Facing stigma and discrimination with resistance and resilience

University of Miami faculty and scholars contribute to highly respected journal addressing HIV-related intersectional stigmas and discrimination

For more than 25 years, Arnetta E. Phillips, a clinical research coordinator at the University of Miami Miller School of Medicine, has contributed her expertise and community connections to dozens of HIV investigators and researchers at the University working to advance the well-being of people living with HIV/AIDS in Miami-Dade County.

"I've known some of these researchers back when they had master's degrees," said Phillips. "I wouldn't necessarily call myself a 'mentor,' but I know that I've made a large impact."

Phillips plays a key role in bridging the gap between researchers and community organizations that work with individuals living with HIV, not only because she has deep roots in Miami, but because she too lives with the virus.  

"I am a gay, Black woman who has been living with HIV for almost 30 years," said Phillips. "If my personal story can help HIV investigators understand how it feels to live with HIV, and the importance of having empathy with others in the community who are like me, then I know they can connect with others with compassion and understanding."

Phillips now has the chance to share her story with a wider audience in a special issue of the American Journal of Public Health (AJPH) entitled, "Addressing HIV-Related Intersectional Stigma and Discrimination to Improve Public Health Outcomes."

The special issue is supported by the National Institutes of Health's Office of AIDS Research (NIH OAR) and the NIH National Institute of Mental Health (NIMH). The special issue features a wide selection of studies, research, editorials, and Phillips' personal narrative—the only personal story in the special issue.

"The intent of the special issue is to further inform and encourage researchers, practitioners, community and program leaders as well as other partners to more fully understand and consider the implications of intersectional stigma for people living with and most affected by HIV," said Paul Gaist, senior science advisor and health scientist at the NIH OAR and Greg Greenwood, a branch chief in NIMH's Division of AIDS Research, both co-authors of an article in the special issue.

Phillips' article is entitled, "Becoming in the Face of Intersectional Stigma – Black, Gay, Woman, and Living with HIV."

"I hope that the article shows the complete person that I am," said Phillips. "We are automatically put into different categories about how or why we contracted HIV in the first place when none of that should matter. What only matters are the persons living with something that has a stigma attached to it, and it's not right."

Dale
Dr. Sannisha Dale

Invited to contribute as a guest editor is Dr. Sannisha Dale, an associate professor in the College of Arts & Sciences'Department of Psychology. The invitation to guest-edit the special issue coincides with Dale's work to ensure that community voices are heard to improve diversity, equity, and inclusion.

Dale founded the Strengthening Health with Innovation and Engagement (SHINE) program, is a co-director of the Culturally focused HIV Advancements through the Next Generation for Equity (CHANGE) Training Program, and director of the Mental Health Disparities Core and Scientific director for Community Engagement of the UM Center for HIV and Research in Mental Health (CHARM).

"It has been a transformative experience to co-lead the special issue as a guest editor with other experts on HIV-related intersectional discrimination and stigma and bring to readers a series of research articles and editorials that present novel findings, theoretical conceptualization, and community voices," said Dale.

Additional co-editors include Lisa Bowleg, a professor from the Department of Psychological and Brain Sciences at The George Washington University; Carmen Logie, associate professor and Canada Research Chair in Global Health Equity and Social Justice with Marginalized Populations with the University of Toronto; and George Ayala, deputy director of the Alameda County Health Department.

"As guest editors, we repeatedly discussed the necessity to shine a light on the intersecting systems of oppression impacting people living with HIV and on efforts and approaches that are built on legacies of resistance and resilience evident in communities most impacted by HIV including LGBTQIA+, Black, Latinx/o/x, and immigrant communities," said Dale.

Also participating in the special issue is Assistant Professor of Economics Ian Wright with the University of Miami Patti and Allan Herbert Business School. His first-authored paper is entitled, "Neighborhood Characteristics, Intersectional Discrimination, Mental Health, and HIV Outcomes among Black Women Living with HIV," and includes other UM scholars as co-authors.  

Wright
Dr. Ian Wright

Wright says the paper focuses on the examination of neighborhood factors for Black women living with HIV who historically, and presently, face intersecting systems of oppression, such as structural racism, within their communities.   

"We hope that readers understand that neighborhoods may have an impact on the intersectional discrimination and stigma that Black women living with HIV experience and their physical and mental health," said Wright. "Health inequities faced by Black women living with HIV and other marginalized groups cannot thoroughly be understood or addressed without taking a multidisciplinary approach."

Their findings suggest that policy changes are needed to increase neighborhood education, employment, low-income housing, and religious organization, while also necessary to decrease crime and increase the household income of Black women living with HIV. "Such changes must be driven by federal, state, and local governments and through coordination and partnership with community-based entities," said Wright.

"I am excited to recommend this special issue to colleagues, team members, and mentees within and outside the field of HIV, because I believe everyone will walk away with a better understanding of drivers of health inequities and steps to move us forward," said Dale.

To view the AJPH special issue, click here.

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