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dc.contributor.authorMagidson, Jessica F
dc.contributor.authorRose, Alexandra L
dc.contributor.authorRegenauer, Kristen S
dc.contributor.authorBrooke-Sumner, Carrie
dc.contributor.authorAnvari, Morgan S
dc.contributor.authorJack, Helen E
dc.contributor.authorJohnson, Kim
dc.contributor.authorBelus, Jennifer M
dc.contributor.authorJoska, John
dc.contributor.authorBassett, Ingrid V
dc.contributor.authorSibeko, Goodman
dc.contributor.authorMyers-Franchi, Bronwyn
dc.date.accessioned2022-09-27T07:46:59Z
dc.date.available2022-09-27T07:46:59Z
dc.date.issued2022
dc.identifier.citationMagidson, J.F. and Rose, A.L. and Regenauer, K.S. and Brooke-Sumner, C. and Anvari, M.S. and Jack, H.E. and Johnson, K. et al. 2022. "It's all about asking from those who have walked the path": Patient and stakeholder perspectives on how peers may shift substance use stigma in HIV care in South Africa. Addiction Science & Clinical Practice. 17 (1): 52.
dc.identifier.urihttp://hdl.handle.net/20.500.11937/89367
dc.identifier.doi10.1186/s13722-022-00330-5
dc.description.abstract

BACKGROUND: South Africa has the highest number of people with HIV (PWH) globally and a significant burden of co-occurring substance use disorder (SUD). Health care worker (HCW) stigma towards SUD is a key barrier to HIV care engagement among PWH with SUD. Support from peers-individuals with lived experience of SUD-may be a promising solution for addressing SUD stigma, while also improving engagement in HIV care. We evaluated the perceived acceptability of integrating a peer role into community-based HIV care teams as a strategy to address SUD stigma at multiple levels and improve patient engagement in HIV care.

METHODS: Patients and stakeholders (N = 40) were recruited from publicly-funded HIV and SUD organizations in Cape Town, South Africa. We conducted a quantitative assessment of stigma among stakeholders using an adapted Social Distance Scale (SDS) and patient perceptions of working with a peer, as well as semi-structured interviews focused on experiences of SUD stigma, acceptability of a peer model integrated into community-based HIV care, and potential peer roles.

RESULTS: On the SDS, 75% of stakeholders had high stigma towards a patient with SUD, yet 90% had low stigma when in recovery for at least 2 years. All patients endorsed feeling comfortable talking to someone in recovery and wanting them on their HIV care team. Three main themes emerged from the qualitative data: (1) patient-reported experiences of enacted SUD and HIV stigmas were common and impacted HIV care engagement; (2) both patients and stakeholders considered a peer model highly acceptable for integration into HIV care to support engagement and address SUD stigma; and (3) patients and stakeholders identified both individual-level and systems-level roles for peers, how peers could work alongside other providers to improve patient care, and key characteristics that peers would need to be successful in these roles.

CONCLUSIONS: Findings from this formative work point to the promise of a peer model for reducing SUD stigma among patients and HCWs within community-based HIV care teams in SA.

dc.languageeng
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectGlobal mental health
dc.subjectHIV stigma
dc.subjectImplementation science
dc.subjectPeer
dc.subjectSubstance use stigma
dc.subjectSubstance use treatment
dc.subjectHIV Infections
dc.subjectHumans
dc.subjectQualitative Research
dc.subjectSocial Stigma
dc.subjectSouth Africa
dc.subjectSubstance-Related Disorders
dc.title"It's all about asking from those who have walked the path": Patient and stakeholder perspectives on how peers may shift substance use stigma in HIV care in South Africa.
dc.typeJournal Article
dcterms.source.volume17
dcterms.source.number1
dcterms.source.startPage52
dcterms.source.issn1940-0632
dcterms.source.titleAddiction Science & Clinical Practice
dc.date.updated2022-09-27T07:46:44Z
curtin.departmentEnAble Institute
curtin.accessStatusOpen access
curtin.facultyFaculty of Health Sciences
dcterms.source.eissn1940-0640
curtin.contributor.scopusauthoridMyers-Franchi, Bronwyn [7202684194]


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