PROJECTS IN TURKEY:

 

 

1. Free will:

We examine the role of beliefs in free will in stigmatizing attitudes against individuals who attempted a suicide or those who use illicit substances as well as the role of cultural orientation in stigma.

Collaborators are from: Michigan State University

 

2. Epilepsy:

Using mixed methods research, we examine stigmatizing attitudes against individuals living with epilepsy and their families and the effects of these attitudes.

Collaborators are from: Koc University Departments of Neurology and Public Health

 

 

3. Substance Use Prototype:

We examine the prototype of people using substances, as well as predictors and consequences of endorsing this prototype.

Collaborators are from: Koc University Department of Psychology, TED University

 

4. Refugee Prototype:

We examine the prototype of refugees in Turkey in the minds of Turkish people, as well as predictors and consequences of endorsing this prototype.

Collaborators are from: TED University

 

5. Refugee Stigma:

We examine the associations of different dimensions of stigma related to living as a refugee in Turkey with mental and physical health outcomes for Afghan and Syrian refugees living in Turkey.

Collaborators are from: TED University, University of Alabama at Birmingham

 

 

6. Homophobia and HIV-Related Stigma:

We are investigating the intersectional stigma related to sexual orientation and living with HIV on health outcomes.

Collaborators are from: Ege Üniversitesi, Dokuz Eylül Üniversitesi, İzmir Tepecik Eğitim
Araştırma Hastanesi

 

7. HIV Stigma Among Medical Students:

We examine how political orientation is associated with social distance from people living with stigmatized conditions and the mediating roles of stigma and negative intergroup emotions in this association.

Collaborators are from: İzmir Tepecik Eğitim Araştırma Hastanesi, University of Alabama
at Birmingham

 

 

 

PROJECTS OUTSIDE OF TURKEY:

 

 

8. WAVE:

In this study, we examine the longitudinal effects of dimensions of HIV-related stigma on adherence to medications and HIV care visits as well as neurocognitive outcomes in women enrolled in the national Women’s Interagency HIV Study (WIHS) cohort, as well as examining mechanisms and intersecting stigmas.

Collaborators are from: Columbia University, University of California San Francisco,
University of Alabama at Birmingham

 

9. Insecurity Related to Material Needs and Poverty Stigma:

We are examining the separate as well as intersectional effects of 4 specific material-need insecurities (food insecurity, housing insecurity, financial insecurity, healthcare insecurity) on health outcomes and the mediating role of poverty-related stigma in these associations.

Collaborators are from: University of California San Francisco, Columbia University,
University of Alabama at Birmingham

 

10. Stigma in Healthcare Settings:

The goal of this project is to examine the effects of stigma and discrimination in healthcare settings on patient-provider interactions, engagement in care, treatment adherence, and viral load among women living with HIV, using a mixed methods design.

Collaborators are from: Florida State University, University of California San Francisco,
TED University, University of Alabama at Birmingham

 

 

11. Substance Use Stigma:

We are examining the longitudinal association between substance use (non-users vs. categories of users), intersecting stigmas due to substance use and HIV, and health outcomes.

Collaborators are from: Middle Tennessee State University, University of Florida,
Columbia University, University of California San Francisco, University of Alabama at
Birmingham

 

 

 

12. Stigma and Immune Markers:

We will test the longitudinal relationship of stigma/discrimination, depression, and substance use with markers of immune activation, neurobiological pathways, and cognitive impairment phenotypes.

Collaborators are from: Columbia University, University of Alabama at Birmingham

 

 

13. Stigma Measurement:

We are developing and will validate a new “updated” and acceptable measure of internalized HIV-related stigma. Our aim is to create a new measure that PLWH find acceptable, has good reliability and validity, and that is predictive of important HIV health outcomes.

Collaborators are from: TED University, University of Alabama at Birmingham

 

 

14. PREP:

We developed a multi-item measure of PrEP-related stigma in 3 steps: 1) conducting qualitative in-depth interviews (IDIs) with current and potential PrEP users to identify constructs and issues related to PrEP-related stigma and PrEP adherence; 2) creating an item pool using information from these interviews and existing literature; 3) conducting cognitive interviews with PrEP users to evaluate the pool of items and to develop a multi-item measure of PrEP-related stigma, with relevant sub-scales measuring different dimensions. Then we examined the psychometric properties of the new stigma subscales to finalize the multi-subscale measure. Finally, we will examine the associations of the new measure of PrEP stigma with adherence to medication (assessed with drug concentrations in blood samples and self-reports), and to clinic visit adherence (assessed using data extracted from clinic records).

