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      Relatos sobre um livro com experiências de estigma/discriminação de Pessoas Vivendo com HIV/AIDS no Brasil Translated title: Reports on a book with situations of stigma/discrimination of People Living With HIV/ AIDS in Brazil

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          Abstract

          RESUMO Ao longo de 2021, no âmbito de atividades da Associação Brasileira Interdisciplinar de AIDS, foi desenvolvido o projeto ‘E se fosse com você? Histórias vividas de estigma e discriminação em 40 anos de HIV/AIDS’. O projeto buscou reunir histórias reais de estigma e discriminação, bem como mostrar traumáticas experiências vividas pelas pessoas com HIV/AIDS, para estimular a empatia e a solidariedade em torno do grupo. Este texto é um relato sobre a experiência do projeto, realizado por chamada de voluntários nas redes sociais da Associação. Entre estes, foram selecionados dez indivíduos, considerando tipos de situações vividas, faixas etárias, gêneros, raças, orientações sexuais e regiões de origem, para tentar mostrar diferentes aspectos de viver com HIV/AIDS no Brasil. No intuito de nortear as entrevistas, foi preparado roteiro semiestruturado, com dezenas de perguntas adaptadas a individualidades de cada participante, para abordar diferentes histórias. A partir das entrevistas, foram escritas dez histórias diferentes, pontuando situações de estigma e discriminação em distintos momentos da vida, assim como quadros de enfrentamento e resistência. Por ocasião do Dia Mundial de Luta contra a AIDS em 2021, o livro foi lançado no seminário ‘Refazendo a Prevenção’, da mesma Associação, e está disponível para baixar gratuitamente.

          Translated abstract

          ABSTRACT Related to the activities of the Brazilian Interdisciplinary AIDS Association in 2021, the project ‘What if it was with you? Lived Stories of Stigma and Discrimination in 40 Years of HIV/AIDS’ was developed. The project aimed gathering real stories of stigma and discrimination, but also presenting the traumatic experiences lived by people with HIV/AIDS, and stimulating empathy and solidarity around the group. This article is a report on the experience of the project, carried out by calling volunteers on the social networks of the Association. Among the volunteers, ten individuals were selected, considering types of situations experienced, age groups, genders, races, sexual orientations, and origin, trying to show different aspects of living with HIV/AIDS in Brazil. To guide the interviews, a semi-structured script was prepared, with dozens of questions adapted to the individualities of each participant, to address different life stories. From the interviews, ten different stories were written, punctuating situations of stigma and discrimination, in different moments of life, as well as frames of confrontation and resistance. On the occasion of World AIDS Day in 2021, the book was launched at the same Association’s seminar ‘Refazendo a Prevenção’, and it is available for free download.

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          Memória, Esquecimento, Silêncio.

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            Barriers and Facilitators of Adherence to Antiretroviral Drug Therapy and Retention in Care among Adult HIV-Positive Patients: A Qualitative Study from Ethiopia

            Background Antiretroviral therapy (ART) has been life saving for hundreds of thousands of Ethiopians. With increased availability of ART in recent years, achievement of optimal adherence and patient retention are becoming the greatest challenges in the management of HIV/AIDS in Ethiopia. However, few studies have explored factors influencing medication adherence to ART and retention in follow-up care among adult Ethiopian HIV-positive patients, especially in the Amhara region of the country, where almost one-third of the country’s ART is prescribed. The aim of this qualitative study was to collect such data from patients and healthcare providers in the Amhara region of Ethiopia. Methods Semi-structured interviews were conducted with 24 patients, of whom 11 had been lost to follow-up and were non-persistent with ART. In addition, focus group discussions were performed with 15 ART nurses and 19 case managers. All interviews and focus groups were audio-recorded, transcribed, and coded for themes and patterns in Amharic using a grounded theory approach. The emergent concepts and categories were translated into English. Results Economic constraints, perceived stigma and discrimination, fasting, holy water, medication side effects, and dissatisfaction with healthcare services were major reasons for patients being non-adherent and lost to follow-up. Disclosure of HIV status, social support, use of reminder aids, responsibility for raising children, improved health on ART, and receiving education and counseling emerged as facilitators of adherence to ART. Conclusions Improving adherence and retention requires integration of enhanced treatment access with improved job and food security. Healthcare providers need to be supported to better equip patients to cope with the issues associated with ART. Development of social policies and cooperation between various agencies are required to facilitate optimal adherence to ART, patient retention, and improved patient outcomes.
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              Significant association between perceived HIV related stigma and late presentation for HIV/AIDS care in low and middle-income countries: A systematic review and meta-analysis

              Background Late presentation for human immunodeficiency virus (HIV) care is a major impediment for the success of antiretroviral therapy (ART) outcomes. The role that stigma plays as a potential barrier to timely diagnosis and treatment of HIV among people living with HIV/AIDS (acquired immunodeficiency syndrome) is ambivalent. This review aimed to assess the best available evidence regarding the association between perceived HIV related stigma and time to present for HIV/AIDS care. Methods Quantitative studies conducted in English language between 2002 and 2016 that evaluated the association between HIV related stigma and late presentation for HIV care were sought across four major databases. This review considered studies that included the following outcome: ‘late HIV testing’, ‘late HIV diagnosis’ and ‘late presentation for HIV care after testing’. Data were extracted using a standardized Joanna Briggs Institute (JBI) data extraction tool. Meta- analysis was undertaken using Revman-5 software. I2 and chi-square test were used to assess heterogeneity. Summary statistics were expressed as pooled odds ratio with 95% confidence intervals and corresponding p-value. Results Ten studies from low- and middle- income countries met the search criteria, including six (6) and four (4) case control studies and cross-sectional studies respectively. The total sample size in the included studies was 3,788 participants. Half (5) of the studies reported a significant association between stigma and late presentation for HIV care. The meta-analytical association showed that people who perceived high HIV related stigma had two times more probability of late presentation for HIV care than who perceived low stigma (pooled odds ratio = 2.4; 95%CI: 1.6–3.6, I2 = 79%). Conclusions High perceptions of HIV related stigma influenced timely presentation for HIV care. In order to avoid late HIV care presentation due the fear of stigma among patients, health professionals should play a key role in informing and counselling patients on the benefits of early HIV testing or early entry to HIV care. Additionally, linking the systems and positive case tracing after HIV testing should be strengthened.
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                Author and article information

                Journal
                sdeb
                Saúde em Debate
                Saúde debate
                Centro Brasileiro de Estudos de Saúde (Rio de Janeiro, RJ, Brazil )
                0103-1104
                2358-2898
                2022
                : 46
                : spe7
                : 264-276
                Affiliations
                [1] Rio de Janeiro RJ orgnameAssociação Brasileira Interdisciplinar de AIDS (ABIA) Brasil danisorris@ 123456hotmail.com
                Article
                S0103-11042022001200264 S0103-1104(22)04600700264
                10.1590/0103-11042022e719
                1391fea4-3452-4ea1-af27-9128ac5369ce

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 15 March 2022
                : 20 September 2022
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 22, Pages: 13
                Product

                SciELO Public Health

                Categories
                Relato de Experiência

                Estigma social,Brazil,Life history traits,Social discrimination,Social stigma,HIV,Brasil,Traços de história de vida,Discriminação social

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