Addressing Mental Health, Substance Use Stigma Alongside Infectious Disease

Psychology Researchers Work to Reduce Stigma in HIV/TB Care in South Africa

For many countries with high rates of infectious diseases like tuberculosis (TB) and HIV/AIDS, the coronavirus pandemic is exacerbating challenges related to diagnosis and treatment. University of Maryland psychology researchers will soon train community health workers to address another common problem associated with disease outbreaks: mental health and substance use stigma.

Supported by two recently awarded grants from the National Institutes of Health (NIH), a UMD research team will partner with the South African Medical Research Council on projects focused on TB and HIV patients in South Africa, home to the largest number of people living with HIV/AIDS and one of the highest rates of TB globally. The same community health workers deployed to interact with HIV and TB patients are now charged with doing home-based testing for COVID-19, which is prevalent and increasing in South Africa.

“Although our grant proposals were submitted prior to COVID-19, these projects will give us an opportunity to support health

care workers in interacting with patients who have mental health and substance use problems, which we know are at high risk for increasing during and following the COVID-19 pandemic,” said Jessica Magidson, an assistant psychology professor at UMD and a lead investigator on both research projects.

One project, supported by a $600,000 award from the National Institute of Mental Health, involves training community health workers making home visits to HIV and TB patients who have missed clinic appointments. The program aims to reduce stigma around mental health and substance use and develop effective ways to re-engage patients who are struggling with these problems.

The second project, funded by a $360,000 award from the National Institute on Drug Abuse and the Fogarty International Center at NIH, will evaluate how to integrate people with a personal history of substance use into HIV care teams, a strategy that Magidson’s team has been evaluating in the US in response to the opioid crisis.

“We know from prior studies that community health workers had high levels of stigma toward mental health and substance use. Both programs aim to reduce that stigma as a way to improve patient interactions and enhance engagement in HIV care,” Magidson said. “The NIDA award, in part funded by Fogarty, also supports capacity building and training on stigma research at UMD and in sub-Saharan Africa, with the ultimate goal of building a network of researchers focused on mental health, substance use and HIV stigma.”

In addition to Magidson, Bronwyn Myers from the South African Medical Research Council will serve as a co-principal investigator on both research projects, which will take place over the next 2-3 years. Other collaborators include colleagues at University of Cape Town, the service organization TB/HIV Care, Massachusetts General Hospital and George Washington University. The research team from UMD includes Charles Ma, assistant professor of biostatistics in the UMD School of Public Health; postdoctoral fellow Jennifer Belus in psychology; and clinical psychology doctoral students Kristen Regenauer and Alix Rose.