HIV-Related Stigma Among Spanish-speaking Latinos in an Emerging Immigrant Receiving City (original) (raw)

Evaluation of a Community Health Worker Intervention to Reduce HIV/AIDS Stigma and Increase HIV Testing among Underserved Latinos in the Southwestern U.S

Public Health Reports, 2015

Objectives. Latinos are at an elevated risk for HIV infection. Continued HIV/ AIDS stigma presents barriers to HIV testing and affects the quality of life of HIV-positive individuals, yet few interventions addressing HIV/AIDS stigma have been developed for Latinos. Methods. An intervention led by community health workers (promotores de salud, or promotores) targeting underserved Latinos in three southwestern U.S. communities was developed to decrease HIV/AIDS stigma and increase HIV knowledge and perception of risk. The intervention was led by HIV-positive and HIV-affected (i.e., those who have, or have had, a close family member or friend with HIV/AIDS) promotores, who delivered interactive group-based educational sessions to groups of Latinos in Spanish and English. To decrease stigma and motivate behavioral and attitudinal change, the educational sessions emphasized positive Latino cultural values and community assets. The participant pool comprised 579 Latino adults recruited in El Paso, Texas (n5204); San Ysidro, California (n5175); and Los Angeles, California (n5200). Results. From pretest to posttest, HIV/AIDS stigma scores decreased significantly (p,0.001). Significant increases were observed in HIV/AIDS knowledge (p,0.001), willingness to discuss HIV/AIDS with one's sexual partner (p,0.001), and HIV risk perception (p50.006). Willingness to test for HIV in the three months following the intervention did not increase. Women demonstrated a greater reduction in HIV/AIDS stigma scores when compared with their male counterparts, which may have been related to a greater increase in HIV/AIDS knowledge scores (p50.016 and p50.007, respectively). Conclusion. Promotores interventions to reduce HIV/AIDS stigma and increase HIV-related knowledge, perception of risk, and willingness to discuss sexual risk with partners show promise in reaching underserved Latino communities.

Attitudes towards and Beliefs about HIV Testing among Latino Immigrant MSM: A Comparison of Testers and Nontesters

AIDS Research and Treatment, 2013

Latino immigrant men who have sex with men (MSM) are at risk for HIV and delayed diagnosis. An exploratory study using qualitative interviews that assess the beliefs and attitudes of 54 Latino immigrant MSM in Seattle, Washington, is presented. The goal of this research is to determine whether attitudinal differences exist between participants who had and had not been tested and to use any insight into the development of a media campaign to promote testing. Over one-third of the men have never been tested for HIV. Nontesters are more likely to be men who have sex with men and women, have less knowledge about HIV risks, perceive their sexual behaviors as less risky, and deflect HIV-related stigma. Testers are more likely to be self-identified as being gays. Both groups believe that fear of a positive result is the main barrier to testing. Both groups believe that family members have negative attitudes towards HIV testing and that having Latino staff at HIV testing sites hinders confidentiality. Financial concerns with regard to the cost of testing were also expressed by both groups. Based on these insights, recommended strategies for the development of HIV prevention and testing campaigns are made.

HIV- and AIDS-Related Stigma: Psychosocial Aspects in a Representative Spanish Sample

The Spanish Journal of Psychology, 2013

This study evaluates the prevalence of HIV stigma in Spain and analyzes some variables that may affect its existence. In 2008, we conducted a computer-assisted telephone survey of 1607 people, representative of the Spanish population. Two-wave random stratified sampling was performed, first selecting the home and then the person, depending on the rates of age and sex. About 50% of the population feels discomfort about potential contact with people with HIV and tries to avoid it and 20% advocate discriminatory policies involving physical or social segregation of people with HIV. The belief that HIV is easily transmitted through social contact (15%) and blaming people with HIV for their disease (19.3%) are associated with stigmatization. Degree of proximity to people with HIV, political ideology, educational level, and age are also associated with the degree of stigmatization. According to these results, we suggest that, in order to reduce stigma, we need to modify the erroneous beliefs about the transmission pathways, decrease attributions of blame to people with HIV, and increase contact with them. These interventions should particularly target older people, people with a low educational level, and people with a more conservative political ideology.

