Stigma and HIV

Much of our work aims to understand and address stigma and health inequities across the HIV prevention and treatment cascade. Among people at risk for HIV, stigma associated with substance use disorders, race/ethnicity, gender identity, and other characteristics is related to behaviors that increase risk for HIV such as substance use and sex without condoms. Among people living with HIV, stigma associated with HIV is related to less engagement in treatment, less medication adherence, and worse wellbeing. We are collaborating on several projects related to HIV stigma.

Engagement in HIV care is important for maintaining the health and wellbeing of people living with HIV. Yet, approximately 60% of PLWH in the United States and 20% of PLWH in Delaware are not engaged in care. We are working with the Christiana Care HIV Community Program to compare barriers to HIV care engagement in Wilmington, Smyrna, and Georgetown, Delaware via qualitative interviews with people living with HIV and healthcare providers. These sites are proximal to the locations with the highest concentrations of HIV in the state and differ geographically and socio-culturally. Research comparing barriers, including experiences of stigma, can inform the adaptation of interventions to enhance engagement in care throughout the state of Delaware.

Black men who have sex with men experience an alarmingly high rate of HIV and STIs in the US. We are working with Lisa Eaton, PhD to develop and conduct structural and stigma-focused interventions to increase HIV and STI testing uptake among Black men who have sex with men. This study is funded by the National Institute of Mental Health (R01MH109409).

We are working with Chanelle Howe and Akilah Dulin Keita to develop a reliable and valid measure of individual, interpersonal, and neighborhood resilience among African Americans living with HIV. This measure may ultimately inform the development and implementation of novel multilevel resilience-related interventions to reduce persistent racial disparities in HIV disease. This study is funded by the National Institute of Mental Health (R01MH112386).