Intersectional Stigma and Pre-Exposure Prophylaxis Continuation among Female Sex Workers in Namibia

纳米比亚女性性工作者的交叉耻辱和暴露前预防的继续

基本信息

批准号：
10160481
负责人：
Kaitlyn M Atkins
金额：
$ 4.55万
依托单位：
JOHNS HOPKINS UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-11-01 至 2023-10-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10160481
关键词：
AIDS prevention Address Adult Affect Africa South of the Sahara Age Alcohol or Other Drugs use Behavior Behavioral Behavioral Sciences Caring Characteristics Country Data Decision Making Discrimination Epidemic Equation Ethnic Origin Factor Analysis Fellowship Goals Government HIV HIV Infections Human immunodeficiency virus test Improve Access Incidence Infrastructure Interview Logistic Regressions Measurement Measures Mental Depression Mental Health Mentors Methods Modeling Namibia National Institute of Mental Health National Research Service Awards Occupational Outcome Parents Pattern Perception Population Prevalence Provider Psychosocial Factor Public Health Schools Qualitative Research Race Research Research Methodology Research Personnel Research Priority Respondent Risk Role Scientist Services Social Sciences Social support Structure Tenofovir Time Training Treatment outcome United States National Institutes of Health Variant Vulnerable Populations Woman Work antiretroviral therapy base design disparity reduction doctoral student experience female sex worker health disparity improved indexing innovation insight lens pre-exposure prophylaxis prevention service programs psychosocial racial discrimination resilience scale up service delivery service intervention sex skills social social determinants social stigma testing services theories therapy adherence transmission process uptake

项目摘要

PROJECT SUMMARY/ABSTRACT Background. HIV continues to disproportionately impact female sex workers (FSW) in sub-Saharan Africa (SSA), highlighting the urgent need to address factors that put them at risk. Stigma is a key structural barrier to accessing HIV testing and prevention services among marginalized populations, but few HIV scientists have considered it from an intersectional lens. Further, studies assessing PrEP-related stigma have largely not considered the ways in which PrEP stigma intersects with other forms of stigma, such as sexual practices stigma or occupational stigma, to influence patterns of PrEP use. Study Goal and Aims. The goal of this study is to understand how intersectional stigmas, as experienced by FSW in Namibia, influence PrEP continuation. Specifically, the study aims to (1) qualitatively explore experiences of intersectional stigma among in Namibia and how it influences their PrEP outcomes; (2) estimate the burden and predictors of intersectional stigmas among ; and (3) determine the relationship between intersectional stigmas and PrEP continuation. Approach. This study will use an exploratory sequential mixed-methods approach to gain an in-depth understanding of intersectional stigmas and their impact on PrEP access and continuation among FSW FSW a marginalized population in Namibia. Aim 1 will utilize secondary data from approximately 20 in-depth interviews with FSW and primary data from approximately 15 in-depth interviews with PrEP providers to better understand experiences and definitions of stigma. Aim 2 will estimate the burden of intersectional stigmas, using multiple measures of attribute specific stigma (e.g. PrEP stigma) and non-attributed stigma (i.e. stigma related to one’s overall identity, rather than specific attributes or behaviors). Aim 2 will also estimate factors associated with experiencing intersectional stigmas among FSW . In Aim 3, the relationship between multiple intersectional stigmas and PrEP continuation will be estimated using structural equation modeling. Fellowship Information. The proposed research aligns with NIH HIV research priorities to reduce health disparities in HIV infection outcomes and with NIMH research priorities to integrate social and behavioral science with an effective biomedical strategy for HIV prevention. In-depth understanding of intersectional stigmas among this vulnerable population will provide important insights into stigma as a structural barrier to PrEP access and use, and will inform further implementation and scale-up of PrEP programs with FSW in SSA. This NRSA will be dissertation research for Ms. Kaitlyn Atkins, a PhD student at the Johns Hopkins Bloomberg School of Public Health. Ms. Atkins will be mentored by a Sponsor, two Co-Sponsors, a Scientific Advisor, and a Measurement Consultant. A training plan has been developed to provide her with tailored experience to support her towards achieving her goal of becoming a leading, independent HIV researcher.

项目概要/摘要背景艾滋病毒继续产生不成比例的影响。女性性工作者 (FSW) 在撒哈拉以南非洲（SSA），强调迫切需要解决使他们面临风险的因素，耻辱是一个关键的结构性障碍。边缘化人群获得艾滋病毒检测和预防服务，但很少有艾滋病毒科学家此外，评估 PrEP 相关耻辱的研究基本上没有从交叉角度考虑。考虑了 PrEP 耻辱与其他形式耻辱的交叉方式，例如性行为耻辱或职业耻辱，影响 PrEP 使用模式。研究目标本研究的目的是了解交叉耻辱是如何经历的。 F.S.W. 具体而言，该研究旨在 (1) 定性探索经验。纳米比亚的交叉耻辱及其如何影响他们的 PrEP 结果 (2) 估计负担和交叉耻辱的预测因素；以及（3）确定之间的关系交叉耻辱和 PrEP 延续。方法本研究将使用探索性顺序混合方法来获得深入的结果。了解交叉耻辱及其对 PrEP 获取和持续的影响 F.S.W. F.S.W. 边缘的人口目标 1 将利用大约来自纳米比亚的二手数据。 20次FSW深度访谈和主要数据来自与 PrEP 提供者约 15 次深度访谈，以更好地了解经验目标 2 将使用多种措施来估计交叉耻辱的负担。特定属性耻辱（例如 PrEP 耻辱）和非属性耻辱（即与个人整体身份相关的耻辱，而不是特定的属性或行为）。目标 2 还将估计与体验相关的因素。之间的交叉耻辱 F.S.W. 在目标 3 中，多重交叉耻辱与 PrEP 之间的关系将使用结构方程模型来估计连续性。奖学金信息。拟议的研究与 NIH HIV 研究重点相一致，以减少健康状况。 HIV 感染结果的差异以及 NIMH 研究重点以整合社会和行为科学深入了解艾滋病毒预防的交叉耻辱。这个弱势群体将对耻辱作为 PrEP 获取的结构性障碍提供重要见解，的使用，并将为 PrEP 计划的进一步实施和扩大提供信息 F.S.W. 该 NRSA 将是约翰·霍普金斯大学布隆伯格公立学院博士生 Kaitlyn Atkins 女士的论文研究健康。阿特金斯女士将得到一名赞助商、两名共同赞助商、一名科学顾问和一名测量人员的指导。顾问已制定培训计划，为她提供量身定制的经验，以支持她实现目标。实现了成为领先的独立艾滋病毒研究人员的目标。