{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T12:43:32Z","timestamp":1755693812095,"version":"3.41.2"},"reference-count":34,"publisher":"Wiley","issue":"S1","license":[{"start":{"date-parts":[[2022,7,12]],"date-time":"2022-07-12T00:00:00Z","timestamp":1657584000000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The experience of stigma can be multifaceted for people with HIV and cancer. Kaposi's sarcoma (KS), one of the most common HIV\u2010associated cancers in sub\u2010Saharan Africa, often presents with visible skin lesions that may put people at risk for stigmatization. In this way, HIV\u2010associated KS is unique, as people with KS can experience stigma associated with HIV, cancer, and skin disease simultaneously. The aim of this study is to characterize the intersectionality of HIV\u2010related, cancer\u2010related and skin disease\u2010related stigma in people living with HIV and KS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We used a convergent mixed\u2010methods approach nested within a longitudinal study of people with HIV\u2010associated KS in western Kenya. Between February 2019 and December 2020, we collected quantitative surveys among all participants and conducted semi\u2010structured interviews among a purposive sample of participants. Quantitative surveys were adapted from the abridged Berger HIV Stigma Scale to assess overall stigma, HIV\u2010related stigma, cancer\u2010related stigma, and skin disease\u2010related stigma. Qualitative data were coded using stigma constructs from the Health Stigma and Discrimination Framework.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In 88 semi\u2010structured interviews, stigma was a major barrier to KS diagnosis and treatment among people with HIV\u2010associated KS. Participant's stories of stigma were dominated by HIV\u2010related stigma, more than cancer\u2010related or skin disease\u2010related stigma. However, quantitative stigma scores among the 117 participants were similar for HIV\u2010related (Median: 28.00; IQR: 28.0, 34.0), cancer\u2010related (Median: 28.0; IQR: 28.0, 34.8), and skin disease\u2010related stigma (Median: 28.0; IQR: 27.0, 34.0). In semi\u2010structured interviews, cancer\u2010related and skin disease\u2010related stigma were more subtle contributors; cancer\u2010related stigma was linked to fatalism and skin\u2010related stigma was linked to visible disease. Participants reported resolution of skin lesions contributed to lessening stigma over time; there was a significant decline in quantitative scores of overall stigma in time since KS diagnosis (adjusted \u03b2 = \u20130.15, <jats:italic>p<\/jats:italic> &lt;0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study highlights the role mixed\u2010method approaches can play in better understanding stigma in people living with both HIV and cancer. While HIV\u2010related stigma may dominate perceptions of stigma among people with KS in Kenya, intersectional experiences of stigma may be subtle, and quantitative evaluation alone may be insufficient to understand intersectional stigma in certain contexts.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25918","type":"journal-article","created":{"date-parts":[[2022,7,12]],"date-time":"2022-07-12T10:24:24Z","timestamp":1657621464000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Telling the story of intersectional stigma in HIV\u2010associated Kaposi's sarcoma in western Kenya: a convergent mixed\u2010methods approach"],"prefix":"10.1002","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4143-0408","authenticated-orcid":false,"given":"Sigrid","family":"Collier","sequence":"first","affiliation":[{"name":"Division of Dermatology University of Washington  Seattle Washington 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