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Stigmatization is pervasive in society. Stigma may arise from the core attributes of a social group, such as race, nationality, religion, class, sexuality, and disability, which can induce significant negative impacts on group members. While scholars have documented how stigmatized groups can organize to challenge the prejudice they face, research has been slow to account for the rise of social media—a digital disruption that characterizes a critical feature of the "new normal." Yet, the emergence of social media technology has transformed the cultural potential of relationship building within and across social groups. In this paper, we examine anti-stigma organizing in the age of social media. We theorize how social movement organizations use social media to enact three audience-focused anti-stigma framing processes. These processes structure three distinct types of social bond, and, when iterated over time, shape three corresponding types of solidarity that support the social inclusion of stigmatized groups and reduce group stigma. Through our framework, we contribute to research on stigma and social movements by conceptualizing the role of social media in anti-stigma organizing, and by building new theory about the relationship between solidarity and stigma reduction. [ABSTRACT FROM AUTHOR]

It has been claimed that the HR "profession" suffers from a chronic shortage of social legitimacy. In this article, we advance the idea that HR is also to some extent subject to public stigmatization for being immoral. In other words, we maintain that certain aspects of contemporary HR work can be conceptualized as morally dirty work. We provide empirical support for this contention by analyzing a set of 28 films portraying HR practitioners at work. The research results comprise both task‐related and method‐related filmic representations of HR work as immoral, thus furnishing a comprehensive and nuanced picture of the moral issues that can affect the HR profession. Furthermore, the results show that some of the HR characters analyzed—typically those who hold a role as (co‐)protagonists in the story—realize the immorality affecting their work and decide to distance themselves from it by either exiting the role, trying to reform it, or openly raising resistance against their employer. These research results suggest the need to integrate dirty work scholarship into study of the HR profession, while they provide important indications in terms of future HR research, practice and education. [ABSTRACT FROM AUTHOR]

The sudden onset of the COVID-19 pandemic ushered in an unprecedented era of public admiration for healthcare workers. Indeed, the title "healthcare heroes" became a ubiquitous moniker for healthcare providers of all stripes during the pandemic, a sentiment reflected in countless advertisements and banners. Paradoxically, these same "healthcare heroes" who were being publicly celebrated for their work in the fight against a novel coronavirus also faced stigma for their work amid the virus and infected patients. Using grounded theory, we document how stigmatized members of an occupation experience and respond to mixed—and even conflicting—social evaluations. We contribute to the literature on stigma and social evaluations more broadly by showing how targets of stigma evaluate their evaluators through nuanced logical and emotional processing and, moreover, that such processing can lead recipients of mixed evaluations toward a number of outcomes not previously theorized. We explore the concept of "dirty heroes," where workers are celebrated and stigmatized along distinct dimensions of work traditionally studied in dirty work (i.e., physical, social, and moral). Our findings further illustrate how high-legitimacy occupations can be subject to "hero-washing," whereby workers are publicly celebrated yet privately neglected. [ABSTRACT FROM AUTHOR]

Substance use disparities among sexual and gender minority (SGM) people are attributed to minority stress, but few studies have examined minority stress and cannabis use over time or investigated differences in cannabis use trajectories by less-studied gender subgroups. We examined if longitudinal cannabis use trajectories are related to baseline minority stressors and if gender differences persisted after accounting for minority stress. Cannabis use risk was measured annually over four years (2017-2021) within a longitudinal cohort study of SGM adults in the United States (N = 11,813). Discrimination and victimization, internalized stigma, disclosure and concealment, and safety and acceptance comprised minority stress (n = 5,673). Latent class growth curve mixture models identified five cannabis use trajectories: 'low or no risk', 'low moderate risk', 'high moderate risk', 'steep risk increase', and 'highest risk'. Participants who reported past-year discrimination and/or victimization at baseline had greater odds of membership in any cannabis risk category compared to the 'low risk' category (odds ratios [OR] 1.17-1.33). Internalized stigma was related to 'high moderate' and 'highest risk' cannabis use (ORs 1.27-1.38). After accounting for minority stress, compared to cisgender men, gender expansive people and transgender men had higher odds of 'low moderate risk' (ORs 1.61, 1.67) or 'high moderate risk' (ORs 2.09, 1.99), and transgender men had higher odds of 'highest risk' (OR 2.36) cannabis use. This study indicates minority stress is related to prospective cannabis use risk trajectories among SGM people, and transgender men and gender expansive people have greater odds of trajectories reflecting cannabis use risk.

Language barriers are major obstacles that Asian American immigrants face when accessing health care in the USA. This study was conducted to explore the impact of language barriers and facilitators on the health care of Asian Americans. Qualitative, in-depth interviews and quantitative surveys were conducted with 69 Asian Americans (Chinese, Filipino, Japanese, Malaysian, Indonesian, Vietnamese, and mixed Asian backgrounds) living with HIV (AALWH) in three urban areas (New York, San Francisco, and Los Angeles) in 2013 and from 2017 to 2020. The quantitative data indicate that language ability is negatively associated with stigma. Major themes emerged related to communication, including the impact of language barriers on HIV care and the positive impact of language facilitators-family members/friends, case managers, or interpreters-who can communicate with healthcare providers in the AALWH's native language. Language barriers negatively impact access to HIV-related services and thus result in decreased adherence to antiretroviral therapy, increased unmet healthcare needs, and increased HIV-related stigma. Language facilitators enhanced the connection between AALWH and the healthcare system by facilitating their engagement with health care providers. Language barriers experienced by AALWH not only impact their healthcare decisions and treatment choices but also increase levels of external stigma which may influence the process of acculturation to the host country. Language facilitators and barriers to health services for AALWH represent a target for future interventions in this population.

Across sub-Saharan Africa, men are less likely to know their HIV status than women, leading to later treatment initiation. Little is known about how experiences with general health services affect men's use of HIV testing. We used data from a 2019 community-representative survey of men in Malawi to understand frequency and cause of men's negative health service experiences (defined as men reporting they "would not recommend" a facility) and their association with future HIV testing. We conducted univariable and multivariable logistic regressions to determine which aspects of health facility visits were associated with would-not-recommend experiences and to determine if would-not-recommend experiences 12-24 months prior to the survey were associated with HIV testing in the 12 months prior to the survey. Among 1,098 men eligible for HIV testing in the 12 months prior to the survey, median age was 34 years; 9% of men reported at least one would-not-recommend experience, which did not differ by sociodemographics, gender norm beliefs, or HIV stigma beliefs. The factors most strongly associated with would-not-recommend experiences were cost (aOR 5.8, 95%CI 2.9-11.4), cleanliness (aOR 4.2, 95%CI 1.8-9.9), medicine availability (aOR 3.3, 95%CI 1.7-6.4), and wait times (aOR 2.7, 95%CI 1.5-5.0). Reporting a would-not-recommend experience 12-24 months ago was associated with a 59% decrease in likelihood of testing for HIV in the last 12 months (aOR 0.41; 95% CI:0.17-0.96). Dissatisfaction with general health services was strongly associated with reduced HIV testing. Coverage of high-priority screening services like HIV testing may benefit from improving overall health system quality.

Although enacted and internalized stigma is a continuing problem for people living with HIV (PLWH) in Southeast Asia, there is little understanding of how PLWH cope with discrimination, exclusion, and other negative outcomes caused by HIV-related stigmatization. This article aims to bridge this gap by analyzing the lived experiences of HIV-related stigmatization and coping strategies among 30 people with HIV in Myanmar, a country heavily influenced by religion, especially Buddhism. Among the 30 study participants, 20 were female and 10 were male, with ages ranging from 18 to 50 years. Through the lens of Bourdieu's concepts of habitus, field, and capital, this article first elucidates the various forms of stigmatization in family, work, social, and other settings as symbolic violence on people with HIV. The present article shows that spirituality serves as a perceptual and action framework for people with HIV to generate reflexivity toward their HIV infection and related stigmatization and to further engage in agentic responses. More importantly, this article demonstrates how people with HIV draw on spirituality to support peers in reclaiming control over their lives and how they are perceived by society. The findings indicate that the local context, especially cultural and religious resources, should be considered when developing interventions to mitigate HIV-related stigmatization in Southeast Asia.

