(Q30694)

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Intersecting Stigma and the HIV Care Cascade: Qualitative Insights from Sex Workers, Men who have Sex with Men, and Transgender Women Living with HIV in Jamaica. (English)
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In Jamaica, stigma experiences of sex workers (SW), gay men and other men who have sex with men (MSM), and transgender women living with HIV remain understudied. (English)
© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature. (English)
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To address this gap, we explored experiences of stigma and linkages with the HIV care cascade among key populations living with HIV in Jamaica, including cisgender women SW, MSM, and transgender women. (English)
© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature. (English)
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This qualitative study involved n = 9 focus groups (FG), n = 1 FG per population living with HIV (SW, MSM, transgender women) in each of three sites (Kingston, St. Ann, Montego Bay). (English)
© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature. (English)
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We also conducted key informant (KI) interviews. (English)
© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature. (English)
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We applied thematic analysis informed by the Health Stigma and Discrimination (HSD) Framework. (English)
© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature. (English)
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FG participants (n = 67) included SW (n = 18), MSM (n = 28), and trans women (n = 21); we interviewed n = 10 KI (n = 5 cisgender women, n = 5 cisgender men). (English)
© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature. (English)
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Participant discussions revealed that stigma drivers included low HIV treatment literacy, notably misinformation about antiretroviral therapy (ART) benefits and HIV acquisition risks, and a lack of legal protection from discrimination. (English)
© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature. (English)
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Stigma targets health (HIV) and intersecting social identities (sex work, LGBTQ identities, gender non-conformity, low socio-economic status). (English)
© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature. (English)
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Stigma manifestations included enacted stigma in communities and families, and internalized stigma-including lateral violence. (English)
© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature. (English)
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HIV care cascade impacts included reduced and/or delayed HIV care engagement and ART adherence challenges/disruptions. (English)
© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature. (English)
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Participants discussed strategies to live positively with HIV, including ART adherence as stigma resistance; social support and solidarity; and accessing affirming institutional support. (English)
© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature. (English)
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In addition to addressing intersecting stigma, future research and programing should bolster multi-level stigma-resistance strategies to live positively with HIV. (English)
© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature. (English)
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November 2024
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November 2024
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28
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11
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3768-3786
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3768
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3786
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