Impact of a multicomponent navigation strategy on stigma among people living with HIV and Kaposi's sarcoma in Kenya: a qualitative analysis.
Sigrid Marie CollierAggrey S SemeereLinda ChemtaiHelen ByakwagaCelestine LagatMiriam Laker-OkettaJuliet BramanteAnn PachecoMorvarid ZehtabAlexis G StrahanMerridy GrantLaura M BogartIngrid V BassettNaftali BusakhalaJesse OpakasToby MaurerJeffrey N MartinSamson K KipronoEsther E FreemanPublished in: Journal of the National Cancer Institute. Monographs (2024)
Persons with HIV-associated Kaposi's sarcoma (KS) experience three co-existing stigmatizing health conditions: skin disease, HIV, and cancer, which contribute to a complex experience of stigmatization and to delays in diagnosis and treatment. Despite the importance of stigma among these patients, there are few proven stigma-reduction strategies for HIV-associated malignancies. Using qualitative methods, we explore how people with HIV-associated KS in western Kenya between August 2022 and 2023 describe changes in their stigma experience after participation in a multicomponent navigation strategy, which included 1) physical navigation and care coordination, 2) video-based education with motivational survivor stories, 3) travel stipend, 4) health insurance enrollment assistance, 5) health insurance stipend, and 6) peer mentorship. A purposive sample of persons at different stages of chemotherapy treatment were invited to participate. Participants described how a multicomponent navigation strategy contributed to increased knowledge and awareness, a sense of belonging, hope to survive, encouragement, and social support, which served as stigma mitigators, likely counteracting the major drivers of intersectional stigma in HIV-associated KS.
Keyphrases
- hiv aids
- social support
- health insurance
- antiretroviral therapy
- hiv positive
- mental health
- hiv infected
- human immunodeficiency virus
- hiv testing
- mental illness
- healthcare
- affordable care act
- depressive symptoms
- hepatitis c virus
- men who have sex with men
- physical activity
- south africa
- public health
- palliative care
- quality improvement
- squamous cell carcinoma
- radiation therapy
- risk assessment
- climate change
- papillary thyroid
- chronic pain
- patient reported outcomes
- lymph node metastasis
- health information