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Arnold School of Public Health

NIH funds new study on using resilience approaches to combat HIV stigma

January 14, 2022 | Erin Bluvas,

Researchers* at the South Carolina SmartState Center for Healthcare Quality (CHQ) will use a $3 million grant from the National Institute of Mental Health to determine whether a resilience-based approach can mitigate the negative effects of HIV-related stigma. By focusing on the development of strengths, competencies, resources and capacities of people living with HIV, their families and healthcare systems, the team aims to advance HIV management, decrease transmission and reduce adverse health outcomes.

“Stigma and discrimination related to HIV and AIDS have been identified worldwide as major barriers to HIV treatment and care, posing challenges to HIV prevention efforts and provision of adequate care, support and treatment,” says lead principal investigator Xiaoming Li, professor of health promotion, education, and behavior and director for CHQ. “Despite decades of global efforts to tackle HIV-related stigma, previous interventions designed to reduce stigma have been largely ineffective.”

Li and his team of health promotion, policy, psychology and epidemiology experts have determined that the complexity and diversity of stigma play important roles in the knowledge gaps and challenges related to addressing this issue. Their own preliminary research has demonstrated that resilience approaches show promise in the prevention, reduction and mitigation of the negative effects of stigma.

Over the next five years, CHQ researchers will conduct a randomized trial among 800 people living with HIV to assess the effectiveness of a resilience-based intervention developed by the team. Family members of origin/choice and healthcare providers will also participate in the study, which will take place in Guangxi, China. The team will design and test the intervention for improvements in viral suppression, resource availability, chronic stress response and adherence to treatment and care. 

Previous research has already demonstrated that we have the tools to manage HIV and prevent its transmission through antiretroviral therapy. A 2011 study (HPTN 052) led by the HIV Prevention Trials Network, for example, found a 96 percent reduction in HIV incidence among couples with only one HIV-positive partner.

This “treatment as prevention” approach has since emerged as the dominant strategy to ending the HIV epidemic worldwide. Yet, HIV-related stigma generates obstacles that prevent appropriate treatment and optimal clinical outcomes. This is particularly the case in low- and middle-income countries, such as China.

“HIV stigma interferes with seeking and receiving appropriate treatment and care, contributes to depression and other psychiatric disorders, lowers individuals’ quality of life, and produces worsening clinical outcomes,” says Li, who is the world’s most active author in AIDS-related stigma and discrimination. “Based on decades of research, we are hopeful that adopting a resilience-based approach will substantially improve the quality of treatment and care for people living with HIV across the globe.”

*The research team includes Xiaoming Li (principal investigator), Shan Qiao, (co-investigator), Sayward Harrison (co-investigator), Xueying Yang, and George Tam.


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