What do we know about interventions to reduce intersectional stigma and discrimination in the context of HIV? A systematic review.
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
There is ample literature on interventions to reduce human immunodeficiency virus (HIV) stigma and discrimination and extant theory around intersectionality. However, the integration of intersectionality into the design and implementation of stigma reduction interventions is nascent. Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we reviewed 23 studies from six countries to examine the state of the evidence on interventions to reduce intersectional stigma in the context of HIV. Thirteen studies made explicit reference to intersectionality, 11 of which addressed all three stigma domains: drivers, facilitators, and manifestations. Most interventions were multilevel and multistrategy, yet only five included a structural component. Thirteen studies focused on four or more intersections (e.g., HIV, race, sexual identity, gender), five on three intersections, and five on two intersections. Twenty studies (87%) reported medium (n = 5) to high (n = 15) community engagement. The majority of studies (19/23) assessed HIV-related (e.g., antiretroviral therapy [ART] adherence) and/or empowerment-based outcomes (e.g., self-esteem, coping), with 91% reporting some positive intervention effects. Of 13 studies that measured stigma outcomes, only seven (54%) documented some improvement in the stigma measures assessed. Our review revealed a range of sophisticated, intersectionality-informed interventions that were mostly successful at improving HIV, sexual health, and empowerment-based outcomes, but less successful at reducing the aspects of stigma measured. Future research should encompass wider geographical regions, use validated measures of intersectional stigma, and test structural interventions and approaches that challenge the systems of power and oppression that fuel stigma, inequality, and poor health outcomes among multiply marginalized populations.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it