ArticleAddiction science & clinical practice2022
"It's all about asking from those who have walked the path": Patient and stakeholder perspectives on how peers may shift substance use stigma in HIV care in South Africa.
Article in Addiction science & clinical practice, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 41 citations in OpenAlex.
- Siyakhana: A hybrid type 2 effectiveness-implementation stepped-wedge trial to reduce stigma towards substance use and depression among community health workers in HIV/TB care in South Africa.Journal of substance use and addiction treatment · 2025Trial
- Intersectional Stigma and Health of People Living with HIV on ART Who Use Alcohol in Southwestern Uganda.AIDS and behavior · 2026Article
- Article
- Exploring patient perspectives on a new task-shared behavioral health role in Washington State.PLOS mental health · 2026Article
- Analysis of factors influencing rapid treatment initiation decisions among people living with HIV: focusing on the role of social support.Frontiers in public health · 2026Article
- Mapping experiences of workplace stigma and discrimination within the lived-living experience of illicit drug use and bloodborne virus peer workforce: a scoping review.Harm reduction journal · 2025Article
- A stakeholder-driven approach to designing a peer recovery coach role for implementation in community-oriented primary care teams in South Africa.Addiction science & clinical practice · 2025Article
- Family Perspectives on Stigma Toward Women Who Use Drugs in Tanzania.Issues in mental health nursing · 2025Article
- Intersectional HIV stigma in Sub-Saharan Africa, Latin America and the Caribbean: Insights and pathways forward - A scoping review.PLOS global public health · 2025Article
- Development and feasibility of the peer and nurse-led HIV Self-Testing Education and Promotion (STEP) intervention among social networks of men in Dar es Salaam, Tanzania: application of the ADAPT-ITT model.BMC health services research · 2024Article
- Patient and provider perceptions of the relationship between alcohol use and TB and readiness for treatment: a qualitative study in South Africa.BMC public health · 2024Article
- A stakeholder-driven approach to designing a peer recovery coach role for implementation in community-oriented primary care teams in South Africa.Research square · 2024Article
- Community health worker training to reduce mental health and substance use stigma towards patients who have disengaged from HIV/TB care in South Africa: protocol for a stepped wedge hybrid type II pilot implementation trial.Implementation science communications · 2024Article
- Piloting Siyakhana: A community health worker training to reduce substance use and depression stigma in South African HIV and TB care.PLOS global public health · 2024Article
- Community interventions for pandemic preparedness: A scoping review of pandemic preparedness lessons from HIV, COVID-19, and other public health emergencies of international concern.PLOS global public health · 2024Article
- Validation of a brief screener for broad-spectrum mental and substance-use disorders in South Africa.Global mental health (Cambridge, England) · 2024Article
- Patient and provider perceptions of the relationship between alcohol use and TB and readiness for treatment: a qualitative study in South Africa.Research square · 2023Article
- Self-reported alcohol use versus phosphatidylethanol in behavioral trials: A study of people living with HIV in Tshwane, South Africa.Alcohol, clinical & experimental research · 2023Article
- Community-based counselling programme for pregnant women with alcohol problems in Cape Town, South Africa: a qualitative study of the views of pregnant women and healthcare professionals.Frontiers in psychiatry · 2023Article
Corrections and comments
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Authors and funding
12 authors at 6 institutions in 4 countries.
Funding
Abstract
backgroundSouth Africa has the highest number of people with HIV (PWH) globally and a significant burden of co-occurring substance use disorder (SUD). Health care worker (HCW) stigma towards SUD is a key barrier to HIV care engagement among PWH with SUD. Support from peers-individuals with lived experience of SUD-may be a promising solution for addressing SUD stigma, while also improving engagement in HIV care. We evaluated the perceived acceptability of integrating a peer role into community-based HIV care teams as a strategy to address SUD stigma at multiple levels and improve patient engagement in HIV care.
methodsPatients and stakeholders (N = 40) were recruited from publicly-funded HIV and SUD organizations in Cape Town, South Africa. We conducted a quantitative assessment of stigma among stakeholders using an adapted Social Distance Scale (SDS) and patient perceptions of working with a peer, as well as semi-structured interviews focused on experiences of SUD stigma, acceptability of a peer model integrated into community-based HIV care, and potential peer roles.
resultsOn the SDS, 75% of stakeholders had high stigma towards a patient with SUD, yet 90% had low stigma when in recovery for at least 2 years. All patients endorsed feeling comfortable talking to someone in recovery and wanting them on their HIV care team. Three main themes emerged from the qualitative data: (1) patient-reported experiences of enacted SUD and HIV stigmas were common and impacted HIV care engagement; (2) both patients and stakeholders considered a peer model highly acceptable for integration into HIV care to support engagement and address SUD stigma; and (3) patients and stakeholders identified both individual-level and systems-level roles for peers, how peers could work alongside other providers to improve patient care, and key characteristics that peers would need to be successful in these roles.
conclusionsFindings from this formative work point to the promise of a peer model for reducing SUD stigma among patients and HCWs within community-based HIV care teams in SA.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.