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Alanna Bergman

Title: Intersectional Stigma Through the Care Continuum: A Mixed-Methods Study Integrating Theory and Method Lead Investigator: Alanna Bergman Faculty Mentor: Dr. Jason E. Farley

Adherence to HIV and tuberculosis (TB) treatment is the most effective means to improve patient outcomes. Stigma, which undermines adherence and reinforces healthcare inequities, remains a major barrier to achieving TB eradication and HIV prevention goals. Despite this, we know little about if and how stigma changes over time, or in response to hallmark events in infectious disease treatment. As individuals move from pre-diagnosis to diagnosis of one or more infectious diseases, and towards TB cure and/or HIV viral suppression, they move in and out of illness identities. This research will use mixed-methods to explore stigma through the TB/HIV care continuum to determine if individuals experience higher levels of stigma at specified time points, and whether illness identity, mediated by the hallmark events of HIV viral suppression as well as TB smear and/or culture conversion, impact a person’s stigma score.

A nested prospective cohort within LEAP-TB-SA will undergo serial stigma measurements to determine if mean level of stigma changes through the care continuum. This data will be triangulated against serial qualitative interviews to highlight if and how stigma changes over time and across hallmark events.