Objectives: To compare explicit and implicit stigmatizing attitudes towards mental illness among undergraduate students, medical school students, and psychiatrists, and to assess whether attitudes are associated with education level, exposure to, and personal experience with mental illness. Methods: Participants from McMaster University were recruited through email. Participants completed a web-based survey consisting of demographics; the Opening Minds Scale for Healthcare Providers (OMS-HC) 12-item survey, which measures explicit stigma; and an Implicit Association Test (IAT), measuring implicit bias toward physical illness (diabetes mellitus) or mental illness (schizophrenia). Results: A total of 538 people participated: undergraduate students ( n = 382), medical school students ( n = 118), and psychiatrists ( n = 38). Psychiatrists had significantly lower explicit and implicit stigma than undergraduate students and medical school students. Having been diagnosed with mental illness or having had a relationship with someone experiencing one was significantly associated with lower explicit stigma. Mean scores on the OMS-HC “disclosure/help-seeking” subscale were higher compared with the “attitudes towards people with mental illness” subscale. There was no correlation between the OMS-HC and IAT. Conclusions: These findings support the theory that increased education and experience with mental illness are associated with reduced stigma. Attitudes regarding disclosure/help-seeking were more stigmatizing than attitudes towards people with mental illness. The groups identified in this study can potentially benefit from anti-stigma campaigns that focus on reducing specific components of explicit, implicit, public and self-stigma.

Migrants in countries affiliated with the Organization for Economic Co-operation and Development (OECD) have a higher risk of acquiring HIV, experience delayed HIV diagnosis, and have variable levels of engagement with HIV care and treatment when compared to native-born populations. A systematic mixed studies review was conducted to generate a multilevel understanding of the barriers and facilitators affecting HIV Care Cascade steps for migrant people living with HIV (MLWH) in OECD countries. Medline, Embase, Scopus, CINAHL, and the Cochrane Library were searched on March 25, 2020. Screening, critical appraisal, and analysis were conducted independently by two authors. We used qualitative content analysis and the five-level Socio-Ecological Model (i.e., individual, interpersonal, organizational, community, and policy) to categorize barriers and facilitators. Fifty-nine studies from 17 OECD countries were included. MLWH faced similar barriers and facilitators regardless of their host country, ethnic and geographic origins, or legal status. Most barriers and facilitators were associated with the individual and organizational levels and centered around retention in HIV care and treatment. Adapting clinical environments to better address MLWH's competing needs via multidisciplinary models would address retention issues across OECD countries.

Objective: To assess explicit and implicit attitudes toward mental illness of undergraduate students and explore associated variables. Participants: Year 1–4 undergraduate students from a large Canadian university (n = 382). Methods: Participants completed demographics, the Opening Minds Scale for Healthcare Providers, and an Implicit Association Test. Two-tailed independent and paired-samples t-tests, and ANOVA were performed with significance level at p < .05. Results: About 67.5% self-reported having experienced a mental illness and 31.2% had been diagnosed. Lower explicit stigma was associated with females, those with a history of mental illness diagnosis, and those who have had a close relationship with someone experiencing a mental illness. Faculty of Social Sciences students had significantly lower explicit stigma scores than Faculty of Engineering students. Implicit stigma did not show significant associations with any factors. Conclusions: A high proportion of undergraduate students experience mental illness. Increased exposure and experience were associated with reduced explicit stigma.

Opal (opalmedapps.com), a patient portal in use at the Cedars Cancer Centre of the McGill University Health Centre (MUHC) (Montreal, Canada), gives cancer patients access to their medical records, collects information on patient-reported outcome measures (PROMs), and has demonstrated patient satisfaction with care. This feasibility study aims to evaluate Opal’s potential acceptability in the context of HIV care. People living with HIV (PLWH) and their healthcare providers (HCPs) completed cross-sectional surveys from August 2019 to February 2020 at large HIV centers, including the Chronic Viral Illness Service of the MUHC, and other HIV clinical sites in Montreal and Paris, France. This study comprised 114 PLWH (mean age 48 years old, SD = 12.4), including 74% men, 24% women, and 2% transgender or other; and 31 HCPs (mean age 46.5 years old, SD = 11.4), including 32% men, 65% women, and 3% other. Ownership of smartphones and tablets was high (93% PLWH, 96% HCPs), and participants were willing to use Opal (74% PLWH, 68% HCPs). Participants were interested in most Opal functions and PROMs, particularly PROMs capturing quality of life (89% PLWH, 77% HCPs), experience of healthcare (86% PLWH, 97% HCPs), and HIV self-management (92% PLWH, 97% HCPs). This study suggests Opal has high acceptability and potential usefulness as perceived by PLWH and HCPs.

Background: Calls for stakeholders across the global HIV landscape to widely and systematically adopt person-centered care and patient-oriented research approaches have been made by HIV scholars, clinicians, patients, and groups such as the Joint United Nations Programme on HIV/AIDS (UNAIDS). Such calls implicitly acknowledge that the end goal of HIV care, research, and advocacy goes beyond HIV viral suppression or undetectability toward ensuring optimal health-related quality of life (HrQoL) for people living with HIV (PLWH). Indeed, global efforts have focused on keeping people alive yet have failed to ensure that they feel alive. Approach: In this brief report, we highlight the progress that has been made toward evolving the HIV care cascade to better represent actual experiences of PLWH, especially those that are most vulnerable and marginalized. We then describe what person-centered care, patient-oriented research, and HrQoL are and why they are important for our current context in HIV. We conclude by sharing 2 propositions for the global HIV community to consider moving forward. Conclusions: HIV care must not only focus on viral suppression but also better recognize the intersecting and multifaceted challenges faced by PLWH when taking HIV treatment and engaging in care. Evaluating HrQoL at each step of the cascade using validated patient-reported outcome and experience measures would assist in systematically tracking and addressing challenges faced by PLWH. Measures chosen through global consensus may facilitate rigorous comparisons across jurisdictions. Adopting a patient-oriented research paradigm will also be crucial for empowering and meaningfully engaging patients throughout the research process.