Impact of a multicomponent navigation strategy on stigma among people living with HIV and Kaposi's sarcoma in Kenya: a qualitative analysis

J Natl Cancer Inst Monogr. 2024 Jun 5;2024(63):38-44. doi: 10.1093/jncimonographs/lgae017.

Abstract

Persons with HIV-associated Kaposi's sarcoma (KS) experience three co-existing stigmatizing health conditions: skin disease, HIV, and cancer, which contribute to a complex experience of stigmatization and to delays in diagnosis and treatment. Despite the importance of stigma among these patients, there are few proven stigma-reduction strategies for HIV-associated malignancies. Using qualitative methods, we explore how people with HIV-associated KS in western Kenya between August 2022 and 2023 describe changes in their stigma experience after participation in a multicomponent navigation strategy, which included 1) physical navigation and care coordination, 2) video-based education with motivational survivor stories, 3) travel stipend, 4) health insurance enrollment assistance, 5) health insurance stipend, and 6) peer mentorship. A purposive sample of persons at different stages of chemotherapy treatment were invited to participate. Participants described how a multicomponent navigation strategy contributed to increased knowledge and awareness, a sense of belonging, hope to survive, encouragement, and social support, which served as stigma mitigators, likely counteracting the major drivers of intersectional stigma in HIV-associated KS.

MeSH terms

  • Adult
  • Female
  • HIV Infections* / complications
  • HIV Infections* / psychology
  • Humans
  • Kenya / epidemiology
  • Male
  • Middle Aged
  • Patient Navigation
  • Qualitative Research*
  • Sarcoma, Kaposi* / epidemiology
  • Sarcoma, Kaposi* / etiology
  • Sarcoma, Kaposi* / psychology
  • Sarcoma, Kaposi* / therapy
  • Social Stigma*