Valerie A Earnshaw
Biographic Data
| ID | 2631770 |
|---|---|
| NAME | Valerie A Earnshaw |
| GIVEN NAMES | Valerie A |
| FAMILY NAME | Earnshaw |
| SIGNATURE | EARNSHAW V A |
| AFFILIATIONS | University of Delaware |
| ORCID | 0000-0002-4147-3301 |
| VERIFIED | Yes |
| TOTAL WORKS | 110 |
| TOTAL CITATIONS | 452 |
| AUTHOR COUNT | 110 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2009 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 11 |
The Intersectional Discrimination Index – Revised: Refinement and Further Psychometric Assessment
The Intersectional Discrimination Index (InDI) includes three measures of anticipated, day-to-day, and major discrimination for intercategorical intersectionality research. Previous studies found that the measures are unidimensional with high loadings, good test-retest reliability, predictive validity, and measurement invariance between Canadian and United States (US) samples. Gaps included the need for cognitive interviewing, reassessing stabili…
“Once You’re Labeled a Drug User, You Might as Well Stay the F*** Home”: Adverse Police Experiences Among People Who Inject Drugs
BACKGROUND: Despite the growing relevance of rural areas in the overdose crisis, research on rural people who inject drugs and their experiences with law enforcement remains limited. This research examines how rural policing and stigma uniquely shape the lives of people who inject drugs. METHODS: Forty-one semi-structured qualitative interviews were conducted with people who inject drugs in southern Illinois. For this analysis, we focused on part…
HIV-Stigmatizing Beliefs and Attitudes as a Barrier to Early PrEP Care Continuum Engagement Among People Who Inject Drugs
HIV pre-exposure prophylaxis (PrEP) is a highly effective prevention strategy, yet awareness, knowledge, and willingness to use it among people who inject drugs (PWID) remains inadequate despite widespread eligibility. Stigma, particularly HIV-stigmatizing beliefs and attitudes, may be a key barrier to engagement at early stages of the PrEP care continuum. We examine how HIV-stigmatizing beliefs and attitudes affect PrEP awareness, knowledge, and…
Prison-based HIV partner notification in Indonesia: Rationale and design of a hybrid type 1 effectiveness-implementation study
With HIV Assisted Partner Notification (APN), individuals with HIV voluntarily name and authorize trained health care workers to inform their at-risk partner of possible exposure to the virus without disclosing the identity of who had named them. Although APN is safe and effective in increasing HIV partner notification and testing, its successful implementation in prison settings to assist incarcerated people with HIV (IPWH) to inform their pre-i…
Development and Validation of a Provider-Specific Anticipated Stigma Scale for People Who Inject Drugs
Stigma in healthcare settings is a critical barrier to HIV prevention and treatment among people who inject drugs (PWID). While previous tools have measured anticipated stigma, few account for the intersectional and provider-specific experiences of PWID-particularly from syringe service programs (SSPs). We developed and validated the Substance Use Anticipated Provider Stigma Scale (SU-APSS), a multidimensional instrument assessing anticipated sti…
Tell or Not to Tell: Changes in Ukrainian Older Adults’ HIV Status Disclosure Practices During Intersecting Covid-19 and War Crises
Humanitarian crises exacerbate challenges to accessing HIV care. Older people with HIV (OPWH, aged ≥ 50 years) may seek additional support with HIV care, which often requires disclosing their HIV status to healthcare providers, family, or friends. We sought to understand how crises, including COVID-19 and the war with the Russian Federation, have changed OPWH disclosure behaviours over time. We surveyed OPWH in Kyiv, Ukraine, by phone at four-tim…
Using human-centered design to explore telemedicine to improve healthcare engagement among individuals transitioning from prison to community in Malaysia
Pilot randomized controlled trial to reduce HIV-related stigma among clinicians in Malaysia via project Echo®
