{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T16:37:51Z","timestamp":1784824671564,"version":"3.55.0"},"reference-count":42,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,5,6]],"date-time":"2020-05-06T00:00:00Z","timestamp":1588723200000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Providence\/Boston Center for AIDS Research","award":["K99DA041245"],"award-info":[{"award-number":["K99DA041245"]}]},{"name":"Providence\/Boston Center for AIDS Research","award":["P30AI042853"],"award-info":[{"award-number":["P30AI042853"]}]},{"name":"Providence\/Boston Center for AIDS Research","award":["R00DA041245"],"award-info":[{"award-number":["R00DA041245"]}]},{"name":"NIDA INVEST Fellowship"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Intern AIDS Soc"],"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Co\u2010located treatment for HIV and opioid use disorder has been shown to improve care outcomes for HIV\u2010positive people who inject drugs (PWID) in Ukraine. However, patients continue to be stigmatized for both HIV and substance use. This study aimed to assess whether co\u2010located care for HIV\u2010positive PWID receiving opioid agonist treatment (OAT) services in Ukraine is associated with less stigma and better perceived quality of HIV services.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This cross\u2010sectional study enrolled 191 HIV\u2010positive PWID who received OAT services at three healthcare facilities providing substance use treatment (OAT only) and at four facilities that provided co\u2010located care (both OAT and HIV treatment) in six regions in Ukraine during July\u2010September, 2017. Primary outcomes were HIV stigma (Berger scale), substance use stigma (Substance Abuse Stigma Scale) and intersectional stigma (both stigma forms above 75th percentile). Secondary outcome was quality of HIV care, a composite score based on a package of received services. Linear and ordinal regressions were used to assess the predictors of selected outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Study participants were 75% male, mean age 40\u00a0\u00b1\u00a07\u00a0years; 47% received co\u2010located care, and 10.5% had both high HIV and substance use stigma. Co\u2010located care was neither associated with HIV nor substance use stigma but it was linked to better quality of HIV care (adjusted odds ratio: 4.13; 95% CI: 2.31, 7.54). HIV stigma was associated with suicide attempts (adjusted beta (a\u03b2): 5.90; 95% CI: 2.05, 9.75), and substance use stigma was linked to poor mental health (a\u03b2: \u22120.26; 95% CI: \u22120.44, \u22120.08) and lower likelihood of\u00a0receipt of services from non\u2010governmental organization (NGO; a\u03b2: \u22126.40; 95% CI: \u221210.23, \u22122.57).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>One in ten people with HIV in this cohort\u00a0who received OAT services experienced high levels of both HIV and substance use stigma, which was associated with poorer mental health and less NGO support. Co\u2010located HIV and OAT services were linked to better perceived quality of HIV care, but did not seem to reduce stigma for this key population. Stigma interventions for PWID, possibly delivered involving NGOs, may be an approach to mitigate this challenge.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25492","type":"journal-article","created":{"date-parts":[[2020,5,6]],"date-time":"2020-05-06T07:31:23Z","timestamp":1588750283000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Stigma and quality of co\u2010located care for HIV\u2010positive people in addiction treatment in Ukraine: a cross\u2010sectional study"],"prefix":"10.1002","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4017-4561","authenticated-orcid":false,"given":"Yuliia","family":"Sereda","sequence":"first","affiliation":[{"name":"Ukrainian Institute on Public Health Policy Consultant Kyiv Ukraine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetiana","family":"Kiriazova","sequence":"additional","affiliation":[{"name":"Ukrainian Institute on Public Health Policy Kyiv Ukraine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olena","family":"Makarenko","sequence":"additional","affiliation":[{"name":"Ukrainian Institute on Public Health Policy Kyiv Ukraine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer J","family":"Carroll","sequence":"additional","affiliation":[{"name":"Elon University Elon NC USA"},{"name":"Warren Alpert Medical School of Brown University Providence RI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natasha","family":"Rybak","sequence":"additional","affiliation":[{"name":"Warren Alpert Medical School of Brown University Providence RI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andriy","family":"Chybisov","sequence":"additional","affiliation":[{"name":"American Cancer Society Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sally","family":"Bendiks","sequence":"additional","affiliation":[{"name":"Boston Medical Center Boston University Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bulat","family":"Idrisov","sequence":"additional","affiliation":[{"name":"Bashkir State Medical University Ufa Russia"},{"name":"Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation Moscow Russia"},{"name":"Moscow Institute of Physics and Technology Moscow Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arunima","family":"Dutta","sequence":"additional","affiliation":[{"name":"Boston Medical Center Boston University Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fizza S","family":"Gillani","sequence":"additional","affiliation":[{"name":"Warren Alpert Medical School of Brown University Providence RI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey H","family":"Samet","sequence":"additional","affiliation":[{"name":"Boston Medical Center Boston University Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Flanigan","sequence":"additional","affiliation":[{"name":"Warren Alpert Medical School of Brown University Providence RI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8495-0350","authenticated-orcid":false,"given":"Karsten","family":"Lunze","sequence":"additional","affiliation":[{"name":"Boston Medical Center Boston University Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,5,6]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-019-1250-8"},{"key":"e_1_2_9_3_1","unstructured":"Joint United Nations Programme on HIV\/AIDS (UNAIDS).The gap report 2014: people living with HIV. 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