Marija Pantelic|Janina Steinert|Jay Park|Shaun Mellors|Fungai Murau
‘Management of a spoiled identity’: systematic review of interventions to address self-stigma among people living with and affected by HIV
Oxford Policy Management|University of Oxford|University of Göttingen|University of British Columbia
background selfstigma also known internalised stigma global public health threat keeps people accessing hiv health services hampering hiv testing treatment prevention selfstigma compromise sustainability health interventions serious epidemiological consequences review synthesised existing evidence interventions aiming reduce selfstigma experienced people living hiv key populations affected hiv lowincome middleincome countries methods studies identified bibliographic databases grey literature sites study registries back referencing contacts researchers synthesised following cochrane guidelines results 5880 potentially relevant titles 20 studies included review represented studies 9536 people 65 women ethiopia india kenya lesotho malawi nepal south africa swaziland tanzania thailand uganda vietnam seventeen studies recruited people living hiv five focused specifically pregnant women remaining three studies focused young men sex men female sex workers men inject drugs studies clustered four categories based socioecological level risk resilience targeted 1 individual level 2 individual relational levels 3 individual structural levels 4 structural level thirteen studies targeting structural risks without individual components consistently produced significant reductions selfstigma remaining seven studies include component address structural risks produced mixed effects conclusion structural interventions scaleup antiretroviral treatment prevention medication stockouts social empowerment economic strengthening may help substantially reduce selfstigma among individuals research urgently needed understand reduce selfstigma among young people key populations well tackle intersectional selfstigma