关于应对与艾滋病病毒相关的污名化问题以及通过调整后的德尔菲法实现社会促进因素目标的共识。

Consensus on addressing HIV-related stigma and achieving the societal enabler targets using an adapted Delphi process.

作者信息

Molesworth Kate, Nkosi Sbongile, Camacho Salvador, Caswell Georgina, Salem Simone, Baral Stefan, Kamarulzaman Adeeba, Sprague Laurel, Stackpool-Moore Lucy

机构信息

Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland

Global Network of People Living with HIV (GNP+), Johannesburg, South Africa.

出版信息

BMJ Open. 2025 Aug 12;15(8):e092516. doi: 10.1136/bmjopen-2024-092516.

Abstract

OBJECTIVES

To seek consensus among global experts on concepts, measures and approaches to guide national and global action to address HIV-related stigma and formulate a call to action. This outlines priorities to unite actors in more effectively responding to and resourcing efforts to address HIV-related stigma.

DESIGN

An adapted Delphi consensus-building process using two rounds of online questionnaires.

SETTING

Online questionnaires sent to a global expert panel.

PARTICIPANTS

50 global experts on HIV-related stigma and discrimination representing sectors including civil society, people living with HIV and key populations, research and academia, clinical practice, law, non-profit organisations, the United Nations, and policy and donor organisations.

RESULTS

The panel reached consensus on 55 points relating to the 12 broad themes extracted from the evidence base. These comprised the importance of addressing HIV-related stigma at scale; HIV-related stigma terms and definitions; Frameworks; Programming and approaches; Community leadership in HIV-related stigma-reduction implementation; Intersectional stigma and discrimination; Stigma and discrimination measures and assessment scales; Monitoring and evaluation; Stakeholder and community participation in monitoring and evaluation; Knowledge gaps and research needs; Funding and Commitment calls. From these, a consensus statement and call to action were formulated on priorities for strong political and financial commitments by all countries to reduce and mitigate HIV-related stigma and achieve global HIV targets adopted in 2021.

CONCLUSIONS

This study illustrated that global experts across sectors consider that action is needed to support the three critical enablers of the HIV response-society, systems and services-to ensure that HIV services are non-discriminatory and person-centred. The importance of attention and action to reduce stigma is critical in the current geopolitical and funding crisis affecting HIV and global health.

摘要

目标

在全球专家中就指导国家和全球应对与艾滋病相关耻辱感的行动的概念、措施和方法达成共识,并发出行动呼吁。这概述了优先事项,以团结各方行动者,更有效地应对与艾滋病相关耻辱感的问题并为相关努力提供资源。

设计

采用两轮在线问卷的适应性德尔菲共识构建过程。

背景

向全球专家小组发送在线问卷。

参与者

50名全球艾滋病相关耻辱感和歧视问题专家,代表民间社会、艾滋病病毒感染者和关键人群、研究与学术界、临床实践、法律、非营利组织、联合国以及政策和捐助组织等部门。

结果

该小组就从证据基础中提取的12个广泛主题相关的55点达成了共识。这些包括大规模应对与艾滋病相关耻辱感的重要性;与艾滋病相关耻辱感的术语和定义;框架;规划与方法;社区在减少与艾滋病相关耻辱感实施中的领导作用;交叉耻辱感和歧视;耻辱感和歧视的措施及评估量表;监测与评估;利益相关者和社区参与监测与评估;知识差距和研究需求;资金与承诺呼吁。据此,就所有国家做出强有力的政治和财政承诺以减少和减轻与艾滋病相关耻辱感并实现2021年通过的全球艾滋病目标的优先事项制定了一份共识声明和行动呼吁。

结论

本研究表明,各部门的全球专家认为需要采取行动来支持艾滋病应对的三个关键推动因素——社会、系统和服务,以确保艾滋病服务不歧视且以患者为中心。在当前影响艾滋病和全球健康的地缘政治和资金危机中,关注并采取行动减少耻辱感至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e6e8/12352172/e5de1131433c/bmjopen-15-8-g001.jpg

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