Measuring intersecting stigma among key populations living with HIV: implementing the people living with HIV Stigma Index 2.0.
Measuring intersecting stigma among key populations living with HIV: implementing the people living with HIV Stigma Index 2.0.
复制标题
DOI：
10.1002/jia2.25131
复制
发表时间：
2018-07
影响因子：
6
通讯作者：
Geibel S
中科院分区：
文献类型：
--
作者：
Friedland BA;Sprague L;Nyblade L;Baral SD;Pulerwitz J;Gottert A;Amanyeiwe U;Cheng A;Mallouris C;Anam F;Jackson A;Geibel S
解决影响艾滋病毒感染者 (PLHIV) 的耻辱问题是全球优先事项 [1]。污名被定义为“在行使权力的背景下同时发生的标签、刻板印象、分离、地位丧失和歧视”[2]，对艾滋病毒感染者的健康产生负面影响，并导致社会心理压力、胁迫和暴力、失业和社会排斥[3]。在艾滋病毒感染者中，男同性恋者和其他男男性行为者 (MSM)、跨性别者、性工作者和吸毒者 (PWUD)（通常被称为重点人群）处于与艾滋病毒相关的耻辱和对其身份、职业或行为的偏见的交叉点，常常加剧他们的耻辱和歧视经历 [4, 5]。为了支持艾滋病毒感染者重点人群的健康和权利，重要的是要了解他们的耻辱经历，并探讨艾滋病毒、重点人群状况和其他边缘化群体成员（例如少数族裔/和种族、囚犯、移民和残疾人）之间的交叉性。然而迄今为止，对耻辱交叉模式的心理测量研究还很有限。艾滋病毒感染者耻辱指数（Stigma Index）提供了有关耻辱和歧视的证据，这对于为艾滋病毒政策、艾滋病毒感染者权利倡导工作和减少耻辱干预措施提供信息至关重要[6-9]。污名指数由全球艾滋病毒感染者网络 (GNP+)、国际艾滋病毒携带者国际社区 (ICW)、国际计划生育联合会 (IPPF) 和联合国艾滋病规划署 [10] 开发，污名指数是一种研究工具，艾滋病毒感染者可通过该工具获取有关其污名和歧视经历的数据。截至 2017 年 11 月，超过 100,000 名感染者接受了 2000 名经过培训的感染者访谈员以 50 多种语言的采访。 2016 年，人口理事会的 SOAR 项目和耻辱指数合作伙伴（联合国艾滋病规划署、GNP+、ICW）在美国国际开发署 (USAID) 艾滋病毒/艾滋病研究办公室的 PEPFAR 资助下，开展了耻辱指数更新工作，以更全面地了解艾滋病毒感染者的重点人群的经历，应对全球治疗指南的变化，并更好地了解艾滋病毒检测和治疗方面持续存在的障碍。在修订耻辱指数调查问卷的整个协商、迭代过程中，包括艾滋病病毒感染者网络和倡导者在内的多个利益相关者被要求提供意见。一个共同的建议是让受访者能够分享与艾滋病毒相关和与关键人群相关的耻辱感的经历。根据在 90 多个国家实施过程中吸取的经验教训，利益相关者提出了一些具体建议，这些建议已纳入更新后的耻辱指数中，包括： 增加一个单独的部分，其中包含具体问题，以衡量关键人群所经历的耻辱感；确保背景人口问题能够对亚人群的耻辱和歧视进行分析；将经过验证的两部分性别认同问题纳入人口统计部分；在问题和回答中将性别认同与性取向分开；利用现有的调查和量表来衡量关键人群的耻辱和歧视[11-13]；并将时间范围缩小到过去 12 个月，以更好地捕捉随时间变化的情况。更新后的调查——耻辱指数 2.0——由位于乌干达坎帕拉的乌干达艾滋病毒感染者网络国家论坛 (NAFOPHANU) 进行了试点；由 Metabiota 与喀麦隆杜阿拉和雅温得的 ReCAP+ 合作；由 Enda Santé 与塞内加尔达喀尔和济金绍尔的 RNP+ 合作……
Addressing stigma affecting people living with HIV (PLHIV) is a global priority [1]. Stigma, defined as “the co-occurrence of labeling, stereotyping, separation, status loss, and discrimination in a context in which power is exercised”[2], has a negative impact on the health of PLHIV, and contributes to psychosocial stress, coercion and violence, job loss, and social exclusion [3]. Among PLHIV, gay men and other men who have sex with other men (MSM), transgender individuals, sex workers, and people who use drugs (PWUD)–often referred to as key populations–are situated at the intersection of HIV-related stigma and prejudice against their identities, occupations, or behaviours, often exacerbating their experiences of stigma and discrimination [4, 5]. To support the health and rights of key populations living with HIV, it is important to understand their experiences of stigma, as well as to explore the intersectionality between HIV, key population status, and other marginalized group memberships, such as ethnic/and racial minorities, prisoners, migrants, and persons with disabilities. Yet to date, the psychometric study of intersecting patterns of stigma has been limited. The PLHIV Stigma Index (Stigma