Amsterdam 2015
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| Abstract #2379 - The Enigma of Stigma | ||||
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Session: 35.4: The Enigma of Stigma (Symposium) on Thursday @ 14.30-16.00 in C104 Chaired by Danuta Kasprzyk, Jeffrey Fisher Authors: Presenting Author: Dr. Carlos Rodriguez-Diaz - University of Puerto Rico-Medical Sciences Campus, Puerto Rico |
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| Additional Authors: | ||||
| Aim: Globally, men who have sex with men (MSM) continues to show high rates of HIV incidence. In the Unites States of America (U. S.) MSM account for 53% of new HIV infections each year and is the only group in which new infections are rising. Similarly, in Puerto Rico (PR), a commonwealth of the U. S. located in the Caribbean region, of all HIV/AIDS diagnoses, 73% were men and half of these (33%) were MSM. This reflects a 126% increase since 2002. Despite the growing HIV epidemic among MSM in PR, they are among the least likely to be identified and retained in HIV services. Their under-representation in health services is a consequence of the multiple types of stigma which they are subjected to. Sexual minority status remains a highly stigmatized identity in PR. Also, and to some degree because of its early association with MSM, HIV infection is also highly stigmatized and people with HIV are subject to discrimination in health care settings. Despite the evidence of the negative impact of stigma in those affected by the HIV epidemic, very little attention has been place to the development of interventions to address it. | ||||
| Method / Issue: Data was collected using a convergent parallel mixed methods research design to inform the development of a stigma management intervention. The intervention, named Contacto, is targeted to Spanish-speaking HIV+MSM and consists of three encounters with a health educator. Guided by motivational interviewing techniques, the goal of the intervention is to support participants’ management of the negative impact of stigma related to HIV-status, sexual orientation, and the interconnection between them. Implementation feasibility was completed assessing the resources and materials needed for the intervention. Recruitment and retention rates informed acceptability. Initial efficacy has been tested using a pre-post-post assessment. | ||||
| Results / Comments: Participants’ charts were created and included materials used during the intervention (Tools to assess readiness to take action, educational materials, etc.). Other resources needed included a call log sheet as part of a systematized recruitment process, and a private room for encounters. Of all participants approached, 54.0% were recruited. Almost two thirds (64.8%) of those have assisted to at least one encounter with the health educator. Participant retention rate is 91.4%. In preliminary efficacy assessment, participants has expressed the need to explore and make changes related to HIV-status and sexual orientation disclosure, mental health services seeking, and cigarette smoking cessation. | ||||
| Discussion: Preliminary analyses suggest the feasibility of implementation and acceptance of a culturally congruent intervention for stigma management for HIV+MSM in PR. Acceptance of the intervention support the need to address the negative impact of stigma on the healthcare practices of MSM. Initial efficacy assessments evidence the interconnection of stigma as a barrier for disclosure of HIV status and sexual orientation, as well as for seeking mental health services and reducing risky health practices. The intervention has provided participants to identify challenges and plan for changes needed to overcome the negative impact of stigma when using healthcare services. Future research should address the effectiveness of the intervention. | ||||
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