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"That person stopped being human": Intersecting HIV and substance use stigma among patients and providers in South Africa.
Drug Alcohol Depend. 2020 11 01; 216:108322.DA

Abstract

BACKGROUND

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.

METHODS

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.

FINDINGS

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.

CONCLUSIONS

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.

Links

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Authors+Show Affiliations

Regenauer KS
Department of Psychology, University of Maryland, 4094 Campus Drive, College Park, MD, 20740, USA. Electronic address: kregenau@terpmail.umd.edu.
Myers B
Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Francie Van Zyl Drive, Parow, 7505, South Africa; Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
Batchelder AW
Department of Psychiatry, Massachusetts General Hospital/ Harvard Medical School, 1 Bowdoin Square, Boston, MA, 02114, USA.
Magidson JF
Department of Psychology, University of Maryland, 4094 Campus Drive, College Park, MD, 20740, USA.

MeSH

Adaptation, PsychologicalAdultAttitude of Health PersonnelFemaleHIV InfectionsHealth PersonnelHumansMaleMedication AdherenceMiddle AgedSocial StigmaSouth AfricaSubstance-Related Disorders

Pub Type(s)

Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

33010712

Citation

Regenauer, Kristen S., et al. ""That Person Stopped Being Human": Intersecting HIV and Substance Use Stigma Among Patients and Providers in South Africa." Drug and Alcohol Dependence, vol. 216, 2020, p. 108322.
Regenauer KS, Myers B, Batchelder AW, et al. "That person stopped being human": Intersecting HIV and substance use stigma among patients and providers in South Africa. Drug Alcohol Depend. 2020;216:108322.
Regenauer, K. S., Myers, B., Batchelder, A. W., & Magidson, J. F. (2020). "That person stopped being human": Intersecting HIV and substance use stigma among patients and providers in South Africa. Drug and Alcohol Dependence, 216, 108322. https://doi.org/10.1016/j.drugalcdep.2020.108322
Regenauer KS, et al. "That Person Stopped Being Human": Intersecting HIV and Substance Use Stigma Among Patients and Providers in South Africa. Drug Alcohol Depend. 2020 11 1;216:108322. PubMed PMID: 33010712.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - "That person stopped being human": Intersecting HIV and substance use stigma among patients and providers in South Africa. AU - Regenauer,Kristen S, AU - Myers,Bronwyn, AU - Batchelder,Abigail W, AU - Magidson,Jessica F, Y1 - 2020/09/25/ PY - 2020/04/29/received PY - 2020/09/17/revised PY - 2020/09/18/accepted PY - 2020/10/4/pubmed PY - 2021/4/7/medline PY - 2020/10/3/entrez KW - Global mental health KW - HIV stigma KW - HIV/AIDS KW - South Africa KW - Substance use KW - Substance use stigma SP - 108322 EP - 108322 JF - Drug and alcohol dependence JO - Drug Alcohol Depend VL - 216 N2 - BACKGROUND: 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. METHODS: 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. FINDINGS: 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. CONCLUSIONS: 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. SN - 1879-0046 UR - https://www.unboundmedicine.com/medline/citation/33010712/"That_person_stopped_being_human":_Intersecting_HIV_and_substance_use_stigma_among_patients_and_providers_in_South_Africa_ DB - PRIME DP - Unbound Medicine ER -
Grapherence [↓14 ↑33]

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