Stigmas experienced by sexual and gender minority people with HIV in the Dominican Republic: a qualitative study.

IF 3.6 2区心理学 Q1 PSYCHOLOGY, MULTIDISCIPLINARY

Annals of Behavioral Medicine Pub Date : 2025-01-04 DOI:10.1093/abm/kaae073

Henna Budhwani, Ingrid Ruiz De León, John Waters, Princess Nash, Christyenne L Bond, Nelson Varas-Díaz, Sylvie Naar, Laura Nyblade, Robert Paulino-Ramírez, Janet M Turan

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Abstract

Background: As part of a study to test the feasibility and acceptability of the Finding Respect and Ending Stigma around HIV (FRESH) intervention to reduce stigmas and improve HIV viral suppression, our team collected qualitative data from men who have sex with men (MSM) with HIV, transgender women with HIV, and HIV healthcare providers for their perspectives on different stigmas in Dominican Republic healthcare settings.

Purpose: We aimed to develop an understanding of the causes, consequences, and domains of stigma among sexual and gender minorities with HIV in Dominican Republic HIV clinics.

Methods: Data collection occurred in Santo Domingo and Santiago (2020-2021) and included four focus groups with MSM with HIV (n = 26), in-depth interviews with transgender women with HIV (n = 14), and in-depth interviews with HIV healthcare providers (n = 16). All data collection occurred in person and was audio recorded. Standardized guides were used for focus groups and in-depth interviews. Using a deductive process, 2 research associates thematically coded data in the NVivo software.

Results: On average, focus groups were 81 minutes, provider in-depth interviews were 24 minutes, and transgender women in-depth interviews were 32 minutes. We identified 4 key themes that mapped to 4 domains of stigma affecting MSM and transgender women with HIV: migrant stigma, religious stigma, sexual and gender minorities (SGM) stigma, and HIV stigma. All participant types noted the persistence of stigma and discrimination in healthcare settings in the Dominican Republic. The consequences of these stigmas were reported as being significant, including attempted suicide.

Conclusions: Interventions to reduce stigma experienced by SGM populations with HIV should address structural barriers, including inner and outer contexts of HIV care provision and cultural norms and values that propagate stigma. Findings offer insights about which stigmas could be targeted in future studies and how to potentially address stigma to improve population health in the Dominican Republic.

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多米尼加共和国性少数群体和性别少数群体艾滋病毒感染者遭受的污名：一项定性研究。

背景：作为一项研究的一部分，为了测试寻找尊重和结束艾滋病毒耻辱感（FRESH）干预的可行性和可接受性，以减少耻辱感和改善艾滋病毒抑制，我们的团队收集了来自男男性行为者（MSM）艾滋病毒感染者、跨性别艾滋病毒感染者和艾滋病毒医疗服务提供者的定性数据，了解他们对多米尼加共和国医疗机构中不同耻辱感的看法。目的：我们旨在了解多米尼加共和国艾滋病诊所中性少数群体和性别少数群体感染艾滋病毒的原因、后果和耻辱领域。方法：在圣多明各和圣地亚哥（2020-2021年）收集数据，包括4个艾滋病毒男男性接触者焦点小组（n = 26），对艾滋病毒跨性别妇女（n = 14）的深度访谈，以及对艾滋病毒卫生保健提供者的深度访谈（n = 16）。所有的数据收集都是亲自进行的，并有录音。焦点小组和深度访谈采用了标准化指南。使用演绎过程，2研究将NVivo软件中的主题编码数据联系起来。结果：焦点小组平均81分钟，提供者深度访谈24分钟，跨性别女性深度访谈32分钟。我们确定了4个关键主题，这些主题映射到影响感染艾滋病毒的MSM和跨性别妇女的4个耻辱领域：移民耻辱、宗教耻辱、性和性别少数群体（SGM）耻辱和艾滋病耻辱。所有类型的与会者都指出，在多米尼加共和国的卫生保健环境中，耻辱和歧视一直存在。据报道，这些耻辱的后果非常严重，包括企图自杀。结论：减少艾滋病毒感染者的耻辱感的干预措施应该解决结构性障碍，包括艾滋病毒护理提供的内部和外部环境以及传播耻辱感的文化规范和价值观。研究结果提供了关于在未来的研究中可以针对哪些耻辱感以及如何潜在地解决耻辱感以改善多米尼加共和国人口健康的见解。

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来源期刊

Annals of Behavioral Medicine PSYCHOLOGY, MULTIDISCIPLINARY-

CiteScore

7.00

自引率

5.30%

发文量

期刊介绍： Annals of Behavioral Medicine aims to foster the exchange of knowledge derived from the disciplines involved in the field of behavioral medicine, and the integration of biological, psychosocial, and behavioral factors and principles as they relate to such areas as health promotion, disease prevention, risk factor modification, disease progression, adjustment and adaptation to physical disorders, and rehabilitation. To achieve these goals, much of the journal is devoted to the publication of original empirical articles including reports of randomized controlled trials, observational studies, or other basic and clinical investigations. Integrative reviews of the evidence for the application of behavioral interventions in health care will also be provided. .