Index) provides evidence on stigma and discrimination that has been essential for informing HIV policy, PLHIV rights advocacy efforts, and stigma-reduction interventions [6-9]. Developed by the Global Network of PLHIV (GNP+), the International Community of Women Living with HIV (ICW), the International Planned Parenthood Federation (IPPF), and UNAIDS [10] the Stigma Index is a research tool by which PLHIV capture data on their experiences of stigma and discrimination. As of November 2017, more than 100,000 PLHIV had been interviewed in over 50 languages by 2000 trained PLHIV interviewers. In 2016, the Population Council’s Project SOAR and the Stigma Index partners (UNAIDS, GNP+, ICW), with PEPFAR funding from the Office of HIV/AIDS Research of the United States Agency for International Development (USAID), undertook a process to update the Stigma Index to more fully capture the experiences of key populations living with HIV, as well as to respond to changes in global treatment guidelines, and to better understand the persistent barriers to HIV testing and treatment. Throughout the consultative, iterative process of revising the Stigma Index questionnaire, multiple stakeholders, including PLHIV networks and advocates, were asked for their input. A common recommendation was to enable respondents to share experiences of both HIV-related and key population-related stigma. Based on lessons learned from implementation in over 90 countries, stakeholders made a number of specific suggestions that were incorporated into the updated Stigma Index, including: adding a separate section with specific questions to measure stigma experienced by key populations; ensuring background demographic questions would enable analysis of stigma and discrimination by subpopulation; integrating a validated two-part gender identity question into the demographics section; separating gender identity from sexual orientation in questions and responses; utilizing existing surveys and scales for measuring stigma and discrimination in key populations [11-13]; and narrowing the timeframe to the past 12 months to better capture changes over time.The updated survey–the Stigma Index 2.0–was pilottested by the National Forum of PLHIV Networks in Uganda (NAFOPHANU) in Kampala, Uganda; by Metabiota, in collaboration with ReCAP+ in Douala and Yaoundé, Cameroon; and by Enda Santé, in collaboration with RNP+ in Dakar and Ziguinchor, Senegal …
登录
查看更多内容
影响因子：
2.9
作者：
Rueda S;Mitra S;Chen S;Gogolishvili D;Globerman J;Chambers L;Wilson M;Logie CH;Shi Q;Morassaei S;Rourke SB
通讯作者：
Rourke SB
影响因子：
4.5
作者：
Dos Santos MM;Kruger P;Mellors SE;Wolvaardt G;van der Ryst E
通讯作者：
van der Ryst E
影响因子：
8.5
作者：
Stahlman, Shauna;Sanchez, Travis Howard;Baral, Stefan David
通讯作者：
Baral, Stefan David
影响因子：
6
作者：
Kennedy, Caitlin E.;Baral, Stefan D.;Kerrigan, Deanna
通讯作者：
Kerrigan, Deanna
影响因子：
5.6
作者：
Kim, Hae-Young;Grosso, Ashley;Baral, Stefan
通讯作者：
Baral, Stefan