Changes in HIV Internalized and Experienced Stigmas and Social Support After an Urban Gardens and Peer Nutritional Counseling Intervention Among People With HIV and Food Insecurity in the Dominican Republic

被引:0
|
作者
Derose, Kathryn P. [1 ,2 ,3 ]
Palar, Kartika [4 ]
Then-Paulino, Amarilis [5 ]
Han, Bing [2 ,3 ,6 ]
Armenta, Gabriela [2 ,3 ]
Celeste-Villalvir, Alane [1 ,7 ]
Sheira, Lila A. [8 ]
Jimenez-Paulino, Gipsy [5 ]
Donastorg, Yeycy [8 ,10 ]
Acevedo, Ramon [8 ]
Farias, Hugo [9 ,11 ]
Wagner, Glenn J. [2 ,3 ]
机构
[1] Univ Massachusetts, Dept Hlth Promot & Policy, 715 N Pleasant St, Amherst, MA 01003 USA
[2] RAND Corp, Santa Monica, CA USA
[3] Pardee RAND Grad Sch, Santa Monica, CA USA
[4] Univ Calif San Francisco, Dept Med, San Francisco, CA USA
[5] Univ Autonoma Santo Domingo, Fac Ciencias Salud, St oDomingo, Santo Domingo, Dominican Rep
[6] Kaiser Permanente Southern Calif, Pasadena, CA USA
[7] Praxis Project, Oakland, CA USA
[8] Univ Calif San Francisco, Inst Hlth & Aging, Sch Nursing, San Francisco, CA USA
[9] Consejo Nacl deVIH SIDA CONAVIHSIDA, Santo Domingo, Dominican Rep
[10] Inst Dermatol Dominicano & Cirugia Piel Dr Huberto, Unidad Vacunas & Invest, Santo Domingo, Dominican Rep
[11] World Food Programme, Reg Off Latin Amer & Caribbean, Panama City, Panama
基金
美国国家卫生研究院;
关键词
food security; structural interventions; HIV-related stigma; social support; Dominican Republic; INFECTED INDIVIDUALS; VIRAL SUPPRESSION; HIV/AIDS STIGMA; ADHERENCE; OUTCOMES; HEALTH; WOMEN; DETERMINANTS; ASSOCIATION; INSTRUMENT;
D O I
10.1097/QAI.0000000000003462
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Background:Food insecurity and HIV-related stigma negatively affect HIV outcomes. Few studies have examined how food security interventions affect HIV-related stigma and social support.Setting:Two HIV clinics in the Dominican Republic.Methods:A pilot cluster randomized controlled trial of an urban gardens and peer nutritional counseling intervention was conducted to examine outcomes of HIV-related stigmas and social support. Adult patients (>= 18 years of age) with moderate or severe household food insecurity and evidence of suboptimal ART adherence and/or a detectable viral load were enrolled; standard measures of internalized and experienced stigmas and social support were collected at baseline and at 6 and 12 months. Intervention clinic participants received training and materials from agronomists for a home garden, 3-4 sessions of nutritional counseling from the clinic's peer counselor, and a garden produce cooking workshop facilitated by professional nutritionists.Results:Of 109 study participants (46 intervention and 63 control), 103 (94%) completed 12-month follow-up. Difference-in-differences multivariate longitudinal linear regressions adjusting for sociodemographic factors found that intervention participants had reduced internalized stigma by 3.04 points (scale 0-32) at 12 months (P = 0.002); reduced probability of experiencing HIV-related stigma or discrimination in the past 6 months (20 percentage points at 6 months, P = 0.05 and 25 percentage points at 12 months, P = 0.02); and modestly improved social support at 12 months (1.85 points on 30-pt scale, P = 0.093).Conclusion:A fully powered, larger trial is needed to establish the efficacy of the intervention and assess pathways by which the intervention may improve HIV stigma and social support.
引用
收藏
页码:55 / 62
页数:8
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