TY - JOUR
T1 - Effect of stigma reduction intervention strategies on HIV test uptake in low- and middle-income countries
T2 - A realist review protocol
AU - Thapa, Subash
AU - Hannes, Karin
AU - CARGO, Margaret
AU - Buve, Anne
AU - Mathei, Catharina
PY - 2015/11/2
Y1 - 2015/11/2
N2 - Background: Several stigma reduction intervention strategies have been developed and tested for effectiveness in terms of increasing human immunodeficiency virus (HIV) test uptake. These strategies have been more effective in some contexts and less effective in others. Individual factors, such as lack of knowledge and fear of disclosure, and social-contextual factors, such as poverty and illiteracy, might influence the effect of stigma reduction intervention strategies on HIV test uptake in low- and middle-income countries. So far, it is not clearly known how the stigma reduction intervention strategies interact with these contextual factors to increase HIV test uptake. Therefore, we will conduct a review that will synthesize existing studies on stigma reduction intervention strategies to increase HIV test uptake to better understand the mechanisms underlying this process in low- and middle-income countries. Methods: A realist review will be conducted to unpack context-mechanism-outcome configurations of the effect of stigma reduction intervention strategies on HIV test uptake. Based on a scoping review, we developed a preliminary theoretical framework outlining a potential mechanism of how the intervention strategies influence HIV test uptake. Our realist synthesis will be used to refine the preliminary theoretical framework to better reflect mechanisms that are supported by existing evidence. Journal articles and grey literature will be searched following a purposeful sampling strategy. Data will be extracted and tested against the preliminary theoretical framework. Data synthesis and analysis will be performed in five steps: organizing extracted data into evidence tables, theming, formulating chains of inference from the identified themes, linking the chains of inference and developing generative mechanisms, and refining the framework. Discussion: This will be the first realist review that offers both a quantitative and a qualitative exploration of the available evidence to develop and propose a theoretical framework that explains why and how HIV stigma reduction intervention strategies influence HIV test uptake in low- and middle-income countries. Our theoretical framework is meant to provide guidance to program managers on identifying the most effective stigma reduction intervention strategies to increase HIV test uptake. We also include advice on how to effectively implement these strategies to reduce the rate of HIV transmission. Systematic review registration: PROSPERO CRD42015023687
AB - Background: Several stigma reduction intervention strategies have been developed and tested for effectiveness in terms of increasing human immunodeficiency virus (HIV) test uptake. These strategies have been more effective in some contexts and less effective in others. Individual factors, such as lack of knowledge and fear of disclosure, and social-contextual factors, such as poverty and illiteracy, might influence the effect of stigma reduction intervention strategies on HIV test uptake in low- and middle-income countries. So far, it is not clearly known how the stigma reduction intervention strategies interact with these contextual factors to increase HIV test uptake. Therefore, we will conduct a review that will synthesize existing studies on stigma reduction intervention strategies to increase HIV test uptake to better understand the mechanisms underlying this process in low- and middle-income countries. Methods: A realist review will be conducted to unpack context-mechanism-outcome configurations of the effect of stigma reduction intervention strategies on HIV test uptake. Based on a scoping review, we developed a preliminary theoretical framework outlining a potential mechanism of how the intervention strategies influence HIV test uptake. Our realist synthesis will be used to refine the preliminary theoretical framework to better reflect mechanisms that are supported by existing evidence. Journal articles and grey literature will be searched following a purposeful sampling strategy. Data will be extracted and tested against the preliminary theoretical framework. Data synthesis and analysis will be performed in five steps: organizing extracted data into evidence tables, theming, formulating chains of inference from the identified themes, linking the chains of inference and developing generative mechanisms, and refining the framework. Discussion: This will be the first realist review that offers both a quantitative and a qualitative exploration of the available evidence to develop and propose a theoretical framework that explains why and how HIV stigma reduction intervention strategies influence HIV test uptake in low- and middle-income countries. Our theoretical framework is meant to provide guidance to program managers on identifying the most effective stigma reduction intervention strategies to increase HIV test uptake. We also include advice on how to effectively implement these strategies to reduce the rate of HIV transmission. Systematic review registration: PROSPERO CRD42015023687
KW - HIV stigma
KW - HIV test uptake
KW - Low- and middle-income countries
KW - Realist synthesis
KW - Stigma reduction intervention strategies
KW - Humans
KW - Health Knowledge, Attitudes, Practice
KW - HIV Infections/diagnosis
KW - Social Discrimination
KW - Patient Acceptance of Health Care
KW - Systematic Reviews as Topic
KW - Developing Countries
KW - Social Stigma
KW - Research Design
UR - http://www.scopus.com/inward/record.url?scp=84945915681&partnerID=8YFLogxK
UR - http://www.mendeley.com/research/effect-stigma-reduction-intervention-strategies-hiv-test-uptake-low-middleincome-countries-realist-r-1
UR - http://www.mendeley.com/research/effect-stigma-reduction-intervention-strategies-hiv-test-uptake-low-middleincome-countries-realist-r
U2 - 10.1186/s13643-015-0130-3
DO - 10.1186/s13643-015-0130-3
M3 - Article
C2 - 26527403
SN - 2046-4053
VL - 4
SP - 1
EP - 7
JO - Systematic Reviews
JF - Systematic Reviews
IS - 1
M1 - 142
ER -