February 1, 2019
In a recent bibliometric analysis of global literature from 1980 to 2017 in AIDS-related stigma and discrimination,
Xiaoming Li, professor of health promotion, education, and behavior and Endowed Chair and founding director of the South Carolina SmartState Center for Healthcare Quality (CHQ), was identified as the world’s most active author in the field. The analysis
was published in Translational Behavioral Medicine, Practice, Policy, Research, which
is one of the two peer-reviewed journals published by the Society of Behavioral Medicine.
Leading the effort to end stigma and discrimination
With a goal to create an analytical inventory of worldwide research output in AIDS-related stigma and discrimination, author Waleed Sweileh used the SciVerse Scopus, one of the largest electronic databases in the world, to retrieve documents in AIDS-related stigma and discrimination. He retrieved a total of 2,509 documents with approximately 40 percent of them published between 2013 and 2017.
Sweileh also identified the ten most active countries, ten most active institutions
and ten most active authors. Li was ranked 1st among the ten most active authors with a total of 39 identified publications (1.6
percent of the total worldwide documents identified by the author). His long-term
collaborator, Bonita Stanton, professor of pediatrics and the Founding Dean of the Hackensack-Meridian School
of Medicine at Seton Hall University, was named 6th in the same report.
A continuing epidemic
“Despite nearly four decades of research, policy and community efforts, the HIV epidemic perseveres, with nearly 37 million people currently living with HIV across the globe,” says Li. “Highly effective antiretroviral medications have been developed that can suppress the virus and prevent it from being transmitted to others, yet large gaps remain in their acceptance and use.”
Worldwide, only about half the people living with HIV are in treatment and virally suppressed. Stigma and discrimination against people living with HIV—often referred to as “HIV-related stigma”—have persisted in the U.S. and around the world since the first HIV case was reported in 1981.
“HIV-related stigma impedes preventive health behaviors such as testing, prevents
people living with HIV from disclosing their HIV status to others, reduces HIV care-seeking,
and negatively impacts the overall quality of life for people living with HIV and
their families,” Li adds. “Thus, even though we now have the biomedical tools necessary
to effectively ‘end the epidemic’ within one generation, this is unlikely to happen—largely
due to psychosocial and systemic barriers, such as AIDS-related stigma and discrimination
encountered by people living with HIV and their families and communities.”
HIV/AIDS in South Carolina
Since joining the Arnold School in 2015, Li and his CHQ colleagues have actively participated in research and community outreach efforts to fight against AIDS-related stigma and other barriers in both international and domestic settings, including South Carolina. The first AIDS case in South Carolina was documented in 1981. Today, nearly 19,000 South Carolinians are living with HIV.
This number continues to grow, with an average of 66 new diagnoses per month in South Carolina in 2016. South Carolina now ranks 8th among all U.S. states for HIV rates, with Columbia consistently ranking in the top 15 among all U.S. metropolitan areas for both HIV and AIDS rates.
“Like many of our state’s other health disparities, HIV is an unevenly distributed epidemic, with our most vulnerable populations often experiencing the highest risk and the poorest outcomes,” says Li. “In South Carolina, HIV continues to disproportionately impact people of color, as well as sexual and gender minority groups.”
“The impacts of HIV are far-reaching, affecting not only the individuals who are living
with the virus, but also their partners, families, friends, and communities,” Arnold
School Dean Tomas Chandler said to a group of healthcare providers, HIV researchers, community activists, state
agencies and people who are living with HIV in November at a UofSC event in honor
of World AIDS Day. “People living with HIV must cope with the health and healthcare-related
challenges associated with the virus, and also with HIV stigma and discrimination
which continue to be far too prevalent. In order to stop the HIV epidemic, we must
redouble our efforts for HIV prevention and intervention, including stigma reduction,
here in South Carolina and around the globe.”
About Xiaoming Li
With a background in computational mathematics and educational psychology, Li has worked with interdisciplinary teams of physicians, psychologists and other healthcare professionals in health-related research for over 26 years. He is an internationally recognized leader in HIV prevention intervention, having published >480 peer-reviewed articles, book chapters, and special reports with > 15,000 citations and an H-index of 65.
Li and his team have worked on National Institutes of Health (NIH)-funded HIV research since 1992, with his first stigma-specific grant awarded by NIH in 2003. They are currently funded by the NIH and China’s National Science Foundation to study the impact of HIV-related stigma on people living with HIV’s clinical outcomes and the mechanisms of such impacts in the U.S. and China.
His HIV-related research has spanned multiple cultural settings (e.g., urban and rural areas in the U.S., China, The Bahamas, Mexico, India, Viet Nam, Namibia, Nigeria, Zambia) and has generated valuable insights into multiple aspects of HIV-related stigma. One recent example of his work is a cross-national investigation of the association between HIV prevalence and levels of stigma in 42 countries using the UNAIDS’ global HIV epidemiological data and the World Value Survey.