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BACKGROUND: Despite advances at every stage of the HIV care continuum, HIV-related stigma still presents a significant barrier to accessing care globally for people living with HIV (PLWH). The effect of stigma and discrimination on treatment adherence and health outcomes is especially worsened for younger PLWH belonging to key vulnerable populations and identifying within intersectional gender and/or sexual minorities. In Latin America young PLWH, especially those identifying as MSM (men who have sex with men) and TGW (transgender women) are at a disproportionately higher risk of facing HIV-related stigma, and subsequent under-utilization of HIV prevention and treatment services. Social media-based HIV stigma-reduction campaigns present a growing area of research in designing interventions to disseminate health resources, normalize prevention and treatment, and reduce the harmful HIV-related stigmas PLWH may face. This project’s aims are two-fold: to understand the stigmatizing beliefs and experiences young PLWH living in Lima, Peru encounter, and to identify the key messages and features they believe would be most effective for dissemination in a future HIV stigma-reduction social media campaign. METHODS: This study was conducted as a qualitative focus group interview study in Lima, Peru from November 2022 to February 2023. Interview questions covered their experiences of stigma and suggested messages for social media, and were structured using an interview guide. Participants were recruited from 4 key groups of PLWH: adolescents/young adults with perinatally-acquired infection, adolescents/young adults with recently-acquired infection, young MSM, and young TGW. Creation of a pilot codebook and subsequent qualitative analysis of focus group data were conducted using thematic content analysis and conceptual frameworks determined to be in line with objectives. RESULTS: 7 focus group interviews were conducted with 48 participants aged 17 to 29 years old. Participants represented a diverse range of gender and sexual identities. Participants across all groups faced a range of HIV-related discriminatory/stigmatizing behaviors and stereotypes affecting multiple aspects of everyday life, from relationships with close family and friends to schooling and employment prospects and accessing medical care. Suggestions for future messaging content and design included creating content addressing health-related misconceptions for PLWH navigating their diagnosis and the general public, portraying PLWH with more positivity and normalcy, recruiting influencers from backgrounds not typically targeted in HIV messaging to disseminate content to larger audiences, and creating both short- and long-form content formats to share on social media platforms for engaging users of different ages/demographics. CONCLUSION: Based on the range of different encountered stigmas and messaging suggestions shared by young PLWH, future HIV stigma-reduction social media campaigns should feature accurate health and social messages from a diversity of societal leaders and PLWH, span a breadth of content formats, and do so with tones of optimism to educate the general public and shift attitudes to empower young PLWH as they move forward in their lives. / 2026-03-08T00:00:00Z

The most important aspect of an encounter between a patient and his or her provider is the patient's ability to understand and implement the treatment plan and self-care instructions conferred by the provider. However, the literature in the field of patient-provider communication reveals that there is a noticeable gap in health literacy in certain patient populations that impairs their ability to understand pre-, during, and post-encounter paperwork, terminology, treatment plan, and critical self-care instructions. This has been shown to have detrimental consequences on patient health outcomes. The teach-back method, in which providers request patients to repeat key information discussed during the encounter in their own words, has been shown to successfully improve patient satisfaction, self-efficacy, and knowledge post-encounter. This paper seeks to investigate the impact of health literacy and teach-back on patient satisfaction, self-efficacy, and knowledge, and to determine the effect of a teach-back training intervention on the usage of teach-back during a patient-provider encounter. A total of 88 patients and 11 providers participated in this study over the course of two semesters. A pre- and post-encounter questionnaire was provided to patients and a post-encounter questionnaire to providers. Data regarding teach-back instances during the encounter were obtained via transcripts of encounter audio recordings. Training was given to 17 providers between semesters, 11 of whom were participating in a larger study data collection, and pre- and post-training teach-back instances were compared. The data were coded and statistically analyzed. The results were that there was a statistically significant relationship between health literacy and patient satisfaction as well as patient self-efficacy. Additionally, there was a significant relationship between teach-back and patient self-efficacy with an upward trend observed on the knowledge measures post-teach-back. Teach-back interventional training was also seen to have a statistically significant impact on provider use of teach-back during the patient encounter. Additional research in this field observing fidelity of teach-back practice and observing impacts of teach-back on a separate non-student population could be beneficial in improving patient encounters.

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