“It’s all about asking from those who have walked the path”: Patient and stakeholder perspectives on how peers may shift substance use stigma in HIV care in South Africa

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dc.contributor.authorMagidson, Jessica F.
dc.contributor.authorRose, Alexandra L.
dc.contributor.authorRegenauer, Kristen S.
dc.contributor.authorBrooke-Sumner, Carrie
dc.contributor.authorAnvari, Morgan S.
dc.contributor.authorJack, Helen E.
dc.contributor.authorJohnson, Kim
dc.contributor.authorBelus, Jennifer M.
dc.contributor.authorJoska, John
dc.contributor.authorBassett, Ingrid V.
dc.contributor.authorSibeko, Goodman
dc.contributor.authorMyers, Bronwyn
dc.date.accessioned2023-09-18T11:20:14Z
dc.date.available2023-09-18T11:20:14Z
dc.date.issued2022-09-21
dc.date.updated2022-09-26T07:37:21Z
dc.description.abstractBackground South Africa has the highest number of people with HIV (PWH) globally and a significant burden of co-occurring substance use disorder (SUD). Health care worker (HCW) stigma towards SUD is a key barrier to HIV care engagement among PWH with SUD. Support from peers—individuals with lived experience of SUD—may be a promising solution for addressing SUD stigma, while also improving engagement in HIV care. We evaluated the perceived acceptability of integrating a peer role into community-based HIV care teams as a strategy to address SUD stigma at multiple levels and improve patient engagement in HIV care. Methods Patients and stakeholders (N = 40) were recruited from publicly-funded HIV and SUD organizations in Cape Town, South Africa. We conducted a quantitative assessment of stigma among stakeholders using an adapted Social Distance Scale (SDS) and patient perceptions of working with a peer, as well as semi-structured interviews focused on experiences of SUD stigma, acceptability of a peer model integrated into community-based HIV care, and potential peer roles. Results On the SDS, 75% of stakeholders had high stigma towards a patient with SUD, yet 90% had low stigma when in recovery for at least 2 years. All patients endorsed feeling comfortable talking to someone in recovery and wanting them on their HIV care team. Three main themes emerged from the qualitative data: (1) patient-reported experiences of enacted SUD and HIV stigmas were common and impacted HIV care engagement; (2) both patients and stakeholders considered a peer model highly acceptable for integration into HIV care to support engagement and address SUD stigma; and (3) patients and stakeholders identified both individual-level and systems-level roles for peers, how peers could work alongside other providers to improve patient care, and key characteristics that peers would need to be successful in these roles. Conclusions Findings from this formative work point to the promise of a peer model for reducing SUD stigma among patients and HCWs within community-based HIV care teams in SA.
dc.identifier.apacitationMagidson, Jessica F., Rose, Alexandra L., Regenauer, Kristen S., Brooke-Sumner, C., Anvari, Morgan S., Jack, Helen E., ... Myers, B. (2022). “It’s all about asking from those who have walked the path”: Patient and stakeholder perspectives on how peers may shift substance use stigma in HIV care in South Africa. <i>Addiction Science & Clinical Practice</i>, 17(1), 52. http://hdl.handle.net/11427/38731en_ZA
dc.identifier.chicagocitationMagidson, Jessica F., Alexandra L. Rose, Kristen S. Regenauer, Carrie Brooke-Sumner, Morgan S. Anvari, Helen E. Jack, Kim Johnson, et al "“It’s all about asking from those who have walked the path”: Patient and stakeholder perspectives on how peers may shift substance use stigma in HIV care in South Africa." <i>Addiction Science & Clinical Practice</i> 17, 1. (2022): 52. http://hdl.handle.net/11427/38731en_ZA
dc.identifier.citationMagidson, Jessica F., Rose, Alexandra L., Regenauer, Kristen S., Brooke-Sumner, C., Anvari, Morgan S., Jack, Helen E., Johnson, K. & Belus, Jennifer M. et al. 2022. “It’s all about asking from those who have walked the path”: Patient and stakeholder perspectives on how peers may shift substance use stigma in HIV care in South Africa. <i>Addiction Science & Clinical Practice.</i> 17(1):52. http://hdl.handle.net/11427/38731en_ZA
