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Exploring the Impact of Illness Identity on Intersectional Stigma Through the Care Continuum

通过护理连续体探索疾病身份对交叉耻辱的影响

基本信息

批准号：
10794201
负责人：
Alanna J Bergman
金额：
$ 4.77万
依托单位：
JOHNS HOPKINS UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-09-01 至 2024-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10794201
关键词：
AIDS prevention Active Learning Address Adherence Africa South of the Sahara Analysis of Variance Caring Clinic Clinical Cohort Studies Communicable Diseases Continuity of Patient Care Data Data Collection Diagnosis Directly Observed Therapy Disease Drug resistance in tuberculosis Enrollment Event Fostering Foundations Future Goals HIV HIV resistance HIV/TB Health Hospitals Human immunodeficiency virus test Illness impact Individual Infection Interruption Intervention Interview Measurement Measures Mediating Mental Depression Mentorship Methods Modeling Morbidity - disease rate Outcome Parents Participant Patient-Focused Outcomes Patients Persons Population Prejudice Prospective cohort Province Psychometrics Publishing Randomized Randomized, Controlled Trials Research Research Personnel Resource Allocation Resource-limited setting Risk Science South Africa South African Specific qualifier value Stereotyping Stigmatization Time Training Translating Treatment outcome Tuberculosis Variant Viral Viral Load result Well in self Work antiretroviral therapy barrier to care career cohort coping curative treatments design efficacy evaluation experience health care disparity health seeking behavior improved infectious disease treatment instrument low and middle-income countries marginalized population mortality participant enrollment physical conditioning predictive tools prevent programs prospective recruit research study response skills social social stigma theories tool treatment adherence treatment as usual treatment center tuberculosis treatment

项目摘要

PROJECT SUMMARY Tuberculosis (TB) and HIV stigma causes significant morbidity and mortality in South Africa. Despite curative treatments for TB and antiretroviral therapies that suppress HIV viral load, both diseases continue to spread in low- and middle-income countries. Stigma is a significant barrier to care engagement and treatment adherence for HIV and TB. Intersectional stigma theory acknowledges the infinite combination of identities that contribute to stigma and social erasure. However, this wholistic approach of social constructs is not easily translated into measurement science. The applicant's proposed study, Exploring the Impact of Illness Identity on Intersectional Stigma Through the Care Continuum, will address this gap. The purpose of this project is to explore intersectional TB/HIV stigma through the care continuum to determine whether HIV viral suppression, and TB culture/smear conversion represent changes in illness identity that mitigate stigma. Aim 1 will quantify TB/HIV stigma using the Van Rie Patient Perspectives on TB/HIV Scales and use repeated measures ANOVA to evaluate significance in changes of stigma over time. In Aim 2, the applicant will use in-depth qualitative interviews to explore nuance and variation of intersectional stigma throughout the care continuum as experienced by people living with TB and HIV in South Africa that may not be captured within the Van Rie Scales. From the qualitative interviews, the applicant will develop and pilot four to five additional instrument items to address the overlap in TB/HIV stigma that is not captured within the parallel items of the Van Rie Scales. Finally, in aim 3, the applicant will interpret and integrate the qualitative and quantitative data to create a deeper understanding of intersectional TB/HIV stigma in South Africa and to assess its impact on treatment engagement across the care continuum. The applicant will use data from this proposal to improve the accuracy of stigma measurement in South Africa. This study will lay the foundation for future career in global stigma analysis and intervention work. It is therefore, an important first step in an exciting program of research to reduce stigma and improve TB and HIV treatment outcomes for global populations.

项目概要结核病 (TB) 和艾滋病毒耻辱导致南非显着的发病率和死亡率。尽管有疗效结核病治疗和抑制艾滋病病毒载量的抗逆转录病毒疗法，这两种疾病继续在低收入和中等收入国家。耻辱是护理参与和治疗的重大障碍艾滋病毒和结核病的依从性。交叉耻辱理论承认身份的无限组合助长耻辱和社会抹杀。然而，这种社会建构的整体方法并不容易翻译成测量科学。申请人提出的研究，探索疾病身份的影响关于通过护理连续体的交叉耻辱将解决这一差距。该项目的目的是通过护理连续体探索交叉结核病/艾滋病毒耻辱，以确定是否抑制艾滋病毒病毒，结核病培养/涂片转换代表疾病身份的变化，从而减轻耻辱感。目标 1 将量化使用 Van Rie 患者对 TB/HIV 量表的看法并使用重复测量方差分析来评估 TB/HIV 耻辱评估耻辱随时间变化的显着性。在目标 2 中，申请人将使用深入的定性分析访谈以探讨整个护理过程中交叉耻辱的细微差别和变化南非结核病和艾滋病毒感染者的经历可能无法在 Van Rie 中得到体现秤。根据定性访谈，申请人将开发并试点四到五个额外的工具解决结核病/艾滋病毒耻辱重叠问题的项目在 Van Rie 的平行项目中没有得到体现秤。最后，在目标 3 中，申请人将解释并整合定性和定量数据，以创建更深入地了解南非结核病/艾滋病毒交叉污名并评估其对治疗的影响整个护理过程中的参与。申请人将使用该提案中的数据来改进南非耻辱测量的准确性。本次学习将为未来在全球的职业生涯奠定基础污名分析和干预工作。因此，这是一项令人兴奋的研究计划中重要的第一步减少耻辱并改善全球人口的结核病和艾滋病毒治疗结果。