Department of Public Health, NORC at the University of Chicago, Bethesda, Maryland, USA.
AIDS Patient Care STDS. 2022 Oct;36(S1):S28-S35. doi: 10.1089/apc.2022.0102.
Black men who have sex with men (BMSM) with HIV face significant challenges in accessing health care, including routine HIV care and behavioral health care due in part to perceived stigma in health care settings. This study examined the perspectives of BMSM with HIV and health care providers of how stigma experiences can affect health care access to both clinical and behavioral health support services. We explored how providers can mitigate stigma practices and improve health care experiences for BMSM with HIV, which may ultimately improve engagement in care. Working with eight sites as part of the BMSM Initiative, we recruited 20 BMSM with HIV and 13 health care providers to participate in individual virtual interviews. Participants were asked about perceived discrimination and stigma experienced by BMSM with HIV and strategies to reduce stigma experiences. Participants discussed how current practices could be improved to reduce stigma and how the use of telehealth promoted engagement in care. Recommended strategies to reduce stigma in HIV care delivery included offering personable communication, providing nonclinical resources along with standard HIV care, requiring staff diversity training, diversifying health care teams, and offering telehealth options. Employing stigma reduction strategies can create a safe and comfortable environment for BMSM with HIV to engage in behavioral care in HIV care settings. Providers should seek to incorporate these strategies into current and future models of care with the goal to improve overall health outcomes in BMSM with HIV.
男男性行为者(MSM)与 HIV 感染者在获得医疗保健方面面临着重大挑战,包括常规 HIV 护理和行为健康护理,部分原因是医疗环境中存在感知到的耻辱感。本研究探讨了 HIV 感染者的 MSM 和医疗保健提供者的观点,即耻辱感经历如何影响他们获得临床和行为健康支持服务的机会。我们探讨了提供者如何减轻耻辱感做法并改善 HIV 感染者的医疗保健体验,这最终可能会改善他们的护理参与度。作为 BMSM 倡议的一部分,我们在八个地点与 20 名 HIV 感染者的 MSM 和 13 名医疗保健提供者合作,参与了个人虚拟访谈。参与者被问及 HIV 感染者的 MSM 所经历的感知歧视和耻辱感,以及减少耻辱感的策略。参与者讨论了如何改进当前的做法以减少耻辱感,以及远程医疗如何促进护理参与度。建议的减少 HIV 护理中耻辱感的策略包括提供亲切的沟通、提供非临床资源以及标准的 HIV 护理、要求员工接受多样性培训、使医疗保健团队多样化以及提供远程医疗选择。采用减少耻辱感的策略可以为 HIV 感染者创造一个安全舒适的环境,使他们能够在 HIV 护理环境中参与行为护理。提供者应寻求将这些策略纳入当前和未来的护理模式中,以改善 HIV 感染者的整体健康结果。