Unpacking the "backpack of shame": Exploring intersections of stigma among Latinx people living with HIV in San Francisco, CA.

OBJECTIVE: Ending the HIV epidemic requires addressing structural determinants of health, including stigma. In this qualitative study, we applied an intersectional framework to study various forms of stigma among Latinx people living with HIV (PLWH). METHOD: We conducted focus groups and individual interviews with Spanish- and English-speaking Latinx PLWH (N = 19) at an HIV safety-net clinic in San Francisco, California. Using thematic analysis, we identified co-occurring forms of stigma impacting the participants' lives. RESULTS: Participants described the weight of co-occuring stigma related to their multiple identities, including homophobia and HIV-related stigma, both of which participants experienced in the U.S. and in their Latin American home countries. Importantly, many participants faced anti-immigrant stigma in their day-to-day interactions, which manifested as structural inequities such as difficulty finding stable housing and employment. CONCLUSIONS: Our findings illustrate experiences of intersectional stigma and systems of oppression. They can be used to inform policies that address social exclusion, discrimination, and stigma among Latinx PLWH. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Framing a Consent Form to Improve Consent Understanding and Determine How This Affects Willingness to Participate in HIV Cure Research: An Experimental Survey Study.

HIV cure research carries serious risks and negligible benefits. We investigated how participants understand these risks and what influences their willingness to participate. Through internet-based and in-person convenience sampling, 86 HIV+ participants completed an experimental survey. Participants were randomized to read a standard consent form describing a hypothetical HIV cure study or one adapted using Fuzzy Trace Theory-a decision-making model to facilitate complex information processing. We measured consent understanding and cognitive (e.g., safe/harmful) and affective (e.g., concerning, satisfying) evaluations of HIV cure research. Participants who read the adapted consent form had improved consent understanding, but only positive affective evaluations were associated with a willingness to participate. Consent processes can use decision-making theories to facilitate comprehension of study information.