An intersectionality-informed psychotherapy approach to reduce HIV stigma.

Abstract

HIV stigma represents a major barrier across the continuum of HIV care that is associated with compromised engagement and retention in HIV care along with adherence to antiretroviral treatment. Therefore, stigma reduction efforts are critical to improving HIV health outcomes. However, there is no gold-standard evidence-based psychotherapy intervention for addressing stigma related to HIV or other marginalized identities. This article examines the role of psychotherapy to address the adverse cognitive, emotional, and behavioral effects of HIV stigma among persons with HIV, with the aims of promoting psychological well-being and supporting health behaviors associated with enhanced HIV treatment retention, adherence, and overall health outcomes. A psychotherapy approach informed by intersectionality theory is proposed, according to which multiple categories of identity, social status, privilege, and oppression simultaneously influence psychological life, including the experience of HIV stigma. Intersectionality-informed psychotherapy strategies to address HIV stigma are described and illustrated using a hypothetical clinical case example. Implications of an intersectionality-informed framework for therapist advocacy also are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).