Intersectional Stigma and Pre-Exposure Prophylaxis Continuation among Female Sex Workers in Namibia

纳米比亚女性性工作者的交叉耻辱和暴露前预防的继续

• 批准号: 10266809
• 负责人: Kaitlyn M Atkins
• 金额: $ 3.5万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-11-01 至 2022-05-20
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10266809
• 关键词: AIDS prevention; Address; Adult; Affect; Africa South of the Sahara; Age; Behavior; Behavioral; Behavioral Sciences; Caring; Characteristics; Country; Data; Decision Making; Discrimination; Epidemic; Equation; Ethnic Origin; Factor Analysis; Fellowship; Goals; Government; HIV; HIV Infections; Human immunodeficiency virus test; Improve Access; Incidence; Infrastructure; Interview; Logistic Regressions; Measurement; Measures; Mental Depression; Mental Health; Mentors; Methods; Modeling; Namibia; National Institute of Mental Health; National Research Service Awards; Occupational; Outcome; Parents; Pattern; Perception; Persons; Population; Prevalence; Provider; Psychosocial Factor; Public Health Schools; Qualitative Research; Race; Reduce health disparities; Research; Research Methodology; Research Personnel; Research Priority; Respondent; Risk; Role; Scientist; Services; Social Sciences; Social support; Structure; Tenofovir; Time; Training; Treatment outcome; United States National Institutes of Health; Variant; Vulnerable Populations; Woman; Work; antiretroviral therapy; base; design; disparity reduction; doctoral student; experience; female sex worker; health disparity; implementation barriers; improved; indexing; innovation; insight; lens; marginalized population; pre-exposure prophylaxis; prevention service; programs; psychosocial; racial discrimination; resilience; scale up; service delivery; service intervention; sex; skills; social; social determinants; social stigma; substance use; testing services; theories; therapy adherence; transmission process; uptake

PROJECT SUMMARY/ABSTRACT Background. HIV continues to disproportionately impact female sex workers (FSW) in sub-Saharan Africa (SSA), highlighting the urgent need to address factors that put them at risk. Stigma is a key structural barrier to accessing HIV testing and prevention services among marginalized populations, but few HIV scientists have considered it from an intersectional lens. Further, studies assessing PrEP-related stigma have largely not considered the ways in which PrEP stigma intersects with other forms of stigma, such as sexual practices stigma or occupational stigma, to influence patterns of PrEP use. Study Goal and Aims. The goal of this study is to understand how intersectional stigmas, as experienced by FSW in Namibia, influence PrEP continuation. Specifically, the study aims to (1) qualitatively explore experiences of intersectional stigma among in Namibia and how it influences their PrEP outcomes; (2) estimate the burden and predictors of intersectional stigmas among ; and (3) determine the relationship between intersectional stigmas and PrEP continuation. Approach. This study will use an exploratory sequential mixed-methods approach to gain an in-depth understanding of intersectional stigmas and their impact on PrEP access and continuation among FSW FSW a marginalized population in Namibia. Aim 1 will utilize secondary data from approximately 20 in-depth interviews with FSW and primary data from approximately 15 in-depth interviews with PrEP providers to better understand experiences and definitions of stigma. Aim 2 will estimate the burden of intersectional stigmas, using multiple measures of attribute specific stigma (e.g. PrEP stigma) and non-attributed stigma (i.e. stigma related to one’s overall identity, rather than specific attributes or behaviors). Aim 2 will also estimate factors associated with experiencing intersectional stigmas among FSW . In Aim 3, the relationship between multiple intersectional stigmas and PrEP continuation will be estimated using structural equation modeling. Fellowship Information. The proposed research aligns with NIH HIV research priorities to reduce health disparities in HIV infection outcomes and with NIMH research priorities to integrate social and behavioral science with an effective biomedical strategy for HIV prevention. In-depth understanding of intersectional stigmas among this vulnerable population will provide important insights into stigma as a structural barrier to PrEP access and use, and will inform further implementation and scale-up of PrEP programs with FSW in SSA. This NRSA will be dissertation research for Ms. Kaitlyn Atkins, a PhD student at the Johns Hopkins Bloomberg School of Public Health. Ms. Atkins will be mentored by a Sponsor, two Co-Sponsors, a Scientific Advisor, and a Measurement Consultant. A training plan has been developed to provide her with tailored experience to support her towards achieving her goal of becoming a leading, independent HIV researcher.

项目总结/文摘

项目成果

Health system adaptations and considerations to facilitate optimal oral pre-exposure prophylaxis scale-up in sub-Saharan Africa.

• DOI: 10.1016/s2352-3018(21)00129-6
• 发表时间: 2021-08
• 期刊: LANCET HIV
• 影响因子: 16.1
• 作者: Were, Daniel K.;Musau, Abednego;Atkins, Kaitlyn;Shrestha, Prakriti;Reed, Jason;Curran, Kelly;Mohan, Diwakar
• 通讯作者: Mohan, Diwakar