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艾滋病毒教育、同理心和赋权(HIVE):一种同伴支持干预措施,旨在减少加纳男男性行为者中作为 HIV 检测障碍的交叉性耻辱感。

HIV Education, Empathy, and Empowerment (HIVE): A Peer Support Intervention for Reducing Intersectional Stigma as a Barrier to HIV Testing among Men Who Have Sex with Men in Ghana.

机构信息

Center for Interdisciplinary Research on AIDS, School of Public Health, Yale University, New Haven, CT 06510, USA.

Priorities on Rights and Sexual Health, Accra 00233, Ghana.

出版信息

Int J Environ Res Public Health. 2021 Dec 12;18(24):13103. doi: 10.3390/ijerph182413103.


DOI:10.3390/ijerph182413103
PMID:34948712
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8702001/
Abstract

Men who have sex with men (MSM) in Ghana remain at heightened risk of HIV infection, and face challenges in accessing HIV prevention and care services. Previous research in Ghana shows that MSM face intersectional stigma across ecological levels (family, peers, healthcare settings, and community level) and the criminalization of same-gender sexual behaviors in the country. To protect their wellbeing from exposure to stigma, many MSM avoid interactions with healthcare systems and services, which inadvertently inhibits their opportunities for early detection and treatment of HIV. Consequently, MSM in Ghana carry a disproportionate burden of HIV prevalence (18%) compared to the general population (2%), highlighting the need for culturally relevant processes in HIV/STI prevention, and care communication to optimize sexual health and wellness among MSM in Ghana. To this effect, we collaborated with community partners to use the Assessment, Decision, Adaptation, Production, Topical Experts, Training, Testing (ADAPT-ITT) model to modify a theory-driven smartphone-based peer support intervention to enhance its focus on intersectional stigma reduction, and improve HIV health-seeking behaviors among MSM, including HIV testing and linkage to care. We used the Dennis Peer Support Model to develop the peer support components (emotional, informational, and appraisal support) to increase peer social support, decrease social isolation, and minimize intersectional stigma effects on HIV-related healthcare-seeking behaviors. This paper shows the preliminary acceptability and effectiveness of employing culturally relevant techniques and communication strategies to provide secure peer support to improve HIV prevention and care among key populations in highly stigmatized environments.

摘要

在加纳,男男性行为者(MSM)仍然面临着感染艾滋病病毒的高度风险,并且在获得艾滋病预防和护理服务方面面临挑战。加纳之前的研究表明,MSM 在生态层面(家庭、同龄人、医疗保健环境和社区层面)面临着交叉污名,而且同性性行为在加纳是违法的。为了保护他们的福祉免受污名的影响,许多 MSM 避免与医疗保健系统和服务互动,这无意中抑制了他们及早发现和治疗艾滋病毒的机会。因此,加纳的 MSM 承担着不成比例的 HIV 流行率(18%),而普通人群(2%),这突显了在 HIV/性传播感染预防和护理沟通中需要采用文化相关的过程,以优化加纳 MSM 的性健康和福祉。为此,我们与社区合作伙伴合作,使用评估、决策、适应、制作、主题专家、培训、测试(ADAPT-ITT)模型来修改基于智能手机的理论驱动的同伴支持干预措施,以增强其对交叉污名减少的关注,并改善 MSM 的 HIV 健康寻求行为,包括 HIV 检测和护理衔接。我们使用丹尼斯同伴支持模型来开发同伴支持组件(情感、信息和评估支持),以增加同伴社会支持,减少社会孤立,并最大限度地减少交叉污名对与 HIV 相关的医疗保健寻求行为的影响。本文展示了在高度污名化环境中为关键人群提供安全的同伴支持以改善 HIV 预防和护理的采用文化相关技术和沟通策略的初步可接受性和有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8892/8702001/9d148d31b4c9/ijerph-18-13103-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8892/8702001/9d148d31b4c9/ijerph-18-13103-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8892/8702001/9d148d31b4c9/ijerph-18-13103-g001.jpg

相似文献

[1]
HIV Education, Empathy, and Empowerment (HIVE): A Peer Support Intervention for Reducing Intersectional Stigma as a Barrier to HIV Testing among Men Who Have Sex with Men in Ghana.

Int J Environ Res Public Health. 2021-12-12

[2]
Multi-level intersectional stigma reduction intervention to increase HIV testing among men who have sex with men in Ghana: Protocol for a cluster randomized controlled trial.

PLoS One. 2021

[3]
Community-Based Interventions as Opportunities to Increase HIV Self-Testing and Linkage to Care Among Men Who Have Sex With Men - Lessons From Ghana, West Africa.