Understanding the acceptability of long-acting injectable antiretroviral therapy (LAI-ART) among people with HIV (PWH), especially priority populations, is essential for effective implementation. We conducted semi-structured interviews with patients in three Ryan White-funded HIV clinics in San Francisco, Chicago, and Atlanta. We employed maximal variation sampling across age, gender, race, ethnicity, and time living with HIV and oversampled for individuals with suboptimal clinical engagement. An 8-step hybrid deductive and inductive thematic analysis approach guided data analysis. Between August 2020 and July 2021, we conducted 72 interviews. Median age was 46 years; 28% were ciswomen, 7% transwomen, 44% Black/African-American and 35% Latinx, 43% endorsed a psychiatric diagnosis, 35% were experiencing homelessness/unstable housing, and 10% had recent substance use. Approximately 24% were sub-optimally engaged in care. We observed a spectrum of LAI-ART acceptability, ranging from enthusiasm to hesitancy to rejection. We also characterized four emergent orientations towards LAI-ART: innovator, pragmatist, deliberator, and skeptic. Overall, the majority of participants expressed favorable initial reactions towards LAI-ART. Most approached LAI-ART pragmatically, but acceptability was not static, often increasing over the course of the interview. Participants considered their HIV providers as essential for affirming personal relevance. HIV stigma, privacy concerns, and medical mistrust had varied impacts, sometimes facilitating and other times hindering personal relevance. These findings held across priority populations, specifically young adults, cis/trans women, racial/ethnic minorities, and individuals with suboptimal clinical engagement. Further research is needed to explore the transition from hypothetical acceptance to uptake and to confirm the actual benefits and drawbacks of this treatment.

IntroductionGlobally, transgender ('trans') women experience extreme social and economic marginalisation due to intersectional stigma, defined as the confluence of stigma that results from the intersection of social identities and positions among those who are oppressed multiple times. Among trans women, gender-based stigma intersects with social positions such as engagement in sex work and substance use, as well as race-based stigma to generate a social context of vulnerability and increased risk of HIV acquisition. In Brazil, trans women are the 'most at-risk' group for HIV, with 55 times higher estimated odds of HIV infection than the general population; further, uptake of HIV testing and pre-exposure prophylaxis (PrEP) among trans women is significantly lower than other at-risk groups. Through extensive formative work, we developed Manas por Manas, a multilevel intervention using HIV prevention strategies with demonstrated feasibility and acceptability by trans women in Brazil, to address intersectional stigma and increase engagement in the HIV prevention continuum.Methods and analysisWe are conducting a two-arm randomised wait-list controlled trial of the intervention's efficacy in São Paulo, Brazil, to improve uptake of HIV testing and PrEP among transgender women (N=400). The primary outcomes are changes in HIV testing (self-testing and clinic based), changes in PrEP uptake and changes in PrEP persistence at baseline and follow-up assessment for 12 months at 3-month intervals.Ethics and disseminationThis study was approved by University of California, San Francisco Institutional Review Board (15-17910) and Comissão Nacional de Ética em Pesquisa (Research Ethics National Commission, CAAE: 25215219.8.0000.5479) in Brazil. Participants provided informed consent before enrolment. We are committed to collaboration with National Institutes of Health officials, other researchers, and health and social services communities for rapid dissemination of data and sharing of materials. The results will be published in peer-reviewed academic journals and scientific presentations.Trial registration numberNCT03081559.

BACKGROUND: HIV partner notification services can help people living with HIV (PLHIV) to identify, locate, and inform their sexual and injecting partners who are exposed to HIV and refer them for proper and timely counseling and testing. To what extent these services were used by PLHIV and what are the related barriers and facilitators in southeast Iran are not known. So, this study aimed to explore HIV notification and its barriers and facilitators among PLHIV in Iran. METHODS: In this qualitative study, the number of 23 participants were recruited from November 2022 to February 2023 including PLHIV (N = 12), sexual partners of PLHIV (N = 5), and staff members (N = 6) of a Voluntary Counseling and Testing (VCT) center in Kerman located in the southeast of Iran. Our data collection included purposive sampling to increase variation. The content analysis was conducted using the Graneheim and Lundman approach. The analysis yielded 221 (out of 322) related codes related to HIV notification, its barriers, and its facilitators. These codes were further categorized into one main category with three categories and nine sub-categories. RESULTS: The main category was HIV notification approaches, HIV notification barriers, and facilitators. HIV notification approaches were notification through clear, and direct conversation, notification through gradual preparation and reassurance, notification due to being with PLHIV, notification through suspicious talking of the physician, and notification due to the behavior of others. Also, the barriers were classified into individual, social, and environmental, and healthcare system barriers and the facilitators were at PLHIV, healthcare staff, and community levels. Stigma was a barrier mentioned by most participants. Also, the main facilitator of HIV notification was social support, especially from the family side. CONCLUSIONS: The findings highlighted the multidimensionality of HIV notification emphasizing the importance of tailored support and education to enhance the notification process for PLHIV and their networks. Also, our results show that despite all the efforts to reduce stigma and discrimination in recent years, stigma still exists as a main obstacle to disclosing HIV status and other barriers are the product of stigma. It seems that all programs should be directed towards destigmatization.

This study contributes to the diversity literature by probing whether diversity papers are cited as frequently as nondiversity papers in management and industrial/organizational (I/O) psychology journals. Based on the stigma‐by‐association theory, I argue that as a result of their association with minority groups, diversity papers may be devalued and thus "othered" by scholars. Using a citation analysis of 46,930 papers published in 29 peer‐reviewed management and I/O psychology journals, I present empirical evidence in Study 1 that diversity papers were cited significantly less frequently than nondiversity papers. The authors' gender and institutional prestige, journal tier and domain, and year of publication were not moderators. In Study 2, I used a scenario experiment to demonstrate the stigma‐by‐association effect. The authors' gender demonstrated a significant moderating effect in this experiment. [ABSTRACT FROM AUTHOR]

Period poverty, which is the lack of access to menstrual products, is a public health issue and impacts one in ten college students. Not having access to necessary products results in consequences like missing classes or job shifts and can also lead to an increase in depression and anxiety. However, despite this being a prominent issue on college campuses, there is little awareness and support offered to students experiencing this challenge. This column addresses why it is critical that more awareness is brought to this issue, why academic libraries should play an important role in addressing this issue and discuss different ways library administration can show support for this public health issue. [ABSTRACT FROM AUTHOR]

Debt accumulation has been linked to materialism, impulsivity, shortsightedness, self-control, and lifestyle preferences. However, applying stigma theory allows novel insights into debt accumulation for middle-class individuals who access a variety of credit-related products. The authors define anticipated stigmatization of debt as the negative judgment and discrimination an individual expects to experience because of their consumer indebtedness. Results from a series of studies demonstrate that although financial stress motivates behaviors designed to reduce debt, debtors who anticipate stigmatization perform a variety of concealment behaviors (secrecy, social spending, and help avoidance) that hinder debt reduction and have negative effects on well-being. To understand how to help these individuals, the authors collaborated with a financial education company, designing a field experiment to examine the efficacy of a behavior change course. Individuals who anticipated stigmatization and formed new social connections in a community-based condition reduced their consumer debt. Although the emotional effect of community-based support has been examined in other stigma contexts, this study is the first to investigate the effect on well-being in a debt context and link social benefits to actual behavior change in terms of debt reduction behaviors and debt repayment. [ABSTRACT FROM AUTHOR]

Why do firms take positions on divisive social issues? In this article, I draw on theories of stigma by association to explain why firms' mere proximity to controversial political actors may lead stakeholders to presume that firms silent on social issues are misaligned with the stakeholders' sociopolitical preferences. Firms, in turn, countervail these presumptions of misalignment by eschewing silence and claiming sociopolitical positions. Substantiating this theory in the context of employee recruitment following the 2017 Unite the Right White supremacist rally in Charlottesville, Virginia, I show that Charlottesville's employers combated presumptions that they shared demonstrators' anti-diversity positions by making countervailing pro-diversity claims in their online job postings. In supplementary analysis, I show that the rally was associated with a newfound wage premium in job postings by Charlottesville's employers but that this premium was lower when employers made pro-diversity claims. This study advances understanding of strategic sociopolitical positioning whereby firms make calculated appeals to stakeholders. It contrasts with related research showing that firms use social claims to combat negative evaluations resulting from their own actions or to differentiate from competitors. In doing so, it suggests opportunities for further research investigating, for example, additional motivations for firms' sociopolitical positioning, how positioning might evolve in the context of growing political polarization, and how positioning might relate to workplace inequality and diversity. [ABSTRACT FROM AUTHOR]