HIV-related stigma from clinicians contributes to global disparities in HIV testing and prevention. Scalable interventions, particularly those reaching clinicians beyond individual healthcare facilities, are needed to reach clinicians worldwide. These interventions are especially important in places like Malaysia where substantial HIV-related structural stigma exists. We tested an intervention that incorporated evidence-based stigma reduction too…
Lighting the way forward
Strengthening HIV Activism Among Clinicians in Malaysia: A Randomised Controlled Trial
HIV continues to disproportionately affect key populations in Malaysia, compared to the general population. Lessons learned from decades of research and programmatic experience suggest that HIV activism can be a driver for change. We pilot-tested a tele-training platform, Project ECHO ® for Stigma Reduction (PE-SR), in a randomised controlled trial from July 2022 to March 2023, alongside two comparator groups, i.e., Project ECHO ® -Standard (PE-S…
Maladaptive Coping Strategies Mediate the Relationship Between Depression and Anxiety and Moderate-to-Heavy Alcohol Use in Young South Africans with HIV
Pre-implementation findings on the barriers and potential solutions to initiate same-day antiretroviral therapy among people who inject drugs in Malaysia
Decrease in provider stigma is associated with improved quality health indicators among individuals receiving methadone in primary care centers in Ukraine
An Investigation Into the Role of Attributions of Discrimination and Cognitive Functioning in Older Adults
ObjectiveLimited research has explored how the attributions of discrimination in later life are related to cognitive functioning.MethodsWe analyzed responses from 12,279 adults ages 65+ in the 2008 to 2018 waves of the Health and Retirement Study. Multilevel mixed models assessed whether cognitive functioning was associated with (1) everyday discrimination (without reference to attribution) and (2) frequency of 11 attributions of discrimination.R…
The patient-provider relationship mediates the relationship between health literacy and resilience in young South Africans newly diagnosed with HIV
South African adolescents and young adults (AYAs) with HIV experience worse HIV-related clinical and psychological outcomes compared to older South Africans. Psychological resilience is protective against poorer outcomes, but little is known about disparities in psychological resilience among AYAs with HIV nor the mechanisms by which these differences arise. This study analyzed baseline data from a cohort of 100 AYA ages 18-24 years in Cape Town …
Psychosocial risk factors and cognitive decline in people living with HIV: Results from the Malaysian HIV and aging (MHIVA) study
HIV-associated mortality has improved with the advent of antiretroviral therapy, yet neurocognitive decline persists. We assessed the association between psychosocial risk factors and cognitive function among Malaysian PLWH. Data of virally suppressed PLWH (n = 331) on stable ART, from the Malaysian HIV and Aging study was assessed. Psychosocial factors were assessed using the Lubben Social Network Scale-6 (social isolation) and Depression Anxiet…
Enacted stigma from family and drug use during opioid use disorder treatment
Enacted stigma (i.e., experiences of discrimination from others) is associated with engagement in drug use among people with a wide range of stigmatized statuses. This association may be particularly concerning among people receiving treatment for opioid use disorder (OUD), among whom continued drug use may undermine treatment outcomes and increase risk of overdose. Although past research largely overlooks the source of enacted stigma, theory and…
Experiences of gender-based stigma and health care-related outcomes in the African region: A scoping review
Introduction to the special section on stigma and time
Advancing substance use disorder stigma research: It’s about time
Food insecurity and unemployment as mediators of the relationship between the Covid-19 pandemic and psychological well-being in young South Africans with HIV
Food insecurity may have decreased amongst our sample of young people during the COVID-19 pandemic. Our findings build on our understanding of how the psychological well-being of young people living with HIV was affected by the COVID-19 pandemic and may lend support to interventions targeting food insecurity to improve psychological well-being in this population
