{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T04:56:08Z","timestamp":1785905768553,"version":"3.56.0"},"reference-count":18,"publisher":"American Public Health Association","issue":"S7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Public Health"],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:p> Objectives. To assess changes in perceived external stigma among people living with HIV (PLWH) experiencing homelessness or unstable housing diagnosed with mental health or substance use disorders following an intervention including care coordination and navigation assistance, building trusting relationships, addressing unmet needs, and reducing barriers to seeking and engaging in care. <\/jats:p><jats:p> Methods. This study was part of a national multisite intervention project delivered at 6 geographically diverse sites throughout the United States from September 2013 through February 2017. Participant surveys were conducted at baseline, 6 months, and 12 months. We assessed perceived external stigma, defined as people\u2019s beliefs about others\u2019 attitudes toward them, related to HIV, homelessness, mental health disorders, and substance use disorders with modified stigma scales. <\/jats:p><jats:p> Results. A total of 548 individuals participated. At baseline, more participants reported experiencing any perceived external HIV stigma (81%) than any stigma related to homelessness and mental health or substance use disorders (38.9%). Over time, those reporting any HIV stigma decreased significantly from baseline (81%) to 61.4% and 57.8% at 6 and 12 months, respectively. <\/jats:p><jats:p> Conclusions. PLWH experiencing homelessness or unstable housing with mental health or substance use disorders are impacted by multilayered stigma. Interventions to engage them in care may help reduce stigma. <\/jats:p>","DOI":"10.2105\/ajph.2018.304774","type":"journal-article","created":{"date-parts":[[2018,12,11]],"date-time":"2018-12-11T21:10:20Z","timestamp":1544562620000},"page":"S546-S551","source":"Crossref","is-referenced-by-count":19,"title":["Longitudinal Stigma Reduction in People Living with HIV Experiencing Homelessness or Unstable Housing Diagnosed With Mental Health or Substance Use Disorders: An Intervention Study"],"prefix":"10.2105","volume":"108","author":[{"given":"Manisha Harisingh","family":"Maskay","sequence":"first","affiliation":[{"name":"Manisha Harisingh Maskay is with Prism Health North Texas, Dallas,. Howard J. Cabral is with Department of Biostatistics, Boston University School of Public Health, Boston, MA. Jessica A. Davila is with Center of Innovation, Effectiveness, and Quality, Sections of Health Services Research, Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, TX. Jo Ann Whitlock Davich is with Multnomah County HIV Health Services Center, Portland, OR. Ruthanne Marcus is with Yale..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Howard J.","family":"Cabral","sequence":"additional","affiliation":[{"name":"Manisha Harisingh Maskay is with Prism Health North Texas, Dallas,. Howard J. Cabral is with Department of Biostatistics, Boston University School of Public Health, Boston, MA. Jessica A. Davila is with Center of Innovation, Effectiveness, and Quality, Sections of Health Services Research, Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, TX. Jo Ann Whitlock Davich is with Multnomah County HIV Health Services Center, Portland, OR. Ruthanne Marcus is with Yale..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica A.","family":"Davila","sequence":"additional","affiliation":[{"name":"Manisha Harisingh Maskay is with Prism Health North Texas, Dallas,. Howard J. Cabral is with Department of Biostatistics, Boston University School of Public Health, Boston, MA. Jessica A. Davila is with Center of Innovation, Effectiveness, and Quality, Sections of Health Services Research, Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, TX. Jo Ann Whitlock Davich is with Multnomah County HIV Health Services Center, Portland, OR. Ruthanne Marcus is with Yale..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo Ann","family":"Whitlock Davich","sequence":"additional","affiliation":[{"name":"Manisha Harisingh Maskay is with Prism Health North Texas, Dallas,. Howard J. Cabral is with Department of Biostatistics, Boston University School of Public Health, Boston, MA. Jessica A. Davila is with Center of Innovation, Effectiveness, and Quality, Sections of Health Services Research, Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, TX. Jo Ann Whitlock Davich is with Multnomah County HIV Health Services Center, Portland, OR. Ruthanne Marcus is with Yale..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruthanne","family":"Marcus","sequence":"additional","affiliation":[{"name":"Manisha Harisingh Maskay is with Prism Health North Texas, Dallas,. Howard J. Cabral is with Department of Biostatistics, Boston University School of Public Health, Boston, MA. Jessica A. Davila is with Center of Innovation, Effectiveness, and Quality, Sections of Health Services Research, Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, TX. Jo Ann Whitlock Davich is with Multnomah County HIV Health Services Center, Portland, OR. Ruthanne Marcus is with Yale..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily K.","family":"Quinn","sequence":"additional","affiliation":[{"name":"Manisha Harisingh Maskay is with Prism Health North Texas, Dallas,. Howard J. Cabral is with Department of Biostatistics, Boston University School of Public Health, Boston, MA. Jessica A. Davila is with Center of Innovation, Effectiveness, and Quality, Sections of Health Services Research, Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, TX. Jo Ann Whitlock Davich is with Multnomah County HIV Health Services Center, Portland, OR. Ruthanne Marcus is with Yale..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serena","family":"Rajabiun","sequence":"additional","affiliation":[{"name":"Manisha Harisingh Maskay is with Prism Health North Texas, Dallas,. Howard J. Cabral is with Department of Biostatistics, Boston University School of Public Health, Boston, MA. Jessica A. Davila is with Center of Innovation, Effectiveness, and Quality, Sections of Health Services Research, Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, TX. Jo Ann Whitlock Davich is with Multnomah County HIV Health Services Center, Portland, OR. 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