HIV/AIDS stigma: Measurement and relationships to psycho-behavioral factors in Latino gay/bisexual men and transgender women

AIDS Care, 2013

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Harambee! 2.0: The Impact of HIV-Related and Intersectional Stigmas on HIV Testing Behaviors Among African Immigrant Communities in Seattle, Washington

AIDS and Behavior

African immigrants are disproportionately affected by HIV compared to U.S.-born individuals, and early HIV testing is the key challenge in ending the HIV epidemic in these communities. HIV-related stigma appears to be the most significant barrier to testing for HIV among African communities in King County, WA. In this formative study, we conducted thirty key informant interviews and five focus group discussions (n = total 72 participants) with Ethiopian, Somali, and Eritrean people living with HIV, health professionals, religious and other community leaders, and lay community members in King County to better understand HIV-related and intersectional stigmas' impact on HIV testing behaviors. We used inductive coding and thematic analysis. Participants from all communities reported similar themes for HIV-related and intersectional stigmas' influences on HIV testing behaviors. Misconceptions or poor messaging, e.g., regarding treatability of HIV, as well as normative or religious/moral beliefs around pre/extramarital sex contributed to HIV-related stigma. Intersecting identities such as immigrant status, race/ethnicity, and having a non-English language preference, all intermingle to further influence access to the U.S. healthcare system, including for HIV testing. These findings can be used to inform future research on community-led approaches to addressing early HIV testing amongst African immigrant communities.

Levels of felt stigma among a group of people with HIV in Puerto Rico

Puerto Rico health sciences journal, 2012

HIV felt stigma is a major problem needing to be addressed because of its association with poor treatment adherence, decreases in help-seeking behaviors, high-risk sexual conduct, emotional discomfort, and the reduction of well-being in people with HIV/AIDS (PWHA). The aim of this study was to identify the frequency of felt stigma among PWHA in Puerto Rico. A cross-sectional study was conducted with 249 subjects (59% men, 41% women). Participants completed the Puerto Rico Comprehensive Center for HIV Disparities (PR-CCHD) Sociodemographic Questionnaire and the HIV Felt Sigma Scale. 80% of the subjects showed some level of felt stigma. Women showed significantly higher levels of HIV-related felt stigma than did men. Disclosure, negative self-image, and public attitude scores were also higher in women than in men. Sociodemographic variables such as age, marital status, employment status, income, and educational level showed significant associations with felt stigma and its dimensions....

HIV-Related Felt Stigma among Puerto Ricans Living with HIV/AIDS: A Focus Group Study

Interamerican Journal of Psychology, 2013

Stigma negatively impacts the wellbeing of people living with HIV/AIDS (PLWHA). Feeling stigmatized is known to affect key areas of daily lives of PLWHA. This study characterizes the experience of perceived stigma among a group of Puerto Ricans LWHA, through a focus group (FG) approach. A total of 40 participants were recruited from Ryan White agencies at the southern area of Puerto Rico. A qualitative study was performed to gather data concerning participants' feelings, opinions, and perceptions. The FG were audio recorded and transcribed into a written report. Content analysis was performed and the topics were coded for inter-rate reliability. The topics derived were related to: stigma experiences of rejection, emotional reactions, disclosure, reactions of others, PLWHA coping, physical appearance, and affective relationships.

Measuring HIV felt stigma: a culturally adapted scale targeting PLWHA in Puerto Rico

AIDS Care, 2010

The objective of this study was to culturally adapt and validate a scale to measure HIV-related felt stigma in a group of People living with HIV/AIDS (PLWHA) in Puerto Rico. The researchers conducted a two-phase cross-sectional study with 216 participants (60, first phase; 156, second phase). The first phase consisted of the cultural adaptation of the scale; the second evaluated its psychometric properties. After conducting a factor analysis, a 17-item scale, the HIV Felt-Stigma Scale (HFSS), resulted. Participants completed the Puerto Rico Comprehensive Center for the Study of Health Disparities Socio-demographic Questionnaire, the HFSS, the Beck Depression Inventory-II, and the Sexual Abuse dimension of the History of Abuse Questionnaire; the case managers completed the Case Manager Stigma Guide with subjects. The HFSS measures four dimensions: personalized stigma, disclosure concerns, negative self-image, and concern with public attitudes. The alpha and Pearson correlation coefficients (0.91 and 0.68, respectively) indicated satisfactory validity and reliability; the scale suggested adequate convergent validity. The HFSS is a culturally sensitive instrument that fills the existing gap in the measurement of felt stigma in Spanish-speaking PLWHA.

AIDS stigma combinations in a sample of Puerto Rican health professionals: qualitative and quantitative evidence

Puerto Rico health sciences journal, 2008

The HIV/AIDS epidemic continues to impact Puerto Rico and the Caribbean region with growing numbers of cases each year. The stigma that surrounds the epidemic has harmful implications on the health of people living with the disease and public health in general, fostering health deterioration and new infections. When this stigma emanates from health professionals it can severely hinder access to health services, which are crucial for those living with the virus. Still, AIDS stigma has been previously explored among this population as a separate phenomenon from other pre-existing stigmas. This has yielded a limited perspective on the complexity of how AIDS stigma is manifested. In light of this limitation, the main objectives of this study were: 1) to document AIDS stigma among a sample of Puerto Rican health professionals and health professionals in training and 2) to explore the combination of other stigmas (sexism, homophobia, and negative attitudes towards drug users) with that as...