Feasibility of a Stigma Reduction Intervention for HIV-infected Women

针对艾滋病毒感染妇女的耻辱减少干预措施的可行性

基本信息

批准号：
8254397
负责人：
Julie V Barroso
金额：
$ 19.63万
依托单位：
DUKE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-04-07 至 2013-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8254397
关键词：
AIDS prevention AIDS/HIV problem Accounting Acquaintances Acquired Immunodeficiency Syndrome Adherence Adverse effects Affect Anti-Retroviral Agents Attention Behavior Caring Cause of Death Cellular Phone Centers for Disease Control and Prevention (U.S.)Child Civil Rights Communities Control Groups Data Devices Diagnosis Disclosure Discrimination Disease Epidemic Face Feeling Friends Fright Gays General Population HIV HIV Infections Health Personnel Human Resources Human immunodeficiency virus test Imagery Intervention Laws Leadership Life Literature Mental Processes Minority Outcome Persons Pharmaceutical Preparations Positioning Attribute Prejudice Prevention Privacy Public Health Regimen Relative (related person)Research Personnel Safety Self Efficacy Sexual Partners Signal Transduction South Africa Stigmata Stigmatization Testing Time Touch sensation Transportation Treatment Efficacy Ursidae Family Violence Vision Woman Work aged base condoms coping cost design discounting disorder prevention efficacy testing experience improved innovation interest lectures male medication compliance men movie pill psychosocial public health relevance safer sex self esteem social social stigma statistics theories trait treatment as usual willingness

项目摘要

DESCRIPTION (provided by applicant): Nearly 30 years into the AIDS epidemic, stigma is still hampering efforts to stop its spread. HIV-infected women are particularly vulnerable to both perceived and enacted stigma, which together are referred to as internalized stigma. As the demographic face of HIV infection in the US has changed from being largely a disease of gay white men to one of poor minority women, the debilitating effects of stigma have worsened. It has a profound impact on prevention and treatment efforts; women with HIV infection may be fearful of insisting that their sexual partners wear condoms because of the possibility that this may signal their serostatus, and they may not want to take antiretroviral medications in front of others, fearing that people may ask questions about their pills and the reasons for taking them. The effects of stigma include a cascade of other negative outcomes as well, including poor self-esteem and self-efficacy, especially self-efficacy for disclosure and for coping. Yet it is nearly impossible to intervene with those who stigmatize others because this group is often as broad as the general public, and they may not be interested in an intervention. Therefore, the best approach may be to work with women who are experiencing stigma, in an effort to decrease stigma, improve self-esteem and coping self-efficacy, and facilitate safe disclosure. To date, there have been few interventions to help HIV-infected women deal with stigma. One option would be a video converted to an MP4 file that can be viewed on an iPod Touch, a small portable viewing device, allowing the woman privacy and safety in viewing. Barroso (PI on the proposed study) assisted in the creation of a video on stigma for women with HIV infection, based on the results of a qualitative metasynthesis. The 45-minute video presents vignettes about five seropositive women and the ways in which stigma has impacted their lives. The primary aim of the proposed study is to assess the feasibility, acceptability and utility of implementing this low-cost, technologically delivered intervention to mitigate the negative effects of HIV-related stigma on seropositive women. The secondary aim is to compare outcomes across time in women who receive the stigma intervention with those of a control group receiving usual care at baseline, 30, and 90 days, and to determine effect sizes for a larger definitive study to test the efficacy of this intervention in reducing internalized stigma, improving coping self-efficacy and self-esteem, and facilitating safe disclosure in HIV-infected women. We believe that this intervention is innovative because we are the first investigators to propose using a video, developed from the findings of a metasynthesis of studies about stigma as it is experienced by HIV-infected women, for this purpose. It is also innovative in the use of a portable viewing device which will allow the women to safely and privately view the video. We further believe that this intervention has the potential to make a significant impact, at a low cost in terms of money and personnel time, in mitigating stigma. PUBLIC HEALTH RELEVANCE: Stigma is a serious problem for HIV-infected women; it has an adverse impact on disclosure to sex partners and adherence to antiretroviral medication. There are few interventions to help them deal with it. This study will test an intervention developed for HIV-infected women to help them feel less stigmatized, and better about themselves and their ability to cope. It will also help them figure out when and how to safely disclose their HIV status to others. The intervention is a video that has been converted to an MP4 file to be viewed on an iPod Touch. The video was developed from many studies conducted with HIV-infected women about stigma. We will see if this is a feasible, acceptable, and useful way to intervene with stigma.

描述（由申请人提供）：在艾滋病流行病中近30年，污名仍在阻碍停止其传播的努力。感染艾滋病毒的妇女特别容易受到感知和颁布的污名的攻击，这些污名共同被称为内部污名。随着美国的艾滋病毒感染的人口表面已经从很大程度上成为同性恋白人的疾病变成了贫困少数妇女中的一名疾病，因此耻辱感的令人衰弱的影响加剧了。它对预防和治疗工作有深远的影响；患有艾滋病毒感染的妇女可能会担心自己的性伴侣会戴避孕套，因为这可能表明她们的血清，并且他们可能不想在其他人面前服用抗逆转录病毒药物，担心人们可能会问有关他们的药丸及其理由的问题。污名的影响还包括一系列其他负面结果，包括自尊和自我效能感，尤其是披露和应对的自我效能感。然而，几乎不可能与那些污名化的人进行干预，因为这个群体通常像公众一样广泛，并且他们可能对干预措施不感兴趣。因此，最好的方法可能是与经历污名的妇女一起工作，以减少污名，提高自尊心和应对自我效能感并促进安全披露。迄今为止，几乎没有干预措施来帮助感染艾滋病毒的妇女应对污名。一个选项是将视频转换为MP4文件，该视频可以在iPod Touch，一个小型便携式查看设备上查看，从而使女性隐私和安全性可以查看。 Barroso（拟议研究的PI）根据定性元合成的结果，协助创建了有关艾滋病毒感染妇女污名的视频。 45分钟的视频展示了有关五名血清阳性女性的小插曲，以及污名影响了她们的生活。拟议研究的主要目的是评估实施这种低成本，技术上提供的干预措施的可行性，可接受性和效用，以减轻与HIV相关的污名对血清阳性女性的负面影响。 The secondary aim is to compare outcomes across time in women who receive the stigma intervention with those of a control group receiving usual care at baseline, 30, and 90 days, and to determine effect sizes for a larger definitive study to test the efficacy of this intervention in reducing internalized stigma, improving coping self-efficacy and self-esteem, and facilitating safe disclosure in HIV-infected women.我们认为，这种干预是创新的，因为我们是第一位提出视频的研究人员，这是根据艾滋病毒感染的妇女所经历的有关污名的元合成的发现而开发的。它在使用便携式查看设备方面也是创新的，该设备将使妇女安全地私下观看视频。我们进一步认为，这种干预措施有可能在减轻污名方面以低成本的成本产生重大影响。公共卫生相关性：污名是感染艾滋病毒的妇女的严重问题；它对向性伴侣的披露和遵守抗逆转录病毒药物有不利影响。几乎没有干预措施可以帮助他们处理。这项研究将测试为艾滋病毒感染的妇女开发的干预措施，以帮助她们感到污名不能，对自己和应对能力更好。这也将帮助他们弄清楚何时以及如何安全地向他人披露他们的艾滋病毒状况。干预是一个已转换为MP4文件以在iPod Touch上查看的视频。该视频是从与HIV感染的妇女有关污名进行的许多研究开发的。我们将看看这是否是一种可行，可接受且有用的方法来干预污名。