A Novel Intersectional HIV Stigma Measure in South Africa

社会对艾滋病毒的污名化阻碍了艾滋病毒护理连续性的每一个沿着步骤，包括获得艾滋病毒治疗 护理，坚持抗逆转录病毒治疗（ART），并持续抑制艾滋病毒。艾滋病毒污名也与 与其他被污名化的身份，如性别和性取向，与交叉污名创造 艾滋病护理的独特经验和障碍。调查交叉污名的研究在以下领域获得了牵引力： 高收入国家，然而，跨内化，颁布和预期交叉污名的研究， 污名化机制仍然有限，尚未有报告指出， 撒哈拉非洲。因此，虽然减少艾滋病毒污名化影响的行为干预对结束艾滋病毒感染至关重要， 艾滋病毒流行，研究尚未确定交叉的污名化身份及其对ART的影响 在艾滋病毒高流行率的国家，如南非，遵守。缺乏经验验证的 交叉艾滋病毒污名的心理测量方法阻碍了在艾滋病流行地区的研究和干预措施。 最大的需要。拟议的研究金利用现有的研究基础设施和项目资源， 南非将进行两个阶段的交叉污名化研究。第一阶段将进行诱导 采访了在开普敦一家艾滋病诊所接受抗逆转录病毒治疗的女性、性少数男性和异性恋男性 南非的小镇。访谈将探讨参与者在交叉污名化方面的经历， 身份从访谈中获得的见解将为污名量表项目的选择和调整提供信息。一个 门诊病人的独立样本将提供关于项目和识别的污名化的反馈 身份将实施一种新的方法来评估交叉污名使用几何 以艾滋病毒污名框架为基础的交叉性概念化， 内化、制定和预期的耻辱。在第二阶段，新开发的交叉柱头量表将 在对女性的短期前瞻性研究中进行可靠性、结构效度和预测效度测试， 性少数男性和异性恋男性在艾滋病毒护理和接受抗逆转录病毒治疗。完成这项研究的目的是 将提供一种新的方法来评估南非的交叉艾滋病毒污名， 采取干预措施，促进抗逆转录病毒疗法的使用和坚持。

The social stigmatization of HIV impedes every step along the HIV continuum of care, including accessing HIV care, adhering to antiretroviral therapy (ART), and sustaining HIV viral suppression. HIV stigma also intersects with other stigmatized identities, such as gender and sexual orientation, with intersectional stigma creating unique experiences and barriers to HIV care. Research investigating intersectional stigma is gaining traction in high-income countries, however, studies of intersectional stigma across internalized, enacted, and anticipated stigma mechanisms remains limited, and has not yet been reported in the low-income countries of sub- Saharan Africa. Thus, while behavioral interventions to reduce the effects of HIV stigma are essential to ending HIV epidemics, studies have not yet identified intersecting stigmatized identities and their impacts on ART adherence in countries with high-HIV prevalence, such as South Africa. The absence of empirically validated psychometric measures of intersectional HIV stigma is hampering research and interventions in places with the greatest need. The proposed fellowship leverages an existing research infrastructure and project resources in South Africa to conduct two-phases of intersectional stigma research. Phase 1 will conduct elicitation interviews with women, sexual minority men, and heterosexual men receiving ART from an HIV clinic in Cape Town, South Africa. The interviews will probe participants’ experiences with respect to intersecting stigmatized identities. Insights gained from the interviews will inform the selection and tailoring of stigma scale items. An independent sample of clinic patients will provide feedback on the items and the identified stigmatized identities will be implemented in a novel approach to assessing intersectional stigma using a geometric conceptualization of intersectionality grounded in the HIV Stigma Framework to assess intersectional internalized, enacted, and anticipated stigma. In Phase 2, the newly developed intersectional stigma scales will be tested for reliability, construct validity, and predictive validity in a short-term prospective study of women, sexual minority men, and heterosexual men in HIV care and receiving ART. The completion of the study aims will offer a novel approach to assessing intersectional HIV stigma in South Africa that will inform behavioral interventions to promote ART uptake and adherence.