Stigma experienced by people living with HIV who are on methadone maintenance treatment and have symptoms of common mental disorders in Hanoi, Vietnam: a qualitative study.

• DOI: 10.60692/wmjqt-zst12
• Publication Date: 2022-12-14
• Authors: H.V. Tran; Teresa R Filipowicz; Kelsey R. Landrum; Ha T. T. Nong; Thuy Thi Thanh Tran; Brian W. Pence; Vivian F. Go; Giang Minh Le; Minh Nguyen; Ruth Verhey; Dixon Chibanda; Hien Thi Ho; Bradley N. Gaynes
• Keywords: Epidemiology; Economics; Social Stigma; Social Sciences; HIV Infections; FOS: Health sciences; Anxiety; Common mental disorders; Focus group; 0302 clinical medicine; Sociology; Methadone maintenance; Psychology; Stigma (botany); Business; Drug use; Qualitative Research; Psychiatry; Marketing; Mental Disorders; Substance Abuse; Methadone maintenance treatment; Human immunodeficiency virus (HIV); Impact of Stigma on Mental Health Care; Social science; 3. Good health; FOS: Sociology; FOS: Psychology; Infectious Diseases; Vietnam; HIV/AIDS; Medicine; Mental health; Family medicine; Social Psychology; Substance-Related Disorders; Social stigma; FOS: Economics and business; 03 medical and health sciences; Qualitative research; Health Sciences; Humans; Global Epidemiology of HIV and Drug Use; Economic growth; drug use; Prevention and Treatment of HIV/AIDS Infection; Health-related Stigma; Research; Health care; HIV; RC581-607; Thematic analysis; Stigma; Immunologic diseases. Allergy; Methadone

Abstract Background Stigma around human immunodeficiency virus (HIV), injection drug use (IDU), and mental health disorders can be co-occurring and have different impacts on the well-being of people living with HIV (PWH) who use drugs and have mental health disorders. This stigma can come from society, health professionals, and internalized stigma. A person who has more than one health condition can experience overlapping health-related stigma and levels of stigma which can prevent them from receiving necessary support and healthcare, serving to intensify their experience with stigma. This study investigates HIV, drug use, and mental health stigmas in three dimensions (social, internalized, and professional) around PWH on methadone maintenance treatment (MMT) who have common mental disorders (CMDs) including depression, anxiety, and stress-related disorders in Hanoi, Vietnam.Please check and confirm whether corresponding author's email id is correctly identified.The cooresponding author's email is correct Methods We conducted semi-structured, in-depth interviews (IDIs) (n = 21) and two focus group discussions (FGDs) (n = 10) with PWH receiving MMT who have CMD symptoms, their family members, clinic health care providers, and clinic directors. We applied thematic analysis using NVIVO software version 12.0, with themes based on IDI and FGD guides and emergent themes from interview transcripts. Results The study found evidence of different stigmas towards HIV, IDU, and CMDs from the community, family, health care providers, and participants themselves. Community and family members were physically and emotionally distant from patients due to societal stigma around illicit drug use and fears of acquiring HIV. Participants often conflated stigmas around drug use and HIV, referring to these stigmas interchangeably. The internalized stigma around having HIV and injecting drugs made PWH on MMT hesitant to seek support for CMDs. These stigmas compounded to negatively impact participants’ health. Conclusions Strategies to reduce stigma affecting PWH on MMT should concurrently address stigmas around HIV, drug addiction, and mental health. Future studies could explore approaches to address internalized stigma to improve self-esteem, mental health, and capacities to cope with stigma for PWH on MMT. Trial registration: NCT04790201, available at clinicaltrials.gov.