HIV-related stigma interventions

This paper has been developed with the intention of providing a framework for people developing HIV-related stigma interventions to consider how to design, implement, and evaluate such activities. The paper first provides a brief explanation of some HIV stigma definitions, followed by an overview of the theory and concepts related to stigma, including its origins and mechanisms. It then describes seven approaches – informed by previous reviews, and specific examples from Australia and elsewhere – used in the development of HIV-related stigma interventions. Finally, it provides an overview of how HIV-related stigma is measured, with an emphasis on how outcome measures need to be calibrated to the approach, the domain, and the level of any specific intervention. The paper is intended as a practical tool for people developing and evaluating interventions.</p

Requesting HIV Results Be Conveyed in-Person: Perspectives of Clinicians and People Recently Diagnosed with HIV

Introduction: Guidelines recommend that, where possible, clinicians convey HIV-positive test results in person in Australia. However, HIV-negative and all other STI results are routinely delivered by phone or text message. Requesting individuals to obtain positive HIV test results in person could be a deviation from the standard delivery of healthcare and be interpreted as indicating a positive HIV diagnosis. Methods: This paper is based on two related, ongoing qualitative studies conducted in Australia with HIV healthcare providers and people recently diagnosed with HIV. In study one, in-depth, semi-structured interviews were conducted with people who had recently received a positive HIV diagnosis. In study two, in-depth, semi-structured interviews were conducted with HIV healthcare and peer support providers. Interviews were analyzed thematically. Results: While clinicians were willing to convey HIV-positive diagnoses by phone, most preferred in-person delivery. In-person delivery enabled clinicians to assess visual cues to better respond to the psychological and emotional needs of patients. For some participants living with HIV, however, the requirement to return to the clinic was interpreted as an unofficial HIV-positive diagnosis. This led to a period in which recently diagnosed participants believed they were HIV-positive without having received an explicit diagnosis. Conclusion: Protocols for delivering HIV diagnoses by phone, followed by a face-to-face appointment, may reduce the period of anxiety for some patients and assist with an early connection to HIV care and support. Policy Implications: In some instances, conveying HIV diagnoses by phone may be more appropriate than recalling individuals to the clinic to deliver a positive HIV diagnosis in person