Collaborators are from: University of Alabama at Birmingham, TED University

 

15. Experience Sampling of Stigma:

Using experience sampling methodology, we assess how within-person changes in stigma are associated with within-person changes in self-esteem, mood, avoidance coping, and self-efficacy in coping with HIV. We also examine whether experiencing discrimination and stigma is associated with a key biological marker of stress: salivary cortisol levels and the role of attachment orientations in these associations.

Collaborators are from: Columbia University

 

16. Harm Reduction:

We are exploring healthcare providers’ attitudes towards working with people living with HIV who use drugs and the ways these relate to their providers’ acceptance and practice of structural and relational harm reductions. We are also examining the degree to which patients’ perceptions of their HIV providers’ harm reduction care are is associated with lower experienced intersectional stigma in HIV primary care settings, quality of the patient-provider relationship, and clinical outcomes. Finally, we will use human-centered design approaches to develop an intervention to operationalize target harm reduction care in HIV clinical settings.

Collaborators are from: Pittsburgh University

 

 

17. HIV Prototype:

We are investigating if there is a negative prototype of people living with HIV in the minds of the community in the United States, as well as predictors and consequences of endorsing this prototype.

Collaborators are from: University of Alabama at Birmingham, TED University

 

18.Transgender women:

The aim is to develop a multi-item measure of trauma specific to transgender women and identify associations between trauma and healthcare utilization.

 

19. Jamii Bora Study:

Testing Strategies for Couple Engagement in PMTCT and Family Health in Kenya. This study is testing the efficacy and cost-effectiveness of an interdependence theory-based couples intervention that reaches pregnant women and male partners through home visits and addresses HIV-related stigma. Baseline analyses are examining the role of couple-level stigma on mental health.

Collaborators: University of Alabama at Birmingham, Kenya Medical Research Institute,
University of Michigan, Sabanci University, and University of North Carolina.

 

20. Pregnant and Postpartum Women in Kenya:

Piloting risk stratification and tailored interventions with pregnant and postpartum women with HIV in Kenya to prevent disengagement from care and viral failure. This proposal seeks to improve HIV outcomes among pregnant and postpartum women living with HIV and their infants in sub-Saharan Africa by using Problem Management Plus to address stigma, mental health problems, and intimate partner violence.

Collaborators: University of Alabama at Birmingham, University of Colorado, Kenya
Medical Research Institute.

 

 

21. Breast Cancer Stigma:

Understanding stigma around breast cancer in Nairobi, Kenya and Karachi Pakistan. Two linked pilot studies are using mixed methods research to understand breast cancer stigma from the point of view of patients, family members, and
providers.

Collaborators: University of Alabama at Birmingham, Aga Khan University-Nairobi, Aga
Khan University-Karachi.

 

22. FRESH DR Study:

Adapting the Finding Respect and Ending Stigma around HIV (FRESH) Intervention for the Dominican Republic. This study addresses stigma against people living with HIV, particularly gender and sexual minorities, that is embedded in the Dominican Republic’s HIV treatment system through the adaptation and testing of a patient-provider intervention.

Collaborators: University of Alabama at Birmingham, UNIBE, CVCC, Florida State
University, RTI.

 

 

23. Intersectional Stigma:

Stigma and the non-communicable disease syndemic in aging HIV positive and HIV negative MSM. This study will provide essential data to elucidate mechanisms and morbidities underlying health inequities affecting sexual minority men in the United States.

Collaborators: University of Alabama at Birmingham, University of Pittsburgh, Rutgers
University.

 

 

24. COVID-19 Stigma:

Reducing Ethical and Social Prejudicial Effects of COVID-19 Testing in Underserved Populations (RESPECT-UP). This project aims to understand and address the social, ethical, and behavioral factors—including stigma–surrounding COVID- 19 testing in vulnerable urban and rural African American communities in Alabama.

Collaborators: University of Alabama at Birmingham.

 

25. Uganda Infertility Stigma:

Exploring how intersectional stigmas among MWH in Uganda contribute to poor HIV outcomes for men and HIV incidence among women of reproductive age. This project works with a disparity population in sub-Saharan Africa. The study used mixed methods research that will position this team to develop interventions to address infertility and HIV stigma for MLWH and their partners and support their engagement and retention in HIV care and prevention.

Collaborators: University of Alabama at Birmingham, Mbarara University, Uganda.

 

26. TB Stigma:

Multi-level and Intersectional Stigma and other Social Determinant Effects on TB Case Detection, Care, and Treatment Outcomes: The MISSED TB Outcomes Study. This study will increase our understanding of the social determinants, with an emphasis on TB- and HIV-related stigmas, that influence progression along the TB cascade.

Collaborators: University of Alabama at Birmingham, Desmond Tutu Foundation, South
Africa.