性少数群体和性别少数群体健康干预措施中污名的系统评价。
A systematic review of stigma in sexual and gender minority health interventions.
机构信息
Human Development and Family Studies Department, The Pennsylvania State University, University Park, PA, USA.
Department of Psychology, Hunter College, City University of New York, New York, NY, USA.
出版信息
Transl Behav Med. 2020 Oct 12;10(5):1200-1210. doi: 10.1093/tbm/ibz200.
Stigma against sexual and gender minorities is a major driver of health disparities. Psychological and behavioral interventions that do not address the stigma experienced by sexual and gender minorities may be less efficacious. We conducted a systematic review of existing psychological and behavioral health interventions for sexual and gender minorities to investigate how interventions target sexual and gender minority stigma and consider how stigma could affect intervention efficacy. Preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines were followed. Eligible studies were peer reviewed and published in English between January 2003 and July 2019 and reported empirical results of behavioral or psychological interventions implemented among sexual and gender minorities. All interventions addressed stigma. We identified 37 eligible interventions. Most interventions targeted sexual minority men. Interventions were frequently developed or adapted for implementation among sexual and gender minorities and addressed multiple levels and types of stigma. Interventions most frequently targeted proximal stressors, including internalized and anticipated stigma. HIV and mental health were the most commonly targeted health outcomes. A limited number of studies investigated the moderating or mediating effects of stigma on intervention efficacy. The application of an intersectional framework was frequently absent and rarely amounted to addressing sources of stigma beyond sexual and gender minority identities. A growing number of interventions address sexual and gender minority stigma in an effort to prevent deleterious health effects. Future research is needed to assess whether stigma modifies the effectiveness of existing psychological and behavioral interventions among sexual and gender minorities. Further, the application of intersectional frameworks is needed to more comprehensively intervene on multiple, intersecting sources of stigma faced by the diverse sexual and gender minority community.
性少数群体和性别少数群体的污名化是健康差距的主要驱动因素。如果心理和行为干预措施不解决性少数群体和性别少数群体所经历的污名化问题，其效果可能会降低。我们对现有的性少数群体和性别少数群体的心理和行为健康干预措施进行了系统审查，以调查干预措施如何针对性少数群体和性别少数群体的污名化问题，并考虑污名化如何影响干预措施的效果。我们遵循了系统评价和荟萃分析的首选报告项目（PRISMA）指南。合格的研究是同行评审的，发表在英语中，时间在 2003 年 1 月至 2019 年 7 月之间，并报告了在性少数群体和性别少数群体中实施的行为或心理干预的实证结果。所有干预措施都针对污名化问题。我们确定了 37 项合格的干预措施。大多数干预措施针对的是性少数男性群体。这些干预措施经常是为在性少数群体和性别少数群体中实施而开发或改编的，针对多个层面和类型的污名化问题。干预措施最常针对的是近端应激源，包括内化和预期的污名化。HIV 和心理健康是最常针对的健康结果。少数研究调查了污名化对干预效果的调节或中介作用。很少有研究应用交叉框架来解决除性少数群体和性别少数群体身份之外的污名化来源。越来越多的干预措施针对性少数群体和性别少数群体的污名化问题，以防止对健康造成有害影响。需要进一步的研究来评估污名化是否会改变现有的心理和行为干预措施在性少数群体和性别少数群体中的有效性。此外，需要应用交叉框架来更全面地干预多样化的性少数群体和性别少数群体所面临的多个交叉来源的污名化问题。
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