIVES: The current study aims to assess longitudinal differences in stigma and HIV outcomes among key populations at risk for and living with HIV. DESIGN: Key populations enrolled into two parallel prospective cohorts; one for female sex workers and one for sexual and gender minorities (SGMs). Participants were recruited from three urban areas in Senegal; were followed for 24 months; and had the option to participate in an integrated stigma mitigation intervention. METHODS: Participants included individuals both at risk for and living with HIV. Sociobehavioral questionnaires and biological HIV testing were administered every 3-4 months. Longitudinal analyses used nonparametric Chi-squared test for trends and multivariable logistic regression with generalized estimating equations. RESULTS: 183 SGM and 192 sex workers were enrolled. Among SGM participants, 39.9% were living with HIV at baseline and incidence over 24 months was 3.21/100 person-years. Among sex workers, 36.6% were living with HIV at baseline and incidence was 1.32/100 person-years. Among SGM, perceived healthcare stigma (P < 0.001), anticipated healthcare stigma (P < 0.001), and perceived friend stigma (P = 0.047) reduced, but differed by HIV status for perceived [adjusted odds ratio (aOR): 3.51; 95% confidence interval (CI): 1.75, 7.06] and anticipated healthcare stigmas (aOR: 2.85; 95% CI: 1.06-7.67). Among sex workers perceived healthcare stigma (P = 0.043) and perceived friend stigma (P = 0.006) reduced. Viral suppression increased among SGM (P = 0.028) and was associated with perceived (aOR: 2.87; 95% CI: 1.39-5.55) and enacted healthcare stigma (aOR: 0.42; 95% CI: 0.18-0.99). CONCLUSIONS: Overall, there were decreases in stigmas observed but clear differences in stigma patterns by HIV status. These data highlight the need to consider specific strategies to address multiple intersecting stigmas as a means of improving HIV-related prevention and treatment outcomes among key populations with diverse identities. |
| Databáze: | OpenAIRE |
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