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HIV-related stigma in the UK then and now: to what extent are we on track to eliminate stigma? A qualitative investigation

BACKGROUND: The introduction of effective antiretroviral treatment in the late 1990s led to the perception that HIV was a chronic but manageable condition. Nevertheless, stigma remains one of the major hurdles for people living with HIV (PLWH) to accessing healthcare and biomedical preventions. Thus...

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Autores principales: Hedge, Barbara, Devan, Karrish, Catalan, Jose, Cheshire, Anna, Ridge, Damien
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8166014/
https://www.ncbi.nlm.nih.gov/pubmed/34053441
http://dx.doi.org/10.1186/s12889-021-11000-7
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author Hedge, Barbara
Devan, Karrish
Catalan, Jose
Cheshire, Anna
Ridge, Damien
author_facet Hedge, Barbara
Devan, Karrish
Catalan, Jose
Cheshire, Anna
Ridge, Damien
author_sort Hedge, Barbara
collection PubMed
description BACKGROUND: The introduction of effective antiretroviral treatment in the late 1990s led to the perception that HIV was a chronic but manageable condition. Nevertheless, stigma remains one of the major hurdles for people living with HIV (PLWH) to accessing healthcare and biomedical preventions. Thus, Fast Track Cities has set a target of zero HIV discrimination by 2030 as part of its strategy to end HIV transmission. METHODS: Fifty-three participants from the United Kingdom, including PLWH (n = 21, 40%), health and social care workers (n = 24, 45%), and charity workers and activists (n = 13, 25%), were recruited. Semi-structured interviews investigated stigma and discrimination, focusing on both before and after the widespread use of effective antiretroviral treatment in the late 1990s. Data were analysed using a thematic approach. RESULTS: Before effective antiretroviral treatment narratives were shaped by two main themes: 1) the media’s role in influencing public opinion and contributing to misunderstandings of HIV transmission; and 2) personal experiences of HIV-related stigma, which for PLWH included incidents of physical violence and aggression, as well as fears of their HIV status being publicised. Contemporary narratives on stigma experiences were organised around four themes: 1) discrimination in healthcare settings; 2) stigma amongst men who have sex with men (MSM); 3) stigma towards African and Afro-Caribbean PLWH; and 4) the limits of change in public HIV-related knowledge and attitudes. Contemporary narratives indicated a reduction in enacted stigma, but continued anticipation of discrimination and self-reported shame, particularly in MSM and African and Afro-Caribbean PLWH. CONCLUSION: The nature of stigma against those with HIV has evolved. The intersection of PLWH and minority groups (e.g. MSM and African and Afro-Caribbean persons) may enhance anticipatory and internalised stigma, with some suggestion that this may contribute to reduced engagement in HIV care and prevention services. Our findings indicate the need for further research in this area, as well as proactive interventions with community groups to enhance knowledge of HIV. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-021-11000-7.
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spelling pubmed-81660142021-06-02 HIV-related stigma in the UK then and now: to what extent are we on track to eliminate stigma? A qualitative investigation Hedge, Barbara Devan, Karrish Catalan, Jose Cheshire, Anna Ridge, Damien BMC Public Health Research Article BACKGROUND: The introduction of effective antiretroviral treatment in the late 1990s led to the perception that HIV was a chronic but manageable condition. Nevertheless, stigma remains one of the major hurdles for people living with HIV (PLWH) to accessing healthcare and biomedical preventions. Thus, Fast Track Cities has set a target of zero HIV discrimination by 2030 as part of its strategy to end HIV transmission. METHODS: Fifty-three participants from the United Kingdom, including PLWH (n = 21, 40%), health and social care workers (n = 24, 45%), and charity workers and activists (n = 13, 25%), were recruited. Semi-structured interviews investigated stigma and discrimination, focusing on both before and after the widespread use of effective antiretroviral treatment in the late 1990s. Data were analysed using a thematic approach. RESULTS: Before effective antiretroviral treatment narratives were shaped by two main themes: 1) the media’s role in influencing public opinion and contributing to misunderstandings of HIV transmission; and 2) personal experiences of HIV-related stigma, which for PLWH included incidents of physical violence and aggression, as well as fears of their HIV status being publicised. Contemporary narratives on stigma experiences were organised around four themes: 1) discrimination in healthcare settings; 2) stigma amongst men who have sex with men (MSM); 3) stigma towards African and Afro-Caribbean PLWH; and 4) the limits of change in public HIV-related knowledge and attitudes. Contemporary narratives indicated a reduction in enacted stigma, but continued anticipation of discrimination and self-reported shame, particularly in MSM and African and Afro-Caribbean PLWH. CONCLUSION: The nature of stigma against those with HIV has evolved. The intersection of PLWH and minority groups (e.g. MSM and African and Afro-Caribbean persons) may enhance anticipatory and internalised stigma, with some suggestion that this may contribute to reduced engagement in HIV care and prevention services. Our findings indicate the need for further research in this area, as well as proactive interventions with community groups to enhance knowledge of HIV. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-021-11000-7. BioMed Central 2021-05-30 /pmc/articles/PMC8166014/ /pubmed/34053441 http://dx.doi.org/10.1186/s12889-021-11000-7 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Hedge, Barbara
Devan, Karrish
Catalan, Jose
Cheshire, Anna
Ridge, Damien
HIV-related stigma in the UK then and now: to what extent are we on track to eliminate stigma? A qualitative investigation
title HIV-related stigma in the UK then and now: to what extent are we on track to eliminate stigma? A qualitative investigation
title_full HIV-related stigma in the UK then and now: to what extent are we on track to eliminate stigma? A qualitative investigation
title_fullStr HIV-related stigma in the UK then and now: to what extent are we on track to eliminate stigma? A qualitative investigation
title_full_unstemmed HIV-related stigma in the UK then and now: to what extent are we on track to eliminate stigma? A qualitative investigation
title_short HIV-related stigma in the UK then and now: to what extent are we on track to eliminate stigma? A qualitative investigation
title_sort hiv-related stigma in the uk then and now: to what extent are we on track to eliminate stigma? a qualitative investigation
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8166014/
https://www.ncbi.nlm.nih.gov/pubmed/34053441
http://dx.doi.org/10.1186/s12889-021-11000-7
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