Battling Stigma for Service Engagement among Women with HIV in Vietnam

越南艾滋病毒感染者与参与服务的耻辱作斗争

• 批准号: 10302007
• 负责人: Chunqing Lin
• 金额: $ 21.94万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-17 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10302007
• 关键词: AIDS prevention; AIDS/HIV problem; Address; Affect; Asians; Behavior Therapy; Behavioral; Biological; California; Caring; Cognitive; Communities; Country; Data; Discrimination; Drug usage; Economics; Emotional; Epidemic; Feedback; Female; Focus Groups; Future; Gender; Gender Role; HIV; HIV Infections; HIV risk; Health; Health Services; Health Services Research; Healthcare; Hybrids; Individual; Inequality; Inferior; Intervention; Intervention Studies; Intervention Trial; Interview; Label; Lead; Life; Light; Los Angeles; Measures; Medical; Mental Health; Mental Health Services; Modeling; Motivation; Nature; Neighborhood Health Center; Outcome; Outcome Measure; Participant; Patient-Focused Outcomes; Patients; Persons; Phase; Pilot Projects; Plant Roots; Process; Research; Research Activity; Research Personnel; Self Administration; Self Efficacy; Series; Services; Shame; Social support; Societies; Southeastern Asia; Stereotyping; Stigmatization; Substance abuse problem; Support Groups; Support System; Targeted Research; Testing; Training; Training Programs; Universities; Ursidae Family; Vietnam; Woman; Work; behavioral health; behavioral response; combat; data format; empowerment; experience; gender disparity; health care service; high risk; improved; male; men; methadone treatment; methamphetamine use; online delivery; online intervention; research study; resilience; response; service engagement; service providers; sex; skills; social; social culture; social stigma; therapy development; virtual

ABSTRACT Women living with HIV/AIDS (WLHA) bear a higher level of stigma because of their socio-cultural vulnerabilities. Women are more likely to internalize social stigma and produce a sense of shame and loss of self-worth, which results in a delay in health service seeking and compromised health outcomes. In Vietnam, stigma towards WLHA is exacerbated by the deeply rooted female inferiority culture. However, research targeting WLHA is generally lacking. We propose this study to address stigma among WLHA and explore the use of virtual support system in WLHA's service engagement in Vietnam. The 2-year study will proceed in two phases in Hanoi, Vietnam. Phase 1 will be formative studies, including in-depth interviews with 30 WLHA and focus groups with 20 service providers and community stakeholders. This phase aims to investigate the cultural and contextual background of HIV and gender roles in Vietnam and to identify effective strategies to support and engage WLHA in healthcare. These formative findings will inform the development of an intervention to be pilot tested in the next phase. Phase 2 will be a 6-month intervention pilot with 90 WLHA using an online/offline hybrid approach. During Month 1 of the pilot, WLHA will participate in an in-person section to form mutual support groups and prepare for the following online components. During Month 2-4 of the pilot, study investigators will teach WLHA a series of empowerment strategies to cope with stigma and utilize social support to seek healthcare services. These skills will be taught via interactive online group activities. During Month 4-6, WLHA will self-administer the online groups without the intervention of study investigators. WLHA's multidimensional stigma measures, mental health burdens, and service use self- efficacy will be assessed at baseline, month 4, and month 6. Progress data of the intervention will be documented to inform the feasibility and sustainability of the online support approach. Acceptability data and feedback will be collected from the WLHA participants upon completion of the 6-month pilot period.

摘要 艾滋病毒/艾滋病患者(WLHA)因其社会文化背景而承受着更高程度的耻辱 漏洞。女性更有可能内化社会污名，并产生羞耻感和丧失 自我价值，导致延迟寻求医疗服务，损害健康结果。在越南， 根深蒂固的女性自卑文化加剧了对WLHA的耻辱。然而，研究表明， 普遍缺乏针对WLHA的治疗。我们提出这项研究是为了解决WLHA中的耻辱问题，并探索 在越南的WLHA服务项目中使用虚拟支持系统。这项为期两年的研究将分两次进行。 越南河内的几个阶段。第一阶段将是形成性研究，包括对30个WLHA和 由20家服务提供商和社区利益相关者组成的焦点小组。此阶段旨在调查 越南艾滋病毒和性别角色的文化和背景背景，并确定有效的战略，以 支持和参与WLHA在医疗保健方面的工作。这些形成的发现将为发展一种 干预措施将在下一阶段进行试点测试。第二阶段将是为期6个月的干预试点，90 WLHA 使用线上/线下混合方法。在试行的第一个月期间，WLHA将参加面对面的 部分组成相互支持小组，并为以下在线组件做准备。第2-4个月 这项试点研究的调查人员将向WLHA传授一系列赋权策略，以应对耻辱和 利用社会支持寻求医疗服务。这些技能将通过在线互动小组传授 活动。在4-6个月内，WLHA将在没有学习干预的情况下自行管理在线小组 调查人员。WLHA的多维污名测量、心理健康负担和服务使用自我 疗效将在基线、4个月和6个月进行评估。干预进展数据将为 记录在案，以告知在线支持方法的可行性和可持续性。可接受性数据和 在为期6个月的试验期结束后，将从WLHA参与者那里收集反馈。