INTRODUCTION: The increasing burden of non-communicable diseases, such as hypertension, diabetes and dyslipidaemia, presents key challenges to achieving optimal HIV care outcomes among ageing people living with HIV. These diseases are often comorbid and are exacerbated by psychosocial and structural inequities. This interaction among multiple health conditions and social factors is referred to as a syndemic. In the USA, there are substantial disparities by social position (ie, racial, ethnic and socioeconomic status) in the prevalence and/or control of non-communicable diseases and HIV. Intersecting stigmas, such as racism, classism and homophobia, may drive these health disparities by contributing to healthcare avoidance and by contributing to a psychosocial syndemic (stress, depression, violence victimisation and substance use), reducing success along the HIV and non-communicable disease continua of care. Our hypothesis is that marginalised populations experience disparities in non-communicable disease incidence, prevalence and control, mediated by intersectional stigma and the psychosocial syndemic. METHODS AND ANALYSIS: Collecting data over a 4 year period, we will recruit sexual minority men (planned n=1800) enrolled in the MACS/WIHS Combined Cohort Study, a long-standing mixed-serostatus observational cohort in the USA, to investigate the following specific aims: (1) assess relationships between social position, intersectional stigma and the psychosocial syndemic among middle-aged and ageing sexual minority men, (2) assess relationships between social position and non-communicable disease incidence and prevalence and (3) assess relationships between social position and HIV and non-communicable disease continua of care outcomes, mediated by intersectional stigma and the psychosocial syndemic. Analyses will be conducted using generalised structural equation models using a cross-lagged panel model design. ETHICS AND DISSEMINATION: This protocol is approved as a single-IRB study (Advarra Institutional Review Board: Protocol 00068335). We will disseminate results via peer-reviewed academic journals, scientific conferences, a dedicated website, site community advisory boards and forums hosted at participating sites.

Purpose: We assessed whether anticipated stigma (i.e., fear of public mistreatment due to gender identity) impacts communication between transgender women (TGW) living with HIV and health care providers. Methods: This is a secondary analysis of baseline data from Trans Amigas, a study conducted in Brazil, 2018. The study population consisted of TGW living with HIV, older than 18 years, residing in the São Paulo metropolitan area. We used multivariable logistic regression (α = 0.05), mediation, and bootstrapping for the analysis. Results: One hundred and thirteen participants completed the study. Fear of public mistreatment had an adjusted odds ratio (aOR) of 7.42 (p = 0.003) for difficulty reporting new symptoms to providers. Concerning fear of public mistreatment, we found that unemployment had an aOR of 3.62 (p = 0.036); sex work, an aOR of 2.95 (p = 0.041); and issues related to name change in documents, an aOR of 2.71 (p = 0.033). For the indirect effect on difficulty reporting new symptoms, mediated by fear of public mistreatment, unemployment had an aOR of 1.52 (confidence interval [CI] = 0.88-2.24); sex work, an aOR of 1.48 (CI = 0.81-2.52); and name change issues, an aOR of 1.47 (CI = 0.96-2.43). Conclusions: Anticipated stigma was associated with communication difficulties between TGW living with HIV and providers. Our data suggest that structural factors associated with anticipated stigma could indirectly impact on difficulty reporting new symptoms. These findings indicate the importance of considering social contexts that intersect with individual experiences when analyzing communication barriers between providers and patients, and the need to strengthen social policies for TGW in Brazil. Clinical Trial Registration number: R34MH112177.

INTRODUCTION: Stigma has inhibited public health practitioners influence during the COVID-19 pandemic. We explore the experienced and anticipated stigma of people affiliated with a large university in the United States, using the Health Stigma and Discrimination Framework. METHODS: We conducted a qualitative secondary substudy of 20 people who tested SARS-CoV-2 positive and 10 who tested negative in the summer of 2020, selected from a study of 3,324 university students and employees. FINDINGS: No participants reported anticipated stigmatization prior to testing positive. However, eight of 20 participants recounted stigma marking (being marked by COVID-19 diagnosis or membership in a high-risk group) or manifestations of stigma after testing positive, including feelings of guilt or shame, and concerns about being judged as selfish or irresponsible. Three described being denied services or social interactions as a result of having had COVID-19, long after their infectiousness ended. Participants noted that clear public health messaging must be paired with detailed scientific information, rather than leaving people to resort to non-experts to understand the science. DISCUSSION: Public health messaging designed to mitigate spread of SARS-CoV-2 and protect the community may perpetuate stigma and exacerbate inequities. As a result, people may avoid testing or treatment, mistrust public health messaging, or even use risk-increasing behavior as coping mechanisms. IMPLICATIONS FOR PRACTICE: Intentional use of language that promotes equity and deters discrimination must be high priority for any COVID-19-related public health messaging. Partnership with community leaders to co-create programs and disseminate messaging is a critical strategy for reducing stigma, especially for historically mistreated groups.

ObjectiveThis study investigated women living with HIV/AIDS (WLHA)'s practices and decision-making regarding disclosure of HIV status in healthcare settings in Vietnam. Introduction: Disclosure of HIV status in healthcare settings is under-studied.MethodsWe conducted in-depth interviews with 30 WLHA in Hanoi, Vietnam. Thematic analysis was conducted to investigate the patterns, considerations, and consequences of HIV disclosure. Results: Most participants chose a selective disclosure strategy based on the type of procedure and healthcare setting. They considered several factors: concerns about stigma/discrimination, risks of confidentiality breach, relevance to healthcare provision, and altruism towards protecting providers and other patients. Selective disclosure or non-disclosure often prevented participants from accessing comprehensive care. Conclusion: The study underscores the need to prepare WLHA to make informed decisions regarding disclosure and provide them with service navigations and support. It also highlights the necessity of reducing stigma and enhancing confidentiality protection to ensure safe disclosure in healthcare settings.

As a proposed mediator between stigma-related stressors and negative mental health outcomes, HIV-related shame has been predictive of increased rates of substance use and difficulties adhering to antiretroviral treatment among people with HIV. These downstream manifestations have ultimately impeded progress toward national goals to End the HIV Epidemic, in part due to limited success of conventional psychotherapies in addressing HIV-related shame. In a pilot clinical trial (N = 12), receipt of psilocybin-assisted group therapy was associated with a large pre-post decrease in HIV-related shame as measured by the HIV and Abuse Related Shame Inventory, with a median (IQR) change of - 5.5 (- 6.5, - 3.5) points from baseline to 3-months follow-up (Z = - 2.6, p = 0.009, r = - 0.75). A paradoxical exacerbation of sexual abuse-related shame experienced by two participants following receipt of psilocybin raises critical questions regarding the use of psilocybin therapy among patients with trauma. These preliminary findings carry potential significance for the future of HIV care.

BackgroundDelivering methadone treatment in community health facilities by primary care providers is a task-shifting strategy to expand access to drug use treatment, especially in rural mountainous areas. This study aims to investigate factors related to confidence in providing methadone treatment among primary care providers in Vietnam to inform good practice development.MethodsWe conducted a cross-sectional survey with 276 primary care providers who were physicians, physician assistants, nurses, pharmacists or dispensing staff from 67 communes in a mountainous province in Northern Vietnam. Using self-report scales, we measured providers' confidence in providing methadone treatment, beliefs in harm reduction, perceived work-related support, perceived stigma and risk in working with drug-using patients, and empathy towards this population. We used multiple linear regression analyses to explore factors associated with providers' confidence in providing methadone treatment in the whole sample and to compare two groups of providers who did and did not have experience providing methadone. Potential associated factors were measured at facility and provider levels.Result114 (41.3%) participants had previously experience in providing methadone treatment. Providers with methadone treatment experiences had higher confidence in and more accurate knowledge of methadone treatment, perceived less stigma of working with drug-using patients, and reported more work-related support than those without experiences. Higher medical education is associated with lower confidence in providing methadone treatment among providers without methadone experiences, but higher confidence among providers with methadone experiences. Better methadone knowledge was associated with greater confidence in providing methadone treatment among inexperienced providers but not among those with experiences. Receiving work-related support was associated with greater confidence in providing treatment in both groups, regardless of their past methadone experiences.ConclusionIn rural provinces where methadone treatment has been expanded to primary care clinics, interventions to improve primary care providers' confidence should benefit professionals with diverse experiences in providing methadone treatment. Continued training and support at work for providers is essential to ensuring quality in decentralized methadone treatment.

