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PLoS One. 2017 Nov 30;12(11):e0188393. doi: 10.1371/journal.pone.0188393. eCollection 2017.

Measuring stigma affecting sex workers (SW) and men who have sex with men (MSM): A systematic review.

Author information

1
Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
2
Community Psychiatry Program, Johns Hopkins Bayview Medical Center, Baltimore, Maryland, United States of America.
3
Centre for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America.
4
HIV/AIDS, STIs & Viral Hepatitis Programme, World Health Organization Regional Office for Europe, Copenhagen, Denmark.
5
Welch Medical Library, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America.
6
School of Medicine, University of Toronto, Toronto, Ontario, Canada.
7
Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.

Abstract

BACKGROUND:

Stigma involves discrediting a person or group based on a perceived attribute, behaviour or reputation associated with them. Sex workers (SW) and men who have sex with men (MSM) are key populations who are often at increased risk for the acquisition and transmission of HIV and who are affected by stigma that can negatively impact their health and well-being. Although stigma was included as an indicator in the US National HIV/AIDS Strategic Plan and there have been consultations focused on adding a stigma indicator within PEPFAR and the Global Fund in relation to potentiating HIV risks among key populations, there remains limited consensus on the appropriate measurement of SW- or MSM-associated stigma. Consequently, this systematic review summarizes studies using quantitative, qualitative, or mixed methods approaches to measure stigma affecting sex workers and men who have sex with men.

METHODS AND FINDINGS:

This systematic review included English, French, and Spanish peer-reviewed research of any study design measuring SW- or MSM-associated stigma. Articles were published from January 1, 2004 to March 26, 2014 in PsycINFO, PubMed, EMBASE, CINAHL Plus, Global Health, and World Health Organization Global Health Library Regional Indexes. Of the 541 articles reviewed, the majority measured stigma toward MSM (over 97%), were conducted in North America, used quantitative methods, and focused on internalized stigma.

CONCLUSIONS:

With the inclusion of addressing stigma in several domestic and international HIV strategies, there is a need to ensure the use of validated metrics for stigma. The field to date has completed limited measurement of stigma affecting sex workers, and limited measurement of stigma affecting MSM outside of higher income settings. Moving forward requires a concerted effort integrating validated metrics of stigma into health-related surveys and programs for key populations.

PMID:
29190642
PMCID:
PMC5708696
DOI:
10.1371/journal.pone.0188393
[Indexed for MEDLINE]
Free PMC Article

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