Poor HIV-related Knowledge, Perceived Risks and Attitudes Among Urban-dwelling Malaysian Older Adults: Key Barriers to Zero HIV Transmission by 2030
HIV Activist Identity, Commitment, and Orientation Scale (Haicos): Psychometric Evaluation to Assess Clinician’s Propensity Towards HIV Activism in Malaysia
Influence of Stigma on Engagement in HIV Care and Adherence to Antiretroviral Therapy in Specialized HIV Clinics Targeting Men Who Have Sex with Men and Transgender Women in Lima, Peru
Family Social Support Mediates the Relationship Between the Covid-19 Pandemic and Psychosocial well-being in a Cohort of Young South Africans Newly Diagnosed with HIV
Concealable Stigmatized Identities and Psychological Well‐Being
Many people have concealable stigmatized identities: Identities that can be hidden from others and that are socially devalued and negatively stereotyped. Understanding how these concealable stigmatized identities affect psychological well-being is critical. We present our model of the components of concealable stigmatized identities including valenced content - internalized stigma, experienced discrimination, anticipated stigma, disclosure reacti…
The Impact of Stigma in Healthcare on People Living with Chronic Illnesses
Approximately half of adults are living with a chronic illness, many of whom may feel stigmatized by their chronic illness in different contexts. We explored the impact of internalized, experienced, and anticipated stigma within healthcare settings on the quality of life of 184 participants living with chronic illnesses (e.g. diabetes, inflammatory bowel disease, asthma). Results of a path analysis demonstrate that participants who internalized s…
Understanding Concealable Stigmatized Identities: The Role of Identity in Psychological, Physical, and Behavioral Outcomes
Concealable stigmatized identities (CSIs) are devalued social identities or attributes, such as mental illness, HIV+ status, and chronic illness, that can be kept concealed from others. We describe two components of a CSI—valenced content and magnitude—that we argue are critical in determining the impact of a CSI on psychological, physical, and behavioral health outcomes. Valenced content contains a range of both negative and positive beliefs abo…
Maternal Experiences with Everyday Discrimination and Infant Birth Weight: A Test of Mediators and Moderators Among Young, Urban Women of Color
Given the association between birth weight and health across the lifespan, it is critical to reduce discrimination directed at young, urban women of color so that all children can begin life with greater promise for health
Intersectionality of internalized HIV stigma and internalized substance use stigma: Implications for depressive symptoms
We adopted an intersectionality framework and examined whether the relationship between internalized HIV stigma and depressive symptoms is moderated by internalized substance use stigma. A total of 85 people living with HIV with a history of substance use in the Bronx, New York, completed a survey. Results revealed evidence of moderation: Participants who internalized HIV stigma experienced greater depressive symptoms only if they also internaliz…
Discredited” Versus “Discreditable: Understanding How Shared and Unique Stigma Mechanisms Affect Psychological and Physical Health Disparities
In his classic treatise, Goffman (1963) delineates between people who are discredited -whose stigma is clearly known or visible-and people who are discreditable -whose stigma is unknown and can be concealable. To what extent has research in the past 50 years advanced Goffman's original ideas regarding the impact of concealability on stigma management strategies and outcomes? In the current article, we outline a framework that articulates how stig…
Everyday discrimination and physical health: Exploring mental health processes
Goals of this study were to examine the mental health processes whereby everyday discrimination is associated with physical health outcomes. Data are drawn from a community health survey conducted with 1299 US adults in a low-resource urban area. Frequency of everyday discrimination was associated with overall self-rated health, use of the emergency department, and one or more chronic diseases via stress and depressive symptoms operating in seria…
