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.

项目摘要在南非，结核病（TB）和HIV污名会引起明显的发病率和死亡率。尽管治愈了抑制HIV病毒载量的结核病和抗逆转录病毒疗法的治疗方法，两种疾病继续扩散低收入和中等收入国家。污名是护理参与和治疗的重大障碍遵守艾滋病毒和结核病。交叉污名理论承认身份的无限结合有助于污名和社会擦除。但是，这种社会构造的这种全面的方法并不容易翻译成测量科学。申请人的拟议研究，探索疾病认同的影响在通过护理连续体的交叉污名上，将解决这一差距。这个项目的目的是通过护理连续体探索交叉TB/HIV污名，以确定HIV病毒抑制是否抑制和结核病培养/涂片转化代表了减轻污名的疾病认同的变化。 AIM 1将量化使用van Rie患者观点对结核/艾滋病毒量表的TB/HIV污名，并使用重复测量方差分析评估随着时间的推移污名变化的显着性。在AIM 2中，申请人将使用深入的定性探索整个护理连续性的交叉污名的访谈和差异在南非患有结核病和艾滋病毒的人经历了可能不会被捕获的范·里（Van Rie）秤。从定性访谈中，申请人将开发和驾驶四到五个乐器解决van rie的平行项目中未捕获的结核病/艾滋病毒污名重叠的项目秤。最后，在AIM 3中，申请人将解释和集成定性和定量数据以创建对南非的交叉结核病/HIV污名的更深入了解，并评估其对治疗的影响在护理连续体中的订婚。申请人将使用此提案中的数据来改进南非污名测量的准确性。这项研究将为全球未来职业奠定基础污名分析和干预工作。因此，这是令人兴奋的研究计划中的重要第一步减少污名并改善全球人群的结核病和HIV治疗结果。