Background: Stigma, anxiety and depressive symptoms are highly prevalent in parents of children with autism spectrum disorder (ASD) and may have a detrimental impact on the rehabilitation and treatment of children with ASD, ultimately leading to more behavioral issues and higher rates of disability. Therefore, the purpose of this study was to identify the association between general self-efficacy, courtesy stigma, and anxiety and depressive symptoms, and to further discuss whether general self-efficacy moderated the association between courtesy stigma and anxiety and depressive symptoms in parents of children with ASD. Methods: A total of 409 parents of children with ASD from Lianyungang, Jiangsu Province, Eastern China participated in a cross-sectional survey. A structured questionnaire was used to collect sociodemographic characteristics, courtesy stigma, general self-efficacy, anxiety symptoms, and depressive symptoms. Hierarchical multiple regression was used to assess the associations of courtesy stigma, general self-efficacy and courtesy stigma x general selfefficacy interaction with anxiety and depressive symptoms. Simple slope analysis was used to visualize the interaction. Results: The courtesy stigma of parents of children with ASD was positively correlated with anxiety (B = 0.374, P < 0.001) and depressive symptoms (B = 0.366, P < 0.001). General self-efficacy was negatively correlated with anxiety (B = -0.200, P < 0.001) and depressive symptoms (B = -0.210, P < 0.001). The association between courtesy stigma and anxiety symptoms was different in the high (1 standard deviation (SD) above the mean, b = 0.258, standard error (SE) = 0.056, t = 4.567, P < 0.001) and low (1 SD below the mean, b = 0.470, SE = 0.053, t = 8.870, P < 0.001) groups of general self-efficacy. In addition, the association between courtesy stigma and depressive symptoms was also different in the high (1 SD above the mean, b = 0.241, SE = 0.056, t = 4.268, P < 0.001) and low (1 SD below the mean, b = 0.469, SE = 0.053, t = 8.844, P < 0.001) groups of general self-efficacy. Conclusions: General self-efficacy could moderate the impact of courtesy stigma on anxiety and depressive symptoms. Therefore, among parents of children with ASD who experienced high courtesy stigma, enhancing general self-efficacy could be an effective strategy to reduce anxiety and depressive symptoms in this population. [ABSTRACT FROM AUTHOR]

AbstractObjectiveDesignStudy sampleResultsConclusionsTo investigate the perspectives and experiences of adults with hearing loss (HL), their family members, and hearing care professionals on how they respond to the stigma of HL and hearing aids (HAs).Qualitative descriptive approach using semi-structured interviews.Three participant groups were recruited, including 20 adults over the age of 50 years with HL, 20 family members who had a close relationship to the adults with HL, and 25 hearing care professionals.Three themes described how adults with HL, family members, and hearing care professionals respond to the stigma of HL and HAs, namely: (1) some people tell others about their HL and HAs and some people don’t; (2) telling or not telling depends on the situation; and (3) people deal with the stigma of HL and HAs in different ways.This study revealed a range of volitional responses to the stigma of HL and HAs. People affected by HL may not tell others about their HL and/or HAs because of the stigma, and these volitional responses are influenced by situational cues. Adults with HL and family members manage the stigma of HL and HAs in different ways and require a person-centred approach. [ABSTRACT FROM AUTHOR]

Background: Adolescent mental health (AMH) is a critical issue worldwide, particularly in West Africa, where it is intensified by socio-economic, cultural, and security challenges. Insecurity and the presence of mining sites expose adolescents to hazardous environments, substance abuse, and adulterated alcohol, further aggravating their mental health. Despite these severe issues, research on AMH in this region remains limited. This study aims to analyze the provision of AMH services in Burkina Faso, Ghana, and Niger, highlighting the unique challenges these countries face within the broader West African healthcare context. Methods: The study adopted a multi-stage, stratified sampling design to collect data from primary healthcare centers (PHCs) in the three countries. Using STATA.17, Descriptive analysis was conducted on the data related to availability of AMH services, types of mental health disorders treated, resources available, and OPD attendance rates. The analysis also incorporated factors such as the rural-urban divide and the presence of national guidelines for AMH services. Results: The findings reveal a significant shortfall in the provision of AMH services across the region, with less than 30% of PHCs across all the countries offering these services. The study also highlights a pronounced rural-urban disparity in AMH service availability, a general absence of national guidelines for AMH care, and low OPD attendance rates. Conclusion: The study highlights the urgent need for comprehensive policy reform and targeted interventions to enhance AMH services in West Africa. Key policy reforms should include the development and implementation of national guidelines for AMH care and integration of AMH services into primary healthcare. Additionally, efforts should focus on capacity building through the training of mental health professionals, increasing public awareness to reduce stigma, and ensuring equitable resource allocation across rural and urban areas. Improving AMH care is essential not only for the well-being of adolescents but also for driving broader socio-economic development in the region. [ABSTRACT FROM AUTHOR]

Lassa fever is an acute viral zoonotic illness endemic in parts of West Africa. In Nigeria, the disease causes periodic large outbreaks, putting strain on healthcare resources and infrastructure. This article reviews the burden and socioeconomic impact of Lassa fever in Nigeria. The vast majority of cases are mild or asymptomatic, however severe illness still occurs in 20% of patients. Late-stage pregnancy infection has high fatality rates. Diagnosis is challenging and early supportive care is critical for survival. The disease affects all age groups in endemic regions, especially impoverished rural communities. Outbreaks disrupt local economies and agriculture and require increased healthcare spending. Specific economic impacts include industry shutdowns, expenditure on protective equipment for healthcare workers, costs for specialized training programs and treatment facilities, high treatment costs for patients, deterrence of investors and businesses, job losses, and declines in tourism revenue. Social impacts include stigmatization of patients. Recommendations for control emphasize improvements to rural healthcare infrastructure, disease surveillance, affordable diagnostics and treatment access, community outreach and education programs, and fostering local economic growth and sustainability. A multidimensional approach engaging all levels of government and civil society is required to mitigate the burden of Lassa fever on Nigeria. This article covers the disease background, populations affected, economic and social impacts, and recommendations to address the substantial public health burden of Lassa fever outbreaks on Nigeria. [ABSTRACT FROM AUTHOR]

Despite the challenges Muslims face because of their stigmatized religious identity, little is known about how they navigate that identity in the workplace. Adopting an interpretivist perspective of identity work, this study investigates this issue by building on two‐round in‐depth interviews (35 in round‐one and 21 in round‐two) with skilled practising British Muslim professionals. It extends work on power positions to show the privileges those in senior managerial positions have, including assertiveness and control over workplace interactions and outcomes. It further advances understanding of authenticity, revealing that, despite their experiences of stigmatization, these professionals tend to remain true to their religious identity, openly practising their religion in the workplace. They perceive identity re‐interpretation to be part of authenticity, and a responsibility to contest religious stigma. Importantly, this study conceptualizes proactive religious coping as an identity work response to workplace stigmatization, theorized in this organizational context as turning to God and religious rituals for meaning, comfort, resilience and reconciliation, whilst also being proactive and fighting to challenge experiences of stigmatization. However, unlike for other stigmatized groups, inclusive organizational practices, particularly religious accommodation, are not a driver for authenticity, but rather a signal for environment‐fit and authenticity is instead driven by religious identity. [ABSTRACT FROM AUTHOR]