Changes in Experiences With Discrimination Across Pregnancy and Postpartum: Age Differences and Consequences for Mental Health
Our results support a life course approach to understanding the impact of experiences with discrimination on health and when to intervene
Objectification in Action: Self- and Other-Objectification in Mixed-Sex Interpersonal Interactions
Although the process of sexual objectification is theorized to occur within interpersonal interactions, we believe this is the first study to examine sexual objectification and self-objectification in actual (nonconfederate) interpersonal encounters. Men and women were brought into the laboratory and interacted in mixed-sex dyads. We used dyadic analysis to detect whether partners’ objectification of each other affected state self-objectification…
Weight- and race-based bullying: Health associations among urban adolescents
Stigma-based bullying is associated with negative mental and physical health outcomes. In a longitudinal study, surveys and physical assessments were conducted with mostly Black and Latino, socioeconomically disadvantaged, urban students. As hypothesized, greater weight- and race-based bullying each was significantly indirectly associated with increased blood pressure and body mass index, as well as decreased overall self-rated health across 2 ye…
The stigma system: How sociopolitical domination, scapegoating, and stigma shape public health
Stigma is a fundamental driver of adverse health outcomes. Although stigma is often studied at the individual level to focus on how stigma influences the mental and physical health of the stigmatized, considerable research has shown that stigma is multilevel and structural. This paper proposes a theoretical approach that synthesizes the literature on stigma with the literature on scapegoating and divide‐and‐rule as strategies that the wealthy and…
Intersectional internalized stigma among Black gay and bisexual men: A longitudinal analysis spanning HIV/sexually transmitted infection diagnosis
Internalized stigma undermines health among people diagnosed with HIV and other sexually transmitted infections (STI), yet limited research has examined how internalized stigma develops. Black gay and bisexual men ( n = 151) reported their race and sexual orientation internalized stigma once before HIV/STI diagnosis and their HIV/STI internalized stigma monthly for 1 year after HIV/STI diagnosis. Multilevel analyses demonstrated that race and sex…
Sexual Stereotypes Ascribed to Black Men Who Have Sex with Men: An Intersectional Analysis
Housing Instability and Birth Weight among Young Urban Mothers
Medical mistrust in the context of Ebola: Implications for intended care-seeking and quarantine policy support in the United States
This investigation explores Ebola conspiracy beliefs, a form of medical mistrust, and their potential impact on health behavior. Results of an online survey in the United States in December 2014 demonstrated that 16 percent of 202 participants held conspiracy beliefs. Participants who were less knowledgeable about Ebola, more mistrustful of medical organizations, and more xenophobic more strongly endorsed conspiracy beliefs. Participants who more…
Discrimination and sexual risk among young urban pregnant women of color
This is the first investigation establishing a link between discrimination and STI diagnosis, not just risk behavior. It does so among a sample of at-risk, young, pregnant, women of color. Findings suggest implications for sexual risk during pregnancy and across the life span, and risks for the pregnancy and fetus. It is vital to reduce discrimination to eliminate disparities in HIV and STIs. Future research should continue examining the role of …
Social Dominance Orientation Relates to Believing Men Should Dominate Sexually, Sexual Self-Efficacy, and Taking Free Female Condoms Among Undergraduate Women and Men
LGBTQ bullying: A qualitative investigation of student and school health professional perspectives
Researchers and practitioners have recently called for greater involvement of school health professionals (SHPs; e.g., school psychologists, nurses, guidance counselors) in interventions to identify and address bullying of lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) students. To inform future interventions, this study explored the perspectives of LGBTQ students and SHPs on LGBTQ bullying and SHPs’ responses to LGBTQ bullyin…
