Background

People living with HIV are increasingly burdened by noncommunicable diseases (NCDs) as a result of the NCD susceptibility that accompanies increased life expectancy and the rising global prevalence of NCDs. Health systems are being strengthened and programs are being developed to address this burden, often building on HIV care strategies and infrastructure or through integrated care models. HIV remains a stigmatized condition and the role of HIV stigma in the provision of NCD care is not well understood.

Methods

We conducted a scoping literature review of both peer reviewed and grey literature to identify evidence of the role of HIV stigma in the NCD-care continuum (prevention, diagnosis, care seeking, retention in care, and adherence to treatment of NCDs). We searched PsychInfo and Pubmed and conducted additional searches of programmatic reports and conference abstracts. Included studies were published in English within the past decade and examined HIV-related stigma as it relates to NCD-care or to integrated NCD-and HIV-care programs.

Results

Sixteen articles met the inclusion criteria. Findings suggest: fear of disclosure, internalized shame and embarrassment, and negative past experiences with or negative perceptions of health care providers negatively influence engagement with NCD care; HIV stigma can adversely affect not only people living with HIV in need of NCD care, but all NCD patients; some NCDs are stigmatized in their own right or because of their association with HIV; integrating NCD and HIV care can both reduce stigma for people living with HIV and a present a barrier to access for NCD care.

Conclusion

Due to the dearth of available research and the variability in initial findings, further research on the role of HIV stigma in the NCD-care continuum for people living with HIV is necessary. Lessons from the field of HIV-stigma research can serve as a guide for these efforts.

中文翻译：

---

对与艾滋病有关的污名和歧视在非传染性疾病治疗中的作用进行范围界定的回顾

背景

由于预期寿命增加和全球非传染性疾病患病率上升，非传染性疾病易感性的结果使艾滋病毒携带者越来越多地受到非传染性疾病的负担。卫生系统正在得到加强，并且正在制定解决方案，以解决这一负担，通常建立在艾滋病毒的治疗策略和基础设施之上，或者通过综合性的治疗模式。艾滋病毒仍然是一种污名化的状况，人们对艾滋病毒耻辱在提供非传染性疾病护理中的作用还没有很好的了解。

方法

我们对同行评审和灰色文献进行了范围界定的文献综述，以找出证据表明艾滋病毒耻辱感在非传染性疾病护理连续性中的作用（预防，诊断，寻求护理，保留护理以及坚持治疗非传染性疾病）。我们搜索了PsychInfo和Pubmed，并进行了程序化报告和会议摘要的其他搜索。纳入的研究在过去十年中以英文发表，并检查了与艾滋病相关的污名，因为它与非传染性疾病的护理或与非传染性疾病和艾滋病毒的综合护理计划有关。

结果

符合纳入标准的文章有16篇。研究结果表明：害怕披露，内在的羞耻和尴尬，以及对医疗保健提供者的过往经历或负面看法，会对与非传染性疾病护理工作的参与产生负面影响；艾滋病毒的污名不仅会对需要非传染性疾病护理的艾滋病毒感染者产生不利影响，而且还会对所有非传染性疾病患者产生不利影响。一些非传染性疾病因其自身或与艾滋病毒的关系而受到污名化；将非传染性疾病和艾滋病毒护理相结合，既可以减少艾滋病毒感染者的污名，也为获得非传染性疾病护理提供了障碍。

结论

由于缺乏可用的研究并且初始结果存在差异，因此有必要进一步研究艾滋病毒耻辱在艾滋病毒感染者的非传染性疾病护理连续性中的作用。艾滋病毒耻辱研究领域的经验教训可以作为这些努力的指南。