Context: Health inequities exist across the healthcare continuum, significantly impacting 2SLGBTQIA + individuals. Palliative care presents unique challenges for sexual and gender minorities due to socio-cultural, psychological, and systemic barriers. The objective of this scoping review was to synthesize existing research on palliative care use among 2SLGBTQIA + individuals and identify common themes in the literature. Methods: A literature review was conducted, focusing on articles published between 2010 and 2023 from the PubMed and CINAHL databases. Arksey and O'Malley's methodological framework for scoping reviews was applied to guide the review process. Results: A total of 31 studies were identified. A significant portion of the research originated in North America, with little research from outside the USA. Palliative care and end-of-life care were most used to describe care, though these terms were often not clearly defined. All studies included a focus on sexual and gender minorities, but there was considerable variation in the terminology used and a noticeable paucity of literature specifically addressing the needs of transgender and gender non-conforming individuals, or use of an intersectional approach in analysis. Key themes identified in the literature include discrimination in palliative care settings, disenfranchised grief experienced by care partners, and a lack of training in palliative care settings concerning the unique needs of 2SLGBTQIA + people utilizing palliative care services. Conclusions: People identifying as 2SLGBTQIA + experience unique inequities in accessing and using palliative care services. To address these challenges, future initiatives should focus on developing identity-affirming palliative care settings, enhancing respect and support for care partners and found family, and ensuring healthcare providers are properly educated to provide care to this community. Future research is also needed that considers more diverse samples, as well as the impact of intersecting identities on the specific needs and challenges they face at end-of-life. [ABSTRACT FROM AUTHOR]

The anti-stigma Opening Minds initiative (Mental Health Commission of Canada) identified the workplace as one of four critical areas for stigma evaluation and programming. Researchers found, however, that no validated tool to measure stigma in this context existed at the time. The purpose of the current research was to develop and assess the psychometric properties of a multi-component quantitative measure of public stigma towards mental illnesses in the workplace: Opening Minds Scale for Workplace Attitudes (OMS-WA). Three studies are discussed. Study 1 outlines the initial development of the OMS-WA, finding a five-factor structure with 23 items (EFA analysis; N = 207). Study 2 utilized employees from various businesses to further validate the OMS-WA, (N = 107), finding good internal consistency and good convergent/divergent validity. Study 3 utilized baseline data from two national large-scale stigma reduction and resiliency programs (first responders and general workplaces) to confirm the factor structure, finding good model fit and reliability with both samples (N = 5385; N = 1207). Together, these results provide strong evidence of the OMS-WA. Its use in measuring workplace stigma related to mental illness is recommended. Considerable future evaluation is warranted, and directions for generalizability studies, as well as suggestions for using the OMS-WA in intervention trials, are provided. [ABSTRACT FROM AUTHOR]

Background Objectives Methods Results Conclusions The psychological impacts of skin disease are well documented, with patients reporting increased anxiety, depression and poorer quality of life. More recent studies suggest that adverse psychopathology is associated with re‐direction of skin‐disease‐related social stigma towards oneself or internalized skin bias (ISB).To refine the Internalized Skin Bias Questionnaire (ISBQ) to reflect the construct of ISB with additional skin‐specific biases as well as to evaluate its psychometric properties in a diverse sample of individuals with various skin conditions.Two‐part observational design including consensus‐building surveys among a dermatology expert group and a cross‐sectional survey among participants with self‐reported dermatological conditions to assess instrument psychometric properties. Eligible participants completed an online survey comprised of the revised ISBQ (ISBQ‐R), the Questionnaire on Experiences with Skin Diseases‐Short Form (QES‐SF), the Dermatology Life Quality Index (DLQI), the Beck Depression Inventory‐II (BDI‐II) and the Burns Anxiety Inventory (BAI).Overall, 33 experts participated including 22 (66.7%) dermatologists or dermatology researchers and 11 (33.3%) patients. Except for three items in the first round, all items received high agreement for inclusion from the expert group. The revised survey was completed by 214 participants who identified mostly as female (n = 185; 86.9%), White (n = 182; 85.5%) and non‐Hispanic/Latino (n = 200; 93.4%). Adding and modifying new items resulted in an instrument with stronger internal consistency (Cronbach's alpha = 0.92) and a stronger correlation with other existing stigma measures (QES‐SF; ρ = 0.72).The ISBQ‐R is a modified instrument with stronger internal consistency and a stronger correlation with other existing stigma measures. Additionally, the study further expanded upon previous research by exploring a two‐factor structure, suggesting that the ISBQ‐R could be used as a single‐ or a dual‐factor instrument depending on investigator goals. [ABSTRACT FROM AUTHOR]

Background: This paper aimed to explore the palliative care (PC) needs and barriers to access among cancer patients in a rural region of North India with a high cancer burden. Methods: A Participatory action research (PAR) approach was employed. Situational assessment, community sensitization workshops (CSWs) and door-to-door surveys were planned, conducted and developed over three PAR cycles. A parallel convergent mixed-methods approach was adopted wherein the quantitative data from door-to-door surveys and qualitative data from CSWs and investigator field notes were collected and analyzed to provide a comprehensive understanding of PC needs and barriers to access. Descriptive statistics and thematic analysis were used. Results: A total of 27 CSWs involving 526 stakeholders were conducted. A total of 256 cancer patients were assessed for PC needs and symptom burden using the Supportive and Palliative Care Indicators (SPICT-4ALL) and the Edmonton Symptom Assessment System (ESAS) tool, respectively. Based on the SPICT assessment, all patients (n = 256) satisfied general and/or cancer-specific indicators for PC. The majority (56.6%) had ≥ one moderate-severe symptom, with the most common symptoms being tiredness, pain and loss of appetite. Analysis of qualitative findings generated three themes: unmet needs, burden of caregiving, and barriers and challenges. Cancer affected all domains of patients' and their families' lives, contributing to biopsychosocial suffering. Social stigma, discrimination, sympathizing attitudes and lack of emotional and material support contributed to psychosocial suffering among cancer patients and their caregivers. Lack of awareness, nearby healthcare facilities, transportation, essential medicines, trained manpower and education in PC, collusion, fear of social discrimination, faulty perceptions and misconceptions about cancer made access to PC difficult. Conclusions: The study emphasize the need for and provide a roadmap for developing context-specific and culturally appropriate CBPC services to address the identified challenges and needs. The findings point towards education of CHWs in PC; improving community awareness about cancer, PC, government support schemes; ensuring an uninterrupted supply of essential medicines; and developing active linkages within the community and with NGOs to address the financial, transportation, educational, vocational and other social needs as some of the strategies to ensure holistic CBPC services. Trial registration: Clinical Trial Registry of India (CTRI/2023/04/051357). [ABSTRACT FROM AUTHOR]

Rent gap theory has long been a staple of gentrification studies, and given that gentrification and territorial stigma have been shown to be closely related, the distinct ways in which the rent gap operates in territorially stigmatised spaces demands attention. This paper examines how governance approaches within territorially stigmatised spaces shape the particular ways in which rent gaps are opened. It illustrates how the rent gap theory has operated in practice across two contexts within Middlesbrough, a town in the North East of England. By tracing the governance approaches which shape the form that rent gap production takes across these contexts, this paper provides evidence for how the rent gap theory operates in practice in stigmatised areas, and indicates how the form which the process of rent gap production takes is contingent upon the particular logics of governance operating within a locality at the point of production. [ABSTRACT FROM AUTHOR]