Intersectional experiences of discrimination in a low‐resource urban community: An exploratory latent class analysis
There have been increasing calls for the application of an intersectionality framework to understand and address discrimination and health inequities among diverse communities. Yet there have been theoretical debates regarding to whom intersectionality applies and how intersectional experiences of discrimination are associated with health outcomes. The current study aimed to contribute to these theoretical debates and inform practical application…
Discrimination and excessive weight gain during pregnancy among Black and Latina young women
What Looks Like Sexism and Why? The Effect of Comment Type and Perpetrator Type on Women's Perceptions of Sexism
Sexist comments are not perceived equally in the eyes of women. We extend previous research by examining the degree to which multiple types of potentially sexist comments made by multiple types of men are perceived as sexist. Further, we examine the degree to which three possible mediators--prototypicality, perceived intent, and interdependence--explained these effects. Female undergraduate students (N = 248) were randomly assigned to read a scen…
The importance of full-time work for urban adults' mental and physical health
The Stigma of Criminal Legal Involvement and Health: A Conceptual Framework
Methods in HIV-Related Intersectional Stigma Research: Core Elements and Opportunities
Researchers are increasingly recognizing the importance of studying and addressing intersectional stigma within the field of HIV. Yet, researchers have, arguably, struggled to operationalize intersectional stigma. To ensure that future research and methodological innovation is guided by frameworks from which this area of inquiry has arisen, we propose a series of core elements for future HIV-related intersectional stigma research. These core elem…
Intended Responses to Rape as Functions of Attitudes, Attributions of Fault, and Emotions
From Conceptualizing to Measuring HIV Stigma: A Review of HIV Stigma Mechanism Measures
Intended Responses to Rape as Functions of Attitudes, Attributions of Fault, and Emotions
Coping with HIV Stigma: Do Proactive Coping and Spiritual Peace Buffer the Effect of Stigma on Depression
Understanding Concealable Stigmatized Identities: The Role of Identity in Psychological, Physical, and Behavioral Outcomes
Concealable stigmatized identities (CSIs) are devalued social identities or attributes, such as mental illness, HIV+ status, and chronic illness, that can be kept concealed from others. We describe two components of a CSI—valenced content and magnitude—that we argue are critical in determining the impact of a CSI on psychological, physical, and behavioral health outcomes. Valenced content contains a range of both negative and positive beliefs abo…
Drug Addiction Stigma in the Context of Methadone Maintenance Therapy: An Investigation into Understudied Sources of Stigma
Social Dominance Orientation Relates to Believing Men Should Dominate Sexually, Sexual Self-Efficacy, and Taking Free Female Condoms Among Undergraduate Women and Men
Maternal Experiences with Everyday Discrimination and Infant Birth Weight: A Test of Mediators and Moderators Among Young, Urban Women of Color
Given the association between birth weight and health across the lifespan, it is critical to reduce discrimination directed at young, urban women of color so that all children can begin life with greater promise for health
The importance of full-time work for urban adults' mental and physical health
The Impact of Stigma in Healthcare on People Living with Chronic Illnesses
Approximately half of adults are living with a chronic illness, many of whom may feel stigmatized by their chronic illness in different contexts. We explored the impact of internalized, experienced, and anticipated stigma within healthcare settings on the quality of life of 184 participants living with chronic illnesses (e.g. diabetes, inflammatory bowel disease, asthma). Results of a path analysis demonstrate that participants who internalized s…
Stigma and racial/ethnic HIV disparities: Moving toward resilience.
