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      Understanding Global HIV Stigma and Discrimination: Are Contextual Factors Sufficiently Studied? (GAP RESEARCH)

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          Abstract

          Stigma and discrimination are among the greatest challenges that people living with human immunodeficiency virus (HIV) face, and both are known to negatively affect quality of life as well as treatment outcomes. We analyzed the growing research and current understanding of HIV-related stigma and contextual factors in HIV/AIDS (human Immunodeficiency virus/ acquired immunodeficiency syndrome) bibliography. A total of 5984 publications published from 1991 to 2017 were retrieved from the Web of Science database. The number of papers and their impacts have been considerably grown in recent years. Research landscapes related to stigma and discrimination include clinical, physical and mental health outcomes, risk behaviors of most-at-risk populations, and HIV-related services. We found a lack of empirical studies not only on social, cultural and economic contexts, but also on specific interventions for particular settings and sub-populations. This study highlights certain gaps and provides a basis for future studies and interventions on this critical issue given the changing drivers of HIV epidemics.

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          Most cited references22

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            HIV-related stigma as a barrier to achievement of global PMTCT and maternal health goals: a review of the evidence.

            The global community has set goals of virtual elimination of new child HIV infections and 50 percent reduction in HIV-related maternal mortality by the year 2015. Although much progress has been made in expanding prevention of mother-to-child transmission (PMTCT) services, there are serious challenges to these global goals, given low rates of utilization of PMTCT services in many settings. We reviewed the literature from low-income settings to examine how HIV-related stigma affects utilization of the series of steps that women must complete for successful PMTCT. We found that stigma negatively impacts service uptake and adherence at each step of this "PMTCT cascade". Modeling exercises indicate that these effects are cumulative and therefore significantly affect rates of infant HIV infection. Alongside making clinical services more available, effective, and accessible for pregnant women, there is also a need to integrate stigma-reduction components into PMTCT, maternal, neonatal, and child health services.
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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                29 May 2019
                June 2019
                : 16
                : 11
                : 1899
                Affiliations
                [1 ]Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam
                [2 ]Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21206, USA; carl.latkin@ 123456jhu.edu
                [3 ]Institute for Global Health Innovations, Duy Tan University, Da Nang 550000, Vietnam; haipt.ighi@ 123456gmail.com (H.T.P.); huong.ighi@ 123456gmail.com (H.L.T.N.)
                [4 ]Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam 700000, Vietnam; chi.coentt@ 123456gmail.com (C.L.H.); pcmrhcm@ 123456nus.edu.sg (R.C.M.H.)
                [5 ]Department of Psychological Medicine, National University Hospital, Singapore 117599, Singapore; cyrushosh@ 123456gmail.com
                [6 ]Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117599, Singapore
                [7 ]Institute for Health Innovation and Technology (iHealthtech) National University of Singapore, Singapore 117599, Singapore
                Author notes
                [* ]Correspondence: bach.ipmph@ 123456gmail.com ; Tel.: +84-982228662
                Author information
                https://orcid.org/0000-0001-7827-8449
                https://orcid.org/0000-0002-7931-2116
                https://orcid.org/0000-0002-7092-9566
                https://orcid.org/0000-0001-9629-4493
                Article
                ijerph-16-01899
                10.3390/ijerph16111899
                6603743
                31146379
                6a8e3a23-add7-472e-b3e5-d0f0184eb54c
                © 2019 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 30 April 2019
                : 27 May 2019
                Categories
                Article

                Public health
                scientometrics,hiv,stigma,discrimination,contextual factors
                Public health
                scientometrics, hiv, stigma, discrimination, contextual factors

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