Background: Transgender individuals often face stigma, discrimination, and various forms of abuse, which negatively impact their mental and physical health. They face a significantly greater risk of HIV, with a higher prevalence than the general population. Despite these challenges, transgender people have limited access to healthcare due to violence, legal barriers, and societal stigma, further exacerbated in countries like Uganda, where transgender identities are criminalized. Therefore, this study explored the lived experiences of HIV researchers working with gender minority populations in criminalizing contexts. Methods: This was an interpretative phenomenological analysis (IPA) qualitative study. Twelve (12) research team members at all levels were involved in the study. Participants had less than five years of involvement in HIV research among gender minority populations. Data were collected using field notes, reflective journals, documentation from daily team debriefing sessions, and semi-structured interviews. The analysis used NVivo software. Results: Positive experiences, barriers, and challenges were captured. The positive experiences were 'respecting cultural diversity', 'expanding networks', 'addressing misconceptions' and 'finding allies'. The barriers included 'experiencing stigma', 'lengthy research processes', 'feeling isolated', 'fearing for personal safety', 'unexpected logistical costs', and 'criminalization of sexual and gender minorities'. The key themes that emerged from the lessons learned were: 'dealing with gatekeepers', 'diversity and sensitivity training', 'leveraging networks', 'meaningful community engagement', 'reflexivity', 'ensuring safety', 'equal partnership', 'giving feedback' and 'awareness of legal implications'. Conclusions: This study highlights the importance of cultural sensitivity, community engagement, and reflexivity in research design and implementation. The findings emphasize the need for innovative strategies to navigate legal, social, and logistical barriers that researchers and participants face. Despite these challenges, the study demonstrates that meaningful collaboration with community members and building trust can significantly enhance the research process and outcomes. Future research should continue to explore these strategies while addressing ethical and safety concerns. [ABSTRACT FROM AUTHOR]

Across two studies, this exploratory research examines stigma faced by larger‐bodied people by exploring the phenomenon of weight‐based mistreatment (WBM), defined as interpersonal disrespect levied on a person explicitly due to their larger body size, at work. Through qualitative research we first describe distinct forms of WBM experienced by 175 self‐defined overweight US employees, as well as consequences of WBM for bullied targets and their organizations. Next, through a quantitative survey distributed to a separate sample of larger‐bodied workers, our exploratory evaluation of WBM found that it is all‐too common in many forms, including overt and covert aggression, microaggression, incivility, and benevolent, yet disrespectful comments oriented around a person's weight. One or more forms of these behaviours were experienced by 75% of our 1008‐person sample, with overt and covert aggression being most common, and coworkers most often perpetrating WBM. Drawing on objectification theory, we observe a host of harmful consequences ranging from diminished engagement, worsened professional interactions, and a lack of self‐care. Altogether, results reveal WBM is a substantial problem, and thus they serve as a call to action for HR professionals, managers, and inclusion advocates to better understand the experiences of this vulnerable population. [ABSTRACT FROM AUTHOR]

Hermeneutical injustice means being unjustly prevented from making sense of one’s experiences, identity or circumstances and/or communicating about them. The literature focusses almost exclusively on whether people have access to adequate conceptual resources. In this paper, we discuss a different kind of hermeneutical struggle caused by stigma. We argue that in some cases of hermeneutic injustice people have access to hermeneutical resources apt to understand their identity but reject employing these due to the stigma attached to the identity. We begin with a reinterpretation of one of the cases discussed in the literature, Edmund White’s novel A Boy’s Own Story. We argue that in this case hermeneutic resources are available but are rejected due to the stigma attached to homosexuality. We then present two analogous kinds of cases: alcohol addiction and being the victim of intimate partner violence. Here, too, hermeneutic injustice occurs because of the stigma attached to an identity rather due to unavailability of resources. We close by suggesting that these cases may, additionally, involve the wrong of ‘Tightlacing’: by meddling with their self-conception, stigma can manipulate individuals into a view of themselves that licenses inappropriate demands on them and makes them complicit in the erasure of their identities. [ABSTRACT FROM AUTHOR]

Despite the growing acknowledgment of the importance of loneliness among older individuals, questionnaire length constraints may hinder the inclusion of common multi-item loneliness scales in surveys. Direct, single-item loneliness measures are a practical alternative, but scholars have expressed concerns that such measures may lead to underreporting. Our aim was to test whether such reservations are justified. We conducted a preregistered list experiment among 2,553 people aged 50 + who participated in the Dutch Longitudinal Internet studies for the Social Sciences (LISS) panel. The list experiment method has been developed to unobtrusively gather sensitive information. We compared the list experiment estimate of the prevalence of frequent loneliness with the corresponding direct question estimate to assess downward bias in the latter. Next to pooled models, we estimated models stratified by gender to assess whether loneliness underreporting differed between women and men. Relying on the direct question, we estimated that 5.9% of respondents frequently felt lonely. Our list experiment indicated that the prevalence of frequent loneliness was 13.1%. Although substantial in magnitude, the difference between both estimates was only marginally significant (Δb: 0.072, 95% CI: − 0.003;0.148, p =.06). No evidence of gender differences was found. Although we cannot be conclusive that loneliness estimates are biased downward when a direct question is used, our results call for caution with direct, single-item measures of loneliness if researchers want to avoid underreporting. Replications are needed to gain more precise insights into the extent to which direct, single-item loneliness measures are prone to downward reporting bias. [ABSTRACT FROM AUTHOR]

Media coverage of depression on social media with specific framings could shape people's perception and attitude, which is significant in reducing the stigma and promoting support for depression sufferers. Adopting the lens of moral foundation theory (MFT), this study aims to explore the effect of inherent moral framings within depression coverage on social media on the stigma and approval attitudes toward depression in audiences' responses. A large language model and a dictionary-based approach were respectively adopted to score depression-related media coverages (n = 919) and corresponding comments (n = 92,505) collected from the Weibo platform against MFT's five dimensions and (de)stigma attitudes. The results indicated that care, purity, and fairness framings are prevalent in depression coverage, surpassing moral framings such as betrayal, harm, and cheating. Most responses expressed approval rather than stigma. Moreover, the use of care and loyalty framings can elicit approval responses but decrease audience engagement. [ABSTRACT FROM AUTHOR]

Background: Australia's commitment to eliminate hepatitis C by 2030 is underpinned by the mobilisation of the primary care sector. Primary care nurses are well placed to contribute to achieving elimination given their unique access to people with/at risk of hepatitis C and their person-centred approach to care delivery. This study examines the enablers to primary care nurse involvement in elimination efforts. Methods: Primary care nurses involved in the care of people with/at risk of hepatitis C were recruited through two national nursing organisations. Participants provided verbal consent to participate in an electronically recorded, semi-structured interview. Interview data were transcribed verbatim, coded and analysed using a thematic analysis. Results: Sixteen interviews were conducted with nurses working in general practice, community health, alcohol and other drug services, and custodial settings, with the findings framed using a social-ecological model. The study identified individual attributes, such as empathy and advocacy for clients deemed 'too hard for everyone else'. Interpersonal enablers included participants' ability to effectively communicate with clients and colleagues, and using trusted professional relationships to improve client access to care. Public policy that addressed community factors, including stigma and confidentiality, were seen as supportive. Conclusions: This study identified the critical and varied role primary care nurses play in hepatitis C elimination. Effective scale up of hepatitis C care involves recognising the pivotal role of primary care nurses, which will help to create an enabling environment that supports nurses to work to their full scope of practice and enhance their contribution to the elimination response. Hepatitis C elimination in Australia is stalling. Primary care nurses are in regular contact with people with/at risk of hepatitis C and have a unique opportunity to contribute to the elimination effort. This study interviewed primary care nurses to identify the individual and systemic enablers that support these nurses to work to their full scope of practice and contribute to achieving Australia's elimination goal. [ABSTRACT FROM AUTHOR]

The study aimed to investigate the stories of Muslim women living with HIV/AIDS after their marriage. The data was derived from in-depth interviews with 10 women infected with HIV as well as a focus group discussion and non-participatory observation of 10 public health officers and medical professionals and 10 people from their community. Analytic induction was used for data analysis. The results revealed that the informants were infected with HIV from their husbands after marriage because the husbands had been addicted to injectable drugs before marriage. Moreover, the study revealed that the women's mental state wasn't significantly affected. Some women experienced regret or ideas of committing suicide because of the death of their husbands as well as the lack of mental support, but not because of the diagnosis of the HIV/AIDS infection. The informants believed that it was a test by God and revealed no anger against their husbands who carried and transmitted the infection. Some of the informants, recognized as HIV carriers, could join hospital activities to get HIV drug resistance. Gaining acceptance from others encouraged these women to continue living. The subjects explained that they did not feel depressed by the infection or disappointed with those who did not accept them. Some of the women mentioned plans to move out to new communities in search of greater acceptance once they achieved better economic status. Moreover, the study confirmed that Thai people in the southernmost border provinces were overall still repulsed by and biased against those infected with HIV/AIDS. [ABSTRACT FROM AUTHOR]