Front Public Health. 2021

[4]
Using a mixed-methods approach to adapt an HIV stigma reduction to address intersectional stigma faced by men who have sex with men in Ghana.

J Int AIDS Soc. 2022-7

[5]
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[6]
"But the moment they find out that you are MSM…": a qualitative investigation of HIV prevention experiences among men who have sex with men (MSM) in Ghana's health care system.

BMC Public Health. 2017-10-3

[7]
Multi-level manifestations of sexual stigma among men with same-gender sexual experience in Ghana.

BMC Public Health. 2023-1-24

[8]
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Afr J AIDS Res. 2020-7

[9]
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[10]
Associations between HIV testing and multilevel stigmas among gay men and other men who have sex with men in nine urban centers across the United States.

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引用本文的文献

[1]
"We have our reasons": Exploring the acceptability of pre-exposure prophylaxis among gay, bisexual, and other men who have sex with men in Ghana.

BMC Public Health. 2025-7-3

[2]
"They recognize me as a doctor": evaluation of an HIV peer mobilisation training programme to promote oral HIV self-testing and referral for acute HIV infection screening among gay and bisexual men and transgender women in coastal Kenya.

medRxiv. 2025-4-10

[3]
Examining Experiences of Gender Identities, Roles, and Relations among Men with Same-Gender Sexual Histories: Implications of Gender Nonconformity on Access to Quality Healthcare in Urban Ghana.

J Urban Health. 2025-4

[4]
Intersectional HIV stigma in Sub-Saharan Africa, Latin America and the Caribbean: Insights and pathways forward - A scoping review.

PLOS Glob Public Health. 2025-2-10

[5]
Codeveloping a community-based, peer-led psychosocial support intervention to reduce stigma and depression among people with tuberculosis and their households in Indonesia: a mixed-methods participatory action study.

NPJ Prim Care Respir Med. 2025-1-27

[6]
Standardly Trained Peer Volunteer-Led, Social App Recruiting-Based Human Immunodeficiency Virus Testing Strategy Using Rapid Testing Kits (SPARK) Among Men Who Have Sex With Men: A Population-Based Survey Evaluation.

Open Forum Infect Dis. 2024-12-2

[7]
Community-based psychosocial support interventions to reduce stigma and improve mental health of people with infectious diseases: a scoping review.

Infect Dis Poverty. 2024-12-3

[8]
A qualitative description of HIV testing and healthcare experiences among trans women in Ghanaian urban slums BSGH-012.

PLOS Glob Public Health. 2024-12-2

[9]
Healthcare worker perspectives on HIV status sharing intervention components for partnered, Black sexual minority men in South Africa.

HIV Res Clin Pract. 2024-12

[10]
Explaining inequity in knowledge, attitude, and services related to HIV/AIDS: a systematic review.

BMC Public Health. 2024-7-8

本文引用的文献

[1]
Community-Based Interventions as Opportunities to Increase HIV Self-Testing and Linkage to Care Among Men Who Have Sex With Men - Lessons From Ghana, West Africa.

Front Public Health. 2021

[2]
A Systematic Review of the Social Network Strategy to Optimize HIV Testing in Key Populations to End the Epidemic in the United States.

AIDS Behav. 2021-9

[3]
Implementation and evaluation of a culturally grounded group-based HIV prevention programme for men who have sex with men in Ghana.

Glob Public Health. 2021-7

[4]
Using Digital Communication Technology to Increase HIV Testing Among Men Who Have Sex With Men and Transgender Women: Systematic Review and Meta-Analysis.

J Med Internet Res. 2020-7-28

[5]
Stigma, discrimination, violence, and HIV testing among men who have sex with men in four major cities in Ghana.

AIDS Care. 2020-8

[6]
"Support for the supporters": a qualitative study of the use of WhatsApp by and for mentor mothers with HIV in the UK.

AIDS Care. 2020-5

[7]
Knowledge and Acceptability of HIV pre-exposure prophylaxis (PrEP) among men who have sex with men (MSM) in Ghana.

AIDS Care. 2020-3

[8]
Ghana's HIV epidemic and PEPFAR's contribution towards epidemic control.

Ghana Med J. 2019-3

[9]
Use of Social Network Strategy Among Young Black Men Who Have Sex With Men for HIV Testing, Linkage to Care, and Reengagement in Care, Tennessee, 2013-2016.

Public Health Rep. 2018

[10]
Implementing a Standardized Social Networks Testing Strategy in a Low HIV Prevalence Jurisdiction.

AIDS Behav. 2019-1

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