dc.identifier.ris TY - Journal Article AU - Magidson, Jessica F. AU - Rose, Alexandra L. AU - Regenauer, Kristen S. AU - Brooke-Sumner, Carrie AU - Anvari, Morgan S. AU - Jack, Helen E. AU - Johnson, Kim AU - Belus, Jennifer M. AU - Joska, John AU - Bassett, Ingrid V. AU - Sibeko, Goodman AU - Myers, Bronwyn AB - Background South Africa has the highest number of people with HIV (PWH) globally and a significant burden of co-occurring substance use disorder (SUD). Health care worker (HCW) stigma towards SUD is a key barrier to HIV care engagement among PWH with SUD. Support from peers—individuals with lived experience of SUD—may be a promising solution for addressing SUD stigma, while also improving engagement in HIV care. We evaluated the perceived acceptability of integrating a peer role into community-based HIV care teams as a strategy to address SUD stigma at multiple levels and improve patient engagement in HIV care. Methods Patients and stakeholders (N = 40) were recruited from publicly-funded HIV and SUD organizations in Cape Town, South Africa. We conducted a quantitative assessment of stigma among stakeholders using an adapted Social Distance Scale (SDS) and patient perceptions of working with a peer, as well as semi-structured interviews focused on experiences of SUD stigma, acceptability of a peer model integrated into community-based HIV care, and potential peer roles. Results On the SDS, 75% of stakeholders had high stigma towards a patient with SUD, yet 90% had low stigma when in recovery for at least 2 years. All patients endorsed feeling comfortable talking to someone in recovery and wanting them on their HIV care team. Three main themes emerged from the qualitative data: (1) patient-reported experiences of enacted SUD and HIV stigmas were common and impacted HIV care engagement; (2) both patients and stakeholders considered a peer model highly acceptable for integration into HIV care to support engagement and address SUD stigma; and (3) patients and stakeholders identified both individual-level and systems-level roles for peers, how peers could work alongside other providers to improve patient care, and key characteristics that peers would need to be successful in these roles. Conclusions Findings from this formative work point to the promise of a peer model for reducing SUD stigma among patients and HCWs within community-based HIV care teams in SA. DA - 2022-09-21 DB - OpenUCT DP - University of Cape Town IS - 1 J1 - Addiction Science & Clinical Practice KW - Peer KW - Substance use stigma KW - Substance use treatment KW - HIV stigma KW - Global mental health KW - Implementation science LK - https://open.uct.ac.za PY - 2022 T1 - “It’s all about asking from those who have walked the path”: Patient and stakeholder perspectives on how peers may shift substance use stigma in HIV care in South Africa TI - “It’s all about asking from those who have walked the path”: Patient and stakeholder perspectives on how peers may shift substance use stigma in HIV care in South Africa UR - http://hdl.handle.net/11427/38731 ER - en_ZA
dc.identifier.urihttps://doi.org/10.1186/s13722-022-00330-5
dc.identifier.urihttp://hdl.handle.net/11427/38731
dc.identifier.vancouvercitationMagidson Jessica F, Rose Alexandra L, Regenauer Kristen S, Brooke-Sumner C, Anvari Morgan S, Jack Helen E, et al. “It’s all about asking from those who have walked the path”: Patient and stakeholder perspectives on how peers may shift substance use stigma in HIV care in South Africa. Addiction Science & Clinical Practice. 2022;17(1):52. http://hdl.handle.net/11427/38731.en_ZA
dc.language.rfc3066en
dc.publisherBioMed Central
dc.publisher.departmentPsychiatry and Mental Health
dc.publisher.facultyHealth Sciences
dc.rights.holderThe Author(s)
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.sourceAddiction Science & Clinical Practice
dc.source.journalissue1
dc.source.journalvolume17
dc.source.pagination52
dc.source.urihttps://ascpjournal.biomedcentral.com/
dc.subjectPeer
dc.subjectSubstance use stigma
dc.subjectSubstance use treatment
dc.subjectHIV stigma
dc.subjectGlobal mental health
dc.subjectImplementation science
dc.title“It’s all about asking from those who have walked the path”: Patient and stakeholder perspectives on how peers may shift substance use stigma in HIV care in South Africa
dc.typeJournal Article
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