TY - JOUR
T1 - Measuring sexual behavior stigma to inform effective HIV prevention and treatment programs for key populations
AU - Stahlman, Shauna
AU - Hargreaves, James R.
AU - Sprague, Laurel
AU - Stangl, Anne L.
AU - Baral, Stefan D.
N1 - Publisher Copyright:
© Shauna Stahlman, James R Hargreaves, Laurel Sprague, Anne L Stangl, Stefan D Baral. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 26.04.2017. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0/)
PY - 2017/4
Y1 - 2017/4
N2 - Background: The levels of coverage of human immunodeficiency virus (HIV) treatment and prevention services needed to change the trajectory of the HIV epidemic among key populations, including gay men and other men who have sex with men (MSM) and sex workers, have consistently been shown to be limited by stigma. Objective: The aim of this study was to propose an agenda for the goals and approaches of a sexual behavior stigma surveillance effort for key populations, with a focus on collecting surveillance data from 4 groups: (1) members of key population groups themselves (regardless of HIV status), (2) people living with HIV (PLHIV) who are also members of key populations, (3) members of nonkey populations, and (4) health workers. Methods: We discuss strengths and weaknesses of measuring multiple different types of stigma including perceived, anticipated, experienced, perpetrated, internalized, and intersecting stigma as measured among key populations themselves, as well as attitudes or beliefs about key populations as measured among other groups. Results: With the increasing recognition of the importance of stigma, consistent and validated stigma metrics for key populations are needed to monitor trends and guide immediate action. Evidence-based stigma interventions may ultimately be the key to overcoming the barriers to coverage and retention in life-saving antiretroviral-based HIV prevention and treatment programs for key populations. Conclusions: Moving forward necessitates the integration of validated stigma scales in routine HIV surveillance efforts, as well as HIV epidemiologic and intervention studies focused on key populations, as a means of tracking progress toward a more efficient and impactful HIV response.
AB - Background: The levels of coverage of human immunodeficiency virus (HIV) treatment and prevention services needed to change the trajectory of the HIV epidemic among key populations, including gay men and other men who have sex with men (MSM) and sex workers, have consistently been shown to be limited by stigma. Objective: The aim of this study was to propose an agenda for the goals and approaches of a sexual behavior stigma surveillance effort for key populations, with a focus on collecting surveillance data from 4 groups: (1) members of key population groups themselves (regardless of HIV status), (2) people living with HIV (PLHIV) who are also members of key populations, (3) members of nonkey populations, and (4) health workers. Methods: We discuss strengths and weaknesses of measuring multiple different types of stigma including perceived, anticipated, experienced, perpetrated, internalized, and intersecting stigma as measured among key populations themselves, as well as attitudes or beliefs about key populations as measured among other groups. Results: With the increasing recognition of the importance of stigma, consistent and validated stigma metrics for key populations are needed to monitor trends and guide immediate action. Evidence-based stigma interventions may ultimately be the key to overcoming the barriers to coverage and retention in life-saving antiretroviral-based HIV prevention and treatment programs for key populations. Conclusions: Moving forward necessitates the integration of validated stigma scales in routine HIV surveillance efforts, as well as HIV epidemiologic and intervention studies focused on key populations, as a means of tracking progress toward a more efficient and impactful HIV response.
KW - HIV
KW - Male homosexuality
KW - Sex workers
KW - Social stigma
KW - Stigmatization
UR - http://www.scopus.com/inward/record.url?scp=85029599851&partnerID=8YFLogxK
U2 - 10.2196/publichealth.7334
DO - 10.2196/publichealth.7334
M3 - Review article
AN - SCOPUS:85029599851
SN - 2369-2960
VL - 3
JO - JMIR Public Health and Surveillance
JF - JMIR Public Health and Surveillance
IS - 2
M1 - e23
ER -