Intersecting internalized stigmas and HIV self-care among men who have sex with men and who use substances.
Intersecting internalized stigmas and HIV self-care among men who have sex with men and who use substances.
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DOI：
10.1016/j.socscimed.2021.113824
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发表时间：
2021-04
期刊：
影响因子：
--
通讯作者：
O'Cleirigh C
中科院分区：
文献类型：
--
作者：
Batchelder AW;Foley JD;Kim J;Thiim A;Kelly J;Mayer K;O'Cleirigh C
男男性行为者（MSM）受到艾滋病毒、药物使用以及与共存或交叉身份有关的污名化的不成比例的影响，这些身份被社会污名化或贬低（例如，性少数男性、艾滋病毒感染者或吸毒者）。有证据表明，当耻辱感内化时，它可能会成为自我护理行为参与的障碍。更好地了解相互交织的内在耻辱如何影响使用药物的男男性行为者的艾滋病毒自我护理。为了调查这些关系，我们进行了半结构化的定性访谈，直到我们达到主题饱和（n=33）与艾滋病毒+男男性接触者使用物质和次优从事艾滋病毒护理。访谈询问身份，内化的耻辱，物质使用，艾滋病毒自我护理行为，概念之间的相互关系。我们的样本是63%的非洲裔美国人，76%的人报告年收入≤ 20，000美元。大约一半的参与者明确描述了交叉内化的耻辱如何影响他们的自我意识和行为。绝大多数人认为，与药物使用有关的内在耻辱感是最沉重的负担，被认为是艾滋病毒自我保健行为的障碍。与会者还描述了与艾滋病毒和性取向有关的内在耻辱感，以及种族、女性化、贫困和住房不稳定，这些因素共同影响了他们的心理健康和艾滋病毒自我护理。我们的研究结果表明，临床医生需要考虑和解决交叉内化的耻辱，特别是与物质使用相关的内化耻辱，以减少物质使用和改善艾滋病毒自我护理的男男性接触者使用物质和次优从事艾滋病毒护理。
Men who have sex with men (MSM) are disproportionately affected by HIV, substance use, and stigma related to co-existing or intersecting identities that are stigmatized or devalued by society (e.g., being a sexual minority male, a person living with HIV, or a person who uses substances). Evidence indicates that when stigma is internalized it may act as a barrier to engagement in self-care behaviors. Gaining a better understanding of how intersecting internalized stigmas affect HIV self-care among MSM who use substances. To investigate these relationships, we conducted semi-structured qualitative interviews until we reached thematic saturation (n=33) with HIV+ MSM who use substances and were sub-optimally engaged in HIV care. Interviews inquired about identity, internalized stigmas, substance use, HIV self-care behaviors, and interrelationships between concepts. Our sample was 63% African American and 76% reported annual incomes of ≤$20,000. Approximately half of the participants explicitly described how intersecting internalized stigmas impacted their sense of self and their behavior. The overwhelming majority conveyed that internalized stigma related to substance use was the most burdensome and was considered a barrier to HIV self-care behaviors. Participants also described internalized stigmas related to HIV and sexual orientation, as well as race, effeminateness, poverty, and housing instability, which together impacted their psychological wellbeing and HIV self-care. Our results indicate a need for clinicians to consider and address intersecting internalized stigmas, particularly internalized stigma related to substance use, to reduce substance use and improve HIV self-care among MSM who use substances and are sub-optimally engaged in HIV care.
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影响因子：
4
作者：
Bowleg, Lisa;Bauer, Greta
通讯作者：
Bauer, Greta
影响因子：
4.4
作者：
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4.4
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作者：
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作者：
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通讯作者：
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