{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T06:18:01Z","timestamp":1791958681739,"version":"4.3.4"},"reference-count":46,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2020,7,1]],"date-time":"2020-07-01T00:00:00Z","timestamp":1593561600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J STD AIDS"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:p>While stigma associated with human immunodeficiency virus (HIV) infection among men who have sex with men (MSM) is well recognized, there remains relatively limited intervention data on effective stigma reduction strategies. This systematic review was conducted to highlight the mechanisms through which sexual and HIV stigma is reduced in relation to HIV prevention and care engagement. Search of PubMed and Scopus resulted in 11 tested interventions to include in our preliminary model constructed from programme frameworks and recommendations. We refined the preliminary programme theory to identify whether, why, or how mitigation strategies produce observed outcomes. Our review showed that the interventions produced stigma reduction through three groups of mechanisms: (1) Self-acceptance, leadership, and motivational activation for behaviour change from intrapersonal strategies, such as education and mobile health strategies, which intervene on internalized and anticipated stigma; (2) socialization, knowledge sharing, and social empowerment from interpersonal strategies, such as peer support and training for care providers; and (3) community introspection, self-reflection, and humanistic activation from structural strategies such as community leaders\u2019 sensitization, which intervene on both anticipated and enacted stigma. Interventions mechanisms act complementarily and can be activated in different contexts in which MSM exposed to and infected with HIV are living.<\/jats:p>","DOI":"10.1177\/0956462420924984","type":"journal-article","created":{"date-parts":[[2020,7,6]],"date-time":"2020-07-06T14:26:26Z","timestamp":1594045586000},"page":"712-723","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":59,"title":["A realist systematic review of stigma reduction interventions for HIV prevention and care continuum outcomes among men who have sex with men"],"prefix":"10.1177","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9134-9288","authenticated-orcid":false,"given":"Willy","family":"Dunbar","sequence":"first","affiliation":[{"name":"Health Systems and Policies \u2013 International Health, School of Public Health, Universit\u00e9 Libre de Bruxelles (ULB), Brussels, Belgium"},{"name":"Haitian Study Group for Kaposi\u2019s Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aline","family":"Labat","sequence":"additional","affiliation":[{"name":"Health Systems and Policies \u2013 International Health, School of Public Health, Universit\u00e9 Libre de Bruxelles (ULB), Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Raccurt","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Quisqueya University, Port-au-Prince, Haiti"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Sohler","sequence":"additional","affiliation":[{"name":"Community Health and Social Medicine, City University of New York, School of Medicine, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean William","family":"Pape","sequence":"additional","affiliation":[{"name":"Haitian Study Group for Kaposi\u2019s Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti"},{"name":"Center for Global Health, Department of Medicine, Weill Cornell Medical College, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie","family":"Maulet","sequence":"additional","affiliation":[{"name":"Ecole de Sant\u00e9 Publique, Universit\u00e9 Catholique de Louvain, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yves","family":"Coppieters","sequence":"additional","affiliation":[{"name":"Health Systems and Policies \u2013 International Health, School of Public Health, Universit\u00e9 Libre de Bruxelles (ULB), Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,7,6]]},"reference":[{"key":"bibr1-0956462420924984","doi-asserted-by":"publisher","DOI":"10.1080\/19317611.2013.853720"},{"key":"bibr2-0956462420924984","doi-asserted-by":"crossref","first-page":"98","DOI":"10.7202\/1077606ar","volume":"1","author":"Lebouch\u00e9 B","year":"2011","journal-title":"Alterstice"},{"key":"bibr3-0956462420924984","doi-asserted-by":"publisher","DOI":"10.1097\/01.aids.0000327438.13291.62"},{"key":"bibr4-0956462420924984","doi-asserted-by":"publisher","DOI":"10.1080\/09540121.2011.613910"},{"key":"bibr5-0956462420924984","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-019-1271-3"},{"key":"bibr6-0956462420924984","volume-title":"Where medicine fails","author":"Wiener C","year":"1997"},{"key":"bibr7-0956462420924984","volume-title":"Stigmate, les usages sociaux des handicaps","author":"Goffman E.","year":"1975"},{"key":"bibr8-0956462420924984","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0188393"},{"key":"bibr9-0956462420924984","unstructured":"Joint United Nations Program on HIV\/AIDS. 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