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Chan, Brian

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Chan

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Chan, Brian

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2013 - 20173

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Author's Publications: search.filters.isAuthorOfPublication.17126764-9810-4929-b97e-afb79e2c4a35

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Now showing 1 - 3 of 3
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    Association between internalized stigma and depression among HIV-positive persons entering into care in Southern India
    (Edinburgh University Global Health Society, 2017) Chan, Brian; Pradeep, Amrose; Prasad, Lakshmi; Murugesan, Vinothini; Chandrasekaran, Ezhilarasi; Kumarasamy, Nagalingeswaran; Mayer, Kenneth; Tsai, Alexander
    Background: In India, which has the third largest HIV epidemic in the world, depression and HIV–related stigma may contribute to high rates of poor HIV–related outcomes such as loss to care and lack of virologic suppression. Methods: We analyzed data from a large HIV treatment center in southern India to estimate the burden of depressive symptoms and internalized stigma among Indian people living with HIV (PLHIV) entering into HIV care and to test the hypothesis that probable depression was associated with internalized stigma. We fitted modified Poisson regression models, adjusted for sociodemographic variables, with probable depression (PHQ–9 score ≥10 or recent suicidal thoughts) as the outcome variable and the Internalized AIDS–Related Stigma Scale (IARSS) score as the explanatory variable. Findings: 521 persons (304 men and 217 women) entering into HIV care between January 2015 and May 2016 were included in the analyses. The prevalence of probable depression was 10% and the mean IARSS score was 2.4 (out of 6), with 82% of participants endorsing at least one item on the IARSS. There was a nearly two times higher risk of probable depression for every additional point on the IARSS score (Adjusted Risk Ratio: 1.83; 95% confidence interval, 1.56–2.14). Conclusions: Depression and internalized stigma are highly correlated among PLHIV entering into HIV care in southern India and may provide targets for policymakers seeking to improve HIV–related outcomes in India.
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    Peritoneal Tuberculosis in a Pregnant Woman from Haiti, United States
    (U.S. National Center for Infectious Diseases, 2013) Ard, Kevin; Chan, Brian; Milner, Danny; Farmer, Paul; Koenig, Serena
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    Personal contact with HIV-positive persons is associated with reduced HIV stigma: cross-sectional analysis of general population surveys from 26 countries in sub-Saharan Africa
    (International AIDS Socity, 2016) Chan, Brian; Tsai, Alexander
    Introduction: HIV-related stigma hampers treatment and prevention efforts worldwide. Effective interventions to counter HIV-related stigma are greatly needed. Although the “contact hypothesis” suggests that personal contact with persons living with HIV (PLHIV) may reduce stigmatizing attitudes in the general population, empirical evidence in support of this hypothesis is lacking. Our aim was to estimate the association between personal contact with PLHIV and HIV-related stigma among the general population of sub-Saharan Africa. Methods: Social distance and anticipated stigma were operationalized using standard HIV-related stigma questions con-tained in the Demographic and Health Surveys and AIDS Indicator Surveys of 26 African countries between 2003 and 2008. We fitted multivariable logistic regression models with country-level fixed effects, specifying social distance as the dependent variable and personal contact with PLHIV as the primary explanatory variable of interest. Results: We analyzed data from 206,717 women and 91,549 men living in 26 sub-Saharan African countries. We estimated a statistically significant negative association between personal contact with PLHIV and desires for social distance (adjusted odds ratio [AOR] = 0.80; p < 0.001; 95% Confidence Interval [CI], 0.73–0.88). In a sensitivity analysis, a similar finding was obtained with a model that used a community-level variable for personal contact with PLHIV (AOR = 0.92; p < 0.001; 95% CI, 0.89–0.95). Conclusions: Personal contact with PLHIV was associated with reduced desires for social distance among the general population of sub-Saharan Africa. More contact interventions should be developed and tested to reduce the stigma of HIV.