Integrating the Visualization and Use of Stigma Data to Maximize the Impact of the Ending the HIV Epidemic Initiative

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The 2021-2025 HIV National Strategic Plan (HIV Plan) recognizes stigma as a barrier to the success of the Ending the HIV Epidemic (EHE) initiative given consistent data highlighting the relationship between stigma and suboptimal HIV testing, prevention, and treatment outcomes. The prioritization of stigma by government agencies has yet to translate to scaled stigma mitigation strategies as a means of improving mental health, quality of life, and optimizing the HIV response. In response, our goal is to address the disconnect between practice and priorities in HIV epidemic control by systematically collecting stigma data in partnership with seven health departments and community partners in priority EHE areas, systematically visualizing key stigma indicators and the potential impact of stigma mitigation on EHE pillars and local HIV incidence, and using implementation research to optimize the usability of these tools and inform stigma mitigation interventions. These goals will be achieved via the following specific aims: Specific Aim 1 – Use historical and future iterations of data from AMIS, TWIST, PLHIV Stigma Index 2.0, NHBS, combined with systematic reviews to create stigma dashboards integrated into AIDSVu. Specific Aim 2 Using stigma data to model and visualize the effects of stigma and stigma mitigation interventions on proximal EHE indicators including incidence, knowledge of status, diagnoses, linkage to HIV care, viral suppression, and PrEP coverage. Specific Aim 3 – Use qualitative methods with health departments and CBO partners to inform the optimization of the Stigma Dashboard including usability, presentation, and information included to inform stigma-related policies and the development of local stigma mitigation strategies. These aims are highly responsive to “Respond: Epidemiology to End the HIV Epidemic” in using data to support effective and tailored approaches to respond to local epidemics and include balanced collaborations between epidemiologists, data scientists, statisticians, and local health departments and community partners. The key outputs of the proposed research will include refined, user-centered stigma dashboards integrated into AIDSVu that allow for data visualization and tools to plan and assess downstream impacts of intervention, as well as guidelines to support implementation of use of stigma dashboards and support connection to evidence for stigma mitigation intervention planning to achieve HIV epidemic control goals in additional health departments. While an ambitious research agenda, the diverse experience and competencies of this investigative team focused on stigma and existing partnerships makes us well placed to be successful in contributing to the Ending HIV Epidemic plan through improved measurement, use of, and response to HIV-related and intersectional stigmas.