Thapa Subash, Hannes Karin, Cargo Margaret, Buve Anne, Mathei Catharina
Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium.
Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155, 2000, Antwerp, Belgium.
Syst Rev. 2015 Nov 2;4:142. doi: 10.1186/s13643-015-0130-3.
Several stigma reduction intervention strategies have been developed and tested for effectiveness in terms of increasing human immunodeficiency virus (HIV) test uptake. These strategies have been more effective in some contexts and less effective in others. Individual factors, such as lack of knowledge and fear of disclosure, and social-contextual factors, such as poverty and illiteracy, might influence the effect of stigma reduction intervention strategies on HIV test uptake in low- and middle-income countries. So far, it is not clearly known how the stigma reduction intervention strategies interact with these contextual factors to increase HIV test uptake. Therefore, we will conduct a review that will synthesize existing studies on stigma reduction intervention strategies to increase HIV test uptake to better understand the mechanisms underlying this process in low- and middle-income countries.
A realist review will be conducted to unpack context-mechanism-outcome configurations of the effect of stigma reduction intervention strategies on HIV test uptake. Based on a scoping review, we developed a preliminary theoretical framework outlining a potential mechanism of how the intervention strategies influence HIV test uptake. Our realist synthesis will be used to refine the preliminary theoretical framework to better reflect mechanisms that are supported by existing evidence. Journal articles and grey literature will be searched following a purposeful sampling strategy. Data will be extracted and tested against the preliminary theoretical framework. Data synthesis and analysis will be performed in five steps: organizing extracted data into evidence tables, theming, formulating chains of inference from the identified themes, linking the chains of inference and developing generative mechanisms, and refining the framework.
This will be the first realist review that offers both a quantitative and a qualitative exploration of the available evidence to develop and propose a theoretical framework that explains why and how HIV stigma reduction intervention strategies influence HIV test uptake in low- and middle-income countries. Our theoretical framework is meant to provide guidance to program managers on identifying the most effective stigma reduction intervention strategies to increase HIV test uptake. We also include advice on how to effectively implement these strategies to reduce the rate of HIV transmission.
PROSPERO CRD42015023687.
已经开发并测试了几种减少污名化的干预策略，以评估其在提高人类免疫缺陷病毒（HIV）检测接受度方面的有效性。这些策略在某些情况下更有效，而在其他情况下则效果较差。个人因素，如知识缺乏和对披露的恐惧，以及社会背景因素，如贫困和文盲，可能会影响减少污名化干预策略对低收入和中等收入国家HIV检测接受度的效果。到目前为止，尚不清楚减少污名化干预策略如何与这些背景因素相互作用以提高HIV检测接受度。因此，我们将进行一项综述，综合现有的关于减少污名化干预策略以提高HIV检测接受度的研究，以便更好地理解低收入和中等收入国家这一过程的潜在机制。
将进行一项实证性综述，以剖析减少污名化干预策略对HIV检测接受度影响的背景-机制-结果配置。基于一项范围综述，我们制定了一个初步的理论框架，概述了干预策略影响HIV检测接受度的潜在机制。我们的实证性综合分析将用于完善初步理论框架，以更好地反映现有证据支持的机制。将按照有目的抽样策略检索期刊文章和灰色文献。将提取数据并对照初步理论框架进行检验。数据综合与分析将分五步进行：将提取的数据整理成证据表、确定主题、从已确定的主题中形成推理链、将推理链联系起来并发展生成机制，以及完善框架。
这将是第一项实证性综述，对现有证据进行定量和定性探索，以开发并提出一个理论框架，解释为什么以及如何减少HIV污名化干预策略会影响低收入和中等收入国家的HIV检测接受度。我们的理论框架旨在为项目管理人员提供指导，以确定最有效的减少污名化干预策略，以提高HIV检测接受度。我们还提供了有关如何有效实施这些策略以降低HIV传播率的建议。
PROSPERO CRD42015023687。
