"That person stopped being human": Intersecting HIV and substance use stigma among patients and providers in South Africa.

Journal: Drug and alcohol dependence

Volume: 216

Issue: 

Year of Publication: 2021

Affiliated Institutions:  Department of Psychology, University of Maryland, Campus Drive, College Park, MD, , USA. Electronic address: kregenau@terpmail.umd.edu. Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Francie Van Zyl Drive, Parow, , South Africa; Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa. Department of Psychiatry, Massachusetts General Hospital/ Harvard Medical School, Bowdoin Square, Boston, MA, , USA. Department of Psychology, University of Maryland, Campus Drive, College Park, MD, , USA.

Abstract summary 

South Africa has the largest number of people living with HIV in the world. Concurrently, problematic alcohol and other drug use (AOD) is prevalent in the country and associated with poor HIV treatment outcomes. Further, the high rates of stigma surrounding HIV and AOD contribute to poor HIV outcomes. Yet, how HIV stigma and AOD stigma together may affect HIV care has not been extensively studied in this context. Thus, we explored HIV and AOD providers' and patients' experiences of HIV and AOD stigma.We conducted 30 semi-structured interviews with patients living with HIV who were struggling with HIV medication adherence and problematic AOD use (n = 19), and providers involved in HIV or AOD treatment (n = 11) in Cape Town, South Africa to assess how HIV and AOD stigmas manifest and relate to HIV care.Two main themes around the intersection of HIV and AOD and their related stigmas were identified: (1) how patients use AOD to cope with HIV stigma; and (2) enacted/ anticipated AOD stigma from HIV care providers, which acts as a barrier to HIV care.Intersecting HIV and AOD stigmas exist at multiple levels and increase barriers to HIV care in this setting. Accordingly, it is important that future interventions address both these stigmas at multiple levels.

Authors & Co-authors:  Regenauer Kristen S KS Myers Bronwyn B Batchelder Abigail W AW Magidson Jessica F JF

Study Outcome 

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Citations :  Azar MM, Springer SA, Meyer JP, Altice FL, 2010. A systematic review of the impact of alcohol use disorders on HIV treatment outcomes, adherence to antiretroviral therapy and health care utilization. Drug Alcohol Depend. 10.1016/j.drugalcdep.2010.06.014
Authors :  4
Identifiers
Doi : 10.1016/j.drugalcdep.2020.108322
SSN : 1879-0046
Study Population
Male,Female
Mesh Terms
Adaptation, Psychological
Other Terms
Global mental health;HIV stigma;HIV/AIDS;South Africa;Substance use;Substance use stigma
Study Design
Cross Sectional Study
Study Approach
Country of Study
South Africa
Publication Country
Ireland