Juliet Bramante, MD(c)
Nominated From: University of Washington
Research Site: Associación Civil Impacta Salud y Educación Clinical Research Site
Research Area: HIV Dermatology, HIV Mental Health
Primary Mentors: Dr. Sigrid Collier, Dr. Javier Lama
Research Project
Comparison of the experience of HIV-related and skin disease-related stigma between communities in the urban capital of Lima and the rural Loreto region of Peru
Between different geographical areas in Peru there are significant differences in access to treatment, preventive measures, and community support for people living with HIV. While the urban capital of Lima has the highest prevalence and number of cases of AIDS, the Amazonian region of Loreto has the next highest number of cases. Loreto faces unique barriers to access compared to the urban setting of Lima, and the majority of healthcare workers are found in urban and coastal areas. Stigmatization due to illness decreases quality of life among affected individuals and creates barriers to health equity. Stigma is an important self-identified barrier to healthcare for communities both in Loreto and in urban communities in Lima and may compound disparities in access to care.
Research Significance
Stigma associated with HIV appears to remain prevalent in both urban and rural communities of Peru and to affect engagement and adherence to available treatment, but to our knowledge no study has compared the experience of stigma in these two environments. Skin diseases associated with HIV are reported by clinicians to be present in these populations. However, the prevalence of skin diseases and their relationship to experiences of stigma in these cohorts have not been characterized. By addressing these knowledge deficits, our study will inform future efforts to tailor treatment and resources to meet the needs of patients in these very different environments and to reduce the burden of stigma. It will additionally help to characterize skin disease in these cohorts, as well as any need for consideration of HIV- associated skin disease in interventions designed to reduce stigma and disease burden.
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