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连续护理的每一步，包括接触艾滋病毒 护理，坚持抗逆转录病毒疗法(ART)，并维持艾滋病毒病毒抑制。艾滋病毒的污名也与 其他污名化的身份，如性别和性取向，并造成交叉的污名 艾滋病毒护理的独特经历和障碍。调查跨部门污名的研究正在获得支持 然而，高收入国家对内部、制定和预期的跨部门污名的研究 耻辱机制仍然有限，尚未在低收入国家报告。 撒哈拉非洲。因此，虽然减少艾滋病毒污名影响的行为干预是结束 艾滋病毒流行，研究尚未确定相互交叉的污名身份及其对ART的影响 在艾滋病毒高流行率的国家，如南非，坚持这样做。缺乏经验性的验证 跨部门艾滋病毒污名的心理测量方法阻碍了在有艾滋病毒感染的地区的研究和干预 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跨部门污名研究。第一阶段将进行启发 采访从开普省一家艾滋病诊所接受抗逆转录病毒治疗的妇女、性少数族裔男子和异性恋男子 南非的小镇。访谈将探讨参与者关于交叉污名的经历 身份。从访谈中获得的见解将为污名量表项目的选择和定制提供参考。一个 临床患者的独立样本将提供关于项目和识别的污名的反馈 身份将在一种新的方法中实施，以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 内化的、制定的和预期的污名。在第二阶段，新开发的交叉柱头鳞片将 在一项女性短期前瞻性研究中测试信度、结构效度和预测效度， 性少数民族男性和异性恋男性在艾滋病护理和接受艺术方面。研究目标的完成 将提供一种新的方法来评估南非的跨部门艾滋病毒污名，这将为行为 促进抗逆转录病毒药物吸收和坚持的干预措施。

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.