Perspectives of African, Caribbean, and Black HIV service providers on the persistent HIV stigma and status non-disclosure in London, Canada
Bibliographic record
Abstract
Despite efforts to prevent new HIV infections and improve care for People Living with HIV (PLHIV), HIV continue to disproportionately affect African, Caribbean, and Black (ACB) communities in Canada, with these populations facing higher levels of stigma, marginalization, and health inequities. In this qualitative study, 12 HIV healthcare workers from the ACB community in London-Ontario were purposively recruited for a short sociodemographic survey and focus group discussions, lasting between 1 to 2 hours. A blend of inductive and deductive thematic qualitative analysis was conducted to generate knowledge that will inform culturally sensitive policy decisions for effective HIV prevention and stigma reduction. We found that the association of HIV status with promiscuousness, and wrong moral judgements of PLHIV, drives persistent HIV stigma and status non-disclosure. An intersection of gender-based discrimination, sexual and racial stereotypes further compound the stigma and status non-disclosure. Systemic discrimination and structural violence against PLHIV in the form of unequal job opportunities, denial of access to accommodation, lack of comprehensive health coverage, as well as the disproportionate criminalization of immigrants for status non-disclosure, are highly stigmatizing experience that induces status non-disclosure. The findings underscore the urgent need for intersectional approaches to HIV stigma reduction, policy reforms, and culturally responsive stigma reduction interventions.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.029 | 0.009 |
| Scholarly communication | 0.006 | 0.001 |
| Open science | 0.001 | 0.005 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 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 itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".