"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.
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 e...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Journal Article |
| Language: | English |
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2022
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| Subjects: | |
| Online Access: | http://hdl.handle.net/20.500.11937/89367 |
| _version_ | 1848765208740233216 |
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| author | Magidson, Jessica F Rose, Alexandra L Regenauer, Kristen S Brooke-Sumner, Carrie Anvari, Morgan S Jack, Helen E Johnson, Kim Belus, Jennifer M Joska, John Bassett, Ingrid V Sibeko, Goodman Myers-Franchi, Bronwyn |
| author_facet | Magidson, Jessica F Rose, Alexandra L Regenauer, Kristen S Brooke-Sumner, Carrie Anvari, Morgan S Jack, Helen E Johnson, Kim Belus, Jennifer M Joska, John Bassett, Ingrid V Sibeko, Goodman Myers-Franchi, Bronwyn |
| author_sort | Magidson, Jessica F |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | 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. |
| first_indexed | 2025-11-14T11:31:36Z |
| format | Journal Article |
| id | curtin-20.500.11937-89367 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| language | eng |
| last_indexed | 2025-11-14T11:31:36Z |
| publishDate | 2022 |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-893672022-10-14T04:29:47Z "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. Magidson, Jessica F Rose, Alexandra L Regenauer, Kristen S Brooke-Sumner, Carrie Anvari, Morgan S Jack, Helen E Johnson, Kim Belus, Jennifer M Joska, John Bassett, Ingrid V Sibeko, Goodman Myers-Franchi, Bronwyn Global mental health HIV stigma Implementation science Peer Substance use stigma Substance use treatment HIV Infections Humans Qualitative Research Social Stigma South Africa Substance-Related Disorders 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. 2022 Journal Article http://hdl.handle.net/20.500.11937/89367 10.1186/s13722-022-00330-5 eng http://creativecommons.org/licenses/by/4.0/ fulltext |
| spellingShingle | Global mental health HIV stigma Implementation science Peer Substance use stigma Substance use treatment HIV Infections Humans Qualitative Research Social Stigma South Africa Substance-Related Disorders Magidson, Jessica F Rose, Alexandra L Regenauer, Kristen S Brooke-Sumner, Carrie Anvari, Morgan S Jack, Helen E Johnson, Kim Belus, Jennifer M Joska, John Bassett, Ingrid V Sibeko, Goodman Myers-Franchi, Bronwyn "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. |
| 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. |
| title_full | "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. |
| title_fullStr | "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. |
| title_full_unstemmed | "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. |
| title_short | "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. |
| title_sort | "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. |
| topic | Global mental health HIV stigma Implementation science Peer Substance use stigma Substance use treatment HIV Infections Humans Qualitative Research Social Stigma South Africa Substance-Related Disorders |
| url | http://hdl.handle.net/20.500.11937/89367 |