Research shows that ethnic minorities are at increased risk of loneliness compared to the general population of the United Kingdom. We hypothesized that stigma salience increases loneliness among ethnic minorities, conducting two experimental studies with ethnic minorities (Study 1: N = 134, Study 2: N = 267) in which participants were randomly assigned to a stigma salience (recalling a personal experience of discrimination based on ethnicity) or control condition (recalling a past meal in Study 1 and the experience of reading a book in Study 2). Across these two studies, we demonstrated that stigma salience consistently increased self‐reported loneliness relative to the control conditions. Study 1 additionally showed evidence for an indirect effect of stigma salience on loneliness through feelings of anxiety. Study 2 replicated the effect of self‐relevant (but not non‐self‐relevant) stigma salience on loneliness and provided suggestive evidence for a more specific indirect effect through identity‐related social anxiety. [ABSTRACT FROM AUTHOR]

Infertility can be stressful for infertile couples. This study aims to examine the intra‐dyadic associations between stigma, communication patterns, and infertility‐related stress in couples undergoing artificial insemination by donor semen (AID). This cross‐sectional study was conducted from January to April 2021. Two hundred and three couples undergoing AID were recruited from a reproductive centre in China. All of the couples completed a two‐item stigma questionnaire, Communication Pattern Questionnaire, and Fertility Problem Inventory. The actor‐partner interdependence mediation analysis was performed using AMOS 23.0. The analysis demonstrated significant actor–actor effects for couples undergoing AID. More specifically, higher levels of stigma among wives and husbands were associated with more negative communication patterns, thereby increasing their own infertility‐related stress. Simultaneously, there was a significant partner–actor effect among infertile wives, demonstrating that the husband's stigma can affect his wife's infertility‐related stress by influencing her communication patterns. Couples undergoing AID experience increased infertility‐related stress when they have high levels of stigma and negative communication patterns, and husbands' stigma is correlated to wives' communication patterns. Therefore, dyadic interventions aiming to improving stigma and enhancing positive communication may be conducive to reducing infertility‐related stress. [ABSTRACT FROM AUTHOR]

Emerging evidence indicates that perceptions of self-harm behaviours and self-harm scars may thwart recovery from depression, yet limited research has explored adolescent accounts of their self-harm and scars during therapy. This study sought to explore how adolescents describe their self-harm behaviours and scars during Cognitive Behavioural Therapy (CBT) and explore the sociocultural discourses that may influence these descriptions. The participants were six female adolescents (aged 14-17 years old) with clinical depression, who were engaging in self-harm. All participants accessed CBT as part of clinical trial evaluating three psychological treatments for major depressive disorder in Child and Adolescent Mental Health Services. Audio-taped CBT sessions were analyzed using discourse analysis. Within CBT sessions, adolescents drew upon stigma discourses in talking about their self-harm. Adolescent also described their self-harm scars as shameful and stigmatizing, and as "proof" of the legitimacy of their depression. It is important for CBT practitioners to understand the context of sociocultural discourses around self-harm behaviours and self-harm scars, which are reflected in how adolescents with depression describe these within therapy and may serve to maintain distress. The study indicates that awareness of use of language and intersecting sociocultural discourses can inform CBT practice. Plain language summary: We know that when teenagers are in treatment for depression, perceptions of their self-harming behaviours and self-harm scars can impact recovery. We also know that wider sociocultural beliefs around self-harm tend to be negative and stigmatizing, which might impact how teenagers perceive their self-harm and scars. This study aimed to explore how depressed adolescents talk about their self-harm behaviours and their self-harm scars during therapy for depression. The participants in this study were six female teenagers (aged 14-17 years old) with depression, who were engaging in self-harm. These teenagers participated in a type of therapy called Cognitive-Behavioural Therapy as a part of a larger study evaluating treatments for teenage depression in Child and Adolescent Mental Health Services in the UK. The therapy sessions were recorded, transcribed, and analyzed with a focus on the language used by the teenagers to describe their self-harm and scars. Within the therapy sessions, the teenagers talked about their self-harm in stigmatizing ways, which reflected prominent societal-held beliefs about self-harm. The teenagers in the study also believed that while their self-harm scars were shameful and stigmatizing, the scars also provided a sense of validation that their depression was legitimate. The findings of this study suggest that it could be helpful for therapists to consider how wider sociocultural beliefs around self-harm may impact how teenagers talk about their self-harm and scars in treatment for depression. [ABSTRACT FROM AUTHOR]

Aims: To investigate the relationships between depression symptoms, perceived stigma, disease severity, patient‐provider communication and medication adherence in fibromyalgia patients. The objectives were to explore how these factors influence treatment adherence and to develop a comprehensive model illustrating their interconnections. Background: Fibromyalgia is a chronic pain syndrome with fatigue, sleep issues and idiopathic pain. Medication adherence is limited by insufficient symptom relief, side effects and costs. Stigma further complicates fibromyalgia. Disease severity affects patient‐provider communication. Associations between depression, stigma, severity, communication and adherence in fibromyalgia are unclear. Design: A cross‐sectional, correlational study. Methods: The STROBE guidelines for cross‐sectional studies were followed. Participants included Hebrew‐speaking participants who were members of two Facebook groups: 'Shades of Purple' and 'Fibromyalgia‐ Get to Know!' Between February and April 2022. They undertook evaluations using The Patient Health Questionnaire‐9 to gauge depression symptoms, assessed perceived stigma, utilised The Revised Fibromyalgia Impact Questionnaire to determine disease severity, employed The Patient Reaction Assessment questionnaire for patient‐provider communication, and used the 8‐item Morisky Medication Adherence Scale (MMAS‐8). Associations between the variables were explored using Pearson's correlations and path analyses. Results: The study included 141 women with fibromyalgia, aged 22 to 76 years. Most reported having a stable partner (69.5%) and 75.2% had children. The treatment adherence levels were as follows: 53.2% (N = 75)—low, 33.3% (N = 47)—medium and 13.5% (N = 19)—high. Depression positively correlated with stigma. Stigma negatively correlated with patient‐provider communication. Patient‐provider communication positively correlated with treatment adherence. A significant negative indirect effect of depression on treatment adherence through stigma and patient‐provider communication was found. Conclusions: Perceived stigma and patient‐provider communication played a mediating role in the relationships between depression and treatment adherence among women with fibromyalgia. Relevance to Clinical Practice: Addressing stigma related to fibromyalgia and effective patient‐provider communication can positively influence treatment adherence. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

AbstractParticipants: A critical public health issue facing many universities is food insecurity. Food insecurity has been associated with many academic, physical, and mental health issues. Although the number of campus-based food pantries has grown exponentially, self-, and social stigma have been associated with low rates of utilization. Methods: The current quantitative study examined perceptions of food pantry stigma among food insecure college students (n = 93) who have accessed food pantry services. Results: Results reveal moderate levels of food pantry stigma with no statistically significant differences in food pantry stigma scores by level of food security (p = .322) and frequency of food pantry use (p = .263). Few participants indicated perceptions of social stigma, yet mixed results were observed regarding self-stigma. Conclusion: More research is warranted aimed at gaining a better understanding of food pantry stigma among college students that can inform campus-based interventions, practices, and policies aimed at increasing the utilization of campus-based food pantry resources. [ABSTRACT FROM AUTHOR]

The main purpose of the article is to present and compare various strategies aimed at encouraging research participants to voice their experiences of racism and discrimination. This is supplemented by the discussion on how scholars can unveil the intersections of multiple systems of oppression reverberating in research participants' narratives, given the challenge of racial asymmetry in research and the politics of interpretation in a race-mute societal context. Based on their study involving young migrants, the authors argue that qualitative research instruments such as individual and focus-group interviews, visual elicitation, co-creative methods, and video interviews enable individuals to frame their experienced reality in complementary ways. Comparing how each method can conceal or disclose racism, the authors warn of treating narrations on racism on face value and plead for carefully analyzing the extent to which individual narrations align with political agendas and normative discourses within the research's contexts. Addressing each research tool's potential and limitations, the authors also show how the researchers' epistemological and political positionalities shape their data collection and analysis. [ABSTRACT FROM AUTHOR]