Internalized stigma and HIV status disclosure among HIV-positive black men who have sex with men
Black men who have sex with men (BMSM) are severely affected by the HIV epidemic, yet research on the relationship between HIV stigma and status disclosure is relatively limited among this population. Within this epidemic, internalized HIV stigma, the extent to which people living with HIV/AIDS endorse the negative beliefs associated with HIV as true of themselves, can negatively shape interpersonal outcomes and have important implications for ps…
Perceived Stigma of Purchasing Sex Among Latino and Non-Latino Male Clients of Female Sex Workers in Tijuana, Mexico
HIV Stigma Mechanisms and Well-Being Among PLWH: A Test of the HIV Stigma Framework
The Impact of Patient Race on Clinical Decisions Related to Prescribing HIV Pre-Exposure Prophylaxis (PrEP): Assumptions About Sexual Risk Compensation and Implications for Access
Discredited” Versus “Discreditable: Understanding How Shared and Unique Stigma Mechanisms Affect Psychological and Physical Health Disparities
In his classic treatise, Goffman (1963) delineates between people who are discredited -whose stigma is clearly known or visible-and people who are discreditable -whose stigma is unknown and can be concealable. To what extent has research in the past 50 years advanced Goffman's original ideas regarding the impact of concealability on stigma management strategies and outcomes? In the current article, we outline a framework that articulates how stig…
Concealable Stigmatized Identities and Psychological Well‐Being
Many people have concealable stigmatized identities: Identities that can be hidden from others and that are socially devalued and negatively stereotyped. Understanding how these concealable stigmatized identities affect psychological well-being is critical. We present our model of the components of concealable stigmatized identities including valenced content - internalized stigma, experienced discrimination, anticipated stigma, disclosure reacti…
Examining Effects of Anticipated Stigma, Centrality, Salience, Internalization, and Outness on Psychological Distress for People with Concealable Stigmatized Identities
Understanding how stigmatized identities contribute to increased rates of depression and anxiety is critical to stigma reduction and mental health treatment. There has been little research testing multiple aspects of stigmatized identities simultaneously. In the current study, we collected data from a diverse, urban, adult community sample of people with a concealed stigmatized identity (CSI). We targeted 5 specific CSIs--mental illness, substanc…
HIV stigma and unprotected sex among PLWH in KwaZulu-Natal, South Africa: A longitudinal exploration of mediating mechanisms
Social and structural factors including HIV stigma are theorized to drive global disparities in HIV prevalence. This study tests whether HIV self-stigma, or experiences of stigma at the individual level, is associated with engagement in unprotected sex among people living with HIV (PLWH) in KwaZulu-Natal, South Africa, where 37.4% of adults are living with HIV compared with 0.8% worldwide. It further explores whether depressive symptoms, HIV stat…
An assessment of health-care students' attitudes toward patients with or at high risk for HIV: Implications for education and cultural competency
Stigma perpetuated by health-care providers has been found to be a barrier to care for vulnerable populations, including HIV-infected, people who inject drugs (PWIDs), and men who have sex with men (MSM) in multiple clinical contexts and remains unexamined among professional health-care students in Malaysia. This cross-sectional, anonymous, and Internet-based survey assessed the attitudes of medical and dental students toward HIV-infected, PWID, …
HIV Stigma and Physical Health Symptoms: Do Social Support, Adaptive Coping, and/or Identity Centrality Act as Resilience Resources
Teacher involvement as a protective factor from the association between race-based bullying and smoking initiation
Housing Instability and Birth Weight among Young Urban Mothers
What Looks Like Sexism and Why? The Effect of Comment Type and Perpetrator Type on Women's Perceptions of Sexism
Sexist comments are not perceived equally in the eyes of women. We extend previous research by examining the degree to which multiple types of potentially sexist comments made by multiple types of men are perceived as sexist. Further, we examine the degree to which three possible mediators--prototypicality, perceived intent, and interdependence--explained these effects. Female undergraduate students (N = 248) were randomly assigned to read a scen…
Changes in Experiences With Discrimination Across Pregnancy and Postpartum: Age Differences and Consequences for Mental Health
Our results support a life course approach to understanding the impact of experiences with discrimination on health and when to intervene
Discrimination and sexual risk among young urban pregnant women of color
This is the first investigation establishing a link between discrimination and STI diagnosis, not just risk behavior. It does so among a sample of at-risk, young, pregnant, women of color. Findings suggest implications for sexual risk during pregnancy and across the life span, and risks for the pregnancy and fetus. It is vital to reduce discrimination to eliminate disparities in HIV and STIs. Future research should continue examining the role of …
Psychology (89 works) · Medicine (77 works) · Psychiatry (61 works) · HIV/AIDS Research and Interventions (48 works) · Public health (42 works) · Social Psychology (40 works) · Clinical Psychology (39 works) · Human immunodeficiency virus (HIV (38 works) · Clinical Psychology (37 works) · Stigma (botany (37 works)