Fetal alcohol spectrum disorder (FASD) is a leading cause of neurodevelopmental disability globally. International organizations have highlighted an urgent need for improved prevention, diagnosis, and support. However, the evidence base needed to inform this is thought to be limited. We conducted two complementary reviews to (i) describe trends in the volume and characteristics of original FASD research articles (Review 1) and (ii) compare the volume of published research on FASD to that of other neurodevelopmental disorders (Review 2). In Review 1, we systematically searched MEDLINE, Embase, CINAHL and PsycInfo for original studies with FASD terms in the title, published between 2000 and 2023. We summarised study characteristics including the article topic(s), sample population, country of origin, and publication year using quantitative content analysis and time‐series plots. A total of 854 studies were eligible. Studies showed a relative focus on diagnosis and screening, compared to prevention and intervention. FASD research originated from 31 countries, however most countries (68%) had fewer than 10 articles published over the 23‐year review period. In Review 2, we searched PubMed for records published between 2000 and 2023 with FASD, autism, or attention‐deficit‐hyperactivity disorder (ADHD) terms in the title. We compared the volume of records for these conditions using descriptive statistics and time‐series plots. Of the 64,069 records retrieved, 2% were for FASD, compared to 60% for autism and 38% for ADHD. FASD remains considerably under‐researched. While there has been an increase in the number of original FASD research articles published annually over time, this is much lower than expected compared to publication trends for other neurodevelopmental conditions, and the wider scientific literature. Further research is needed to understand the impact of FASD across the lifespan, to inform evidence‐based policy and support, and to advance progress in strength‐based, stigma‐reducing approaches to FASD research and practice. [ABSTRACT FROM AUTHOR]

Aim: Stigma is a major mental healthcare barrier. This study compares the efficacy of two types of brief video interventions, targeting public and self‐stigma, in reducing public stigma towards people living with psychosis. We hypothesized both interventions would similarly reduce public stigma and outperform the control group. As a secondary analysis, we explored the effect of familiarity with a person living with serious mental illness (SMI). Methods: Participants (N = 1215) aged 18–35 recruited through crowdsourcing were assessed pre‐ and post‐intervention and at 30‐day follow‐up regarding five public stigma domains: social distance, stereotyping, separateness, social restriction and perceived recovery. Both videos present individual narratives using different approaches: the self‐stigma video was created through focus groups, while the public stigma video portrays a single person's journey. Results: A 3 × 3 analysis of variance (ANOVA) revealed a significant group‐by‐time interaction across all five stigma‐related domains (p's <.001). Effect sizes (Cohen's d) ranged from 0.29 to 0.52 (baseline to post‐intervention), and 0.18 to 0.45 (baseline to 30‐day follow‐up). The two video interventions did not significantly differ. Linear mixed modelling showed a significant difference between participants familiar and unfamiliar with people living with SMI for the public stigma video, with greater stigma reductions for unfamiliar participants. Conclusions: This study corroborates previous findings on the positive influence of social contact‐based interventions on youth mental health perceptions. Results provide insights into the relationship between public and self‐stigma and the impact that familiarity with SMI may have on the efficacy of stigma reduction efforts further validation in diverse groups is needed. [ABSTRACT FROM AUTHOR]

Cross-country research argues that the design of welfare states and social protection systems shapes the intergenerational transmission of inequality. Studies that examine this relationship within a country are however lacking from the literature. Based on a quasi-experimental research design using difference-in-differences estimation and data from the Socio-Economic Panel, I analyse whether the educational disadvantage of children of long-term unemployment assistance recipients increased after changes to eligibility criteria, benefit levels, and conditionality were introduced in Germany in 2005. I find that differences in the probability to enter the academic secondary school track between children of parents receiving long-term unemployment assistance one year before the transition and children of parents not receiving unemployment or social benefits increased by 13 percentage points. In part, this was driven by the introduction of means-testing that changed the composition of unemployment assistance recipients. However, further decreases in the financial conditions of these already disadvantaged families following reductions in benefit levels appear as the main driver of the observed effect. Changes in parental subjective wellbeing due to increased benefit conditionality and stigma do not seem to play a significant mediating role. The findings highlight the important contribution of social policy to social mobility and equality of opportunity. [ABSTRACT FROM AUTHOR]

There is an increasing number of autistic students being educated alongside their neurotypical peers. However, placing a student in the general education setting is not sufficient for meaningful inclusion. Historically, autistic students have had fewer friendships, been less accepted, and experienced stigmatization. Interventions to increase peer attitudes toward autism have emerged as a method for creating more inclusive environments. The purpose of this literature review was to describe the interventions to improve peer attitudes toward autism, review the quality of the research, and determine the effectiveness of interventions. Specifically, this review aimed to answer the following questions: (1) what are participant characteristics and components of interventions designed to improve attitudes toward autistic individuals? (2) What is the methodological quality of interventions designed to improve attitudes toward autistic individuals, as measured by Council for Exceptional Children standards for evidence-based practices in special education (2014) criteria? (3) What is the effectiveness of interventions to improve attitudes toward autistic individuals? A total of 13 studies were located through a systematic search. Included studies were coded for study characteristics, participant characteristics, intervention, and outcomes. Across the studies, there were a total of 2097 participants. All studies included contact (either direct, indirect, or peer-mediation) and most included an education component (k = 10). Findings indicated that interventions are effective at improving attitudes toward autism, but further research is required to determine their overall impact. [ABSTRACT FROM AUTHOR]

How does work come to be constructed as a service to the worker? In the United States, the payment of subminimum wages to disabled workers has been legal since 1938 and was entrenched by 1986 legislation eliminating the previously mandated floor of 50 percent of the minimum wage. This article draws on primary historical materials to explain the passage of these amendments, which I analyze as a case of delaborization, a process through which work is mystified as such and reclassified as something else (e.g., service). I find that the managers of segregated workshops for disabled manual laborers rose to control disability employment policy in the aftermath of deinstitutionalization. Professionals mobilized disability stigma to frame the subminimum wage as a social welfare issue subject to their expertise and to lobby successfully for its entrenchment. Weaknesses in the disability–labor coalition enabled this seizure of jurisdiction. This research illuminates professional expertise, the withdrawal of labor unions, and identity-based stigma as major mechanisms driving delaborization, an important contemporary influence on the organization of work. The case of the subminimum wage thus develops sociological literatures on labor, disability, and politics. [ABSTRACT FROM AUTHOR]

This article examines the possibilities and pitfalls of using Big Data to address sexual and reproductive health concerns as related to the Sustainable Development Goals (SDGs), paying particular attention to contextual difference in development settings. The global datafication of sexual and reproductive life has taken place at great speed. However, evidential deficiencies and a lack of critical engagement of the specific issues around working with sexual and reproductive health Big Data in development contexts is apparent. Informed by critical data studies, and framed by a political economy perspective which calls attention to power structures, we seek to deepen our understanding of the role and challenges that Big Data around sexual and reproductive health in the Low and Middle-Income Countries can play in addressing the SDGs. First, we explore the ways in which sexual datafication processes produce Big Data. We then consider how such Big Data could directly contribute to addressing the SDGs beyond simply monitoring and evaluating. Next, we unpick how the sensitive and stigmatised nature of sexual and reproductive health can have ramifications in data-driven contexts where significant power asymmetries exist. By doing so, we provide a more nuanced articulation of the challenges of datafication by contextualising the stigma around sexual and reproductive in a datafied context. We argue that whilst Big Data in relation to sexual and reproductive health shows potential to support the SDGs, there are specificities that must be considered to ensure that the push for data-driven approaches does no harm. [ABSTRACT FROM AUTHOR]

A paradigm shift in circadian science is underway, exposing ethical tensions from a legacy of pervasive neglect of circadian disorders. This article canvasses ethical questions about stigma, justice, and accommodation that should be formally recognized to reconceive circadian care. Responding to these questions first requires confronting medicine's long-standing history of ableism in how circadian disorders are understood. This article also examines historical origins of the clinical and ethical need to expand diagnostic and therapeutic care access for patients with circadian disorders. Finally, this article recommends how to create space within the disabilities movement for persons with circadian disorders. [ABSTRACT FROM AUTHOR]