Valerie A Earnshaw

Valerie A Earnshaw
University of Delaware | UDel UD · Department of Human Development and Family Studies

PhD in Social Psychology

About

132
Publications
39,299
Reads
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5,740
Citations
Additional affiliations
July 2014 - July 2016
Harvard Medical School
Position
  • Instructor
July 2011 - June 2014
Yale University
Position
  • PostDoc Position
August 2006 - May 2011
University of Connecticut
Position
  • PhD Student

Publications

Publications (132)
Article
Background Caregivers of children with autism are more likely to experience parenting stress than parents of neurotypical children. Research on parenting stress focuses on partnered caregivers and little is known about the comparative social support experienced by single caregivers. Aim To explore differences in perceived social support between si...
Article
HIV continues to heavily burden vulnerable groups including youth, racial/ethnic minorities, sexual and gender minorities, and those who are socioeconomically disadvantaged. Youth living with HIV (YLWH) experience intersecting stigmas that may produce disruptive effects as they navigate adolescence. Considering the dual roles of development and int...
Article
Full-text available
Understanding resilience in relation to HIV-related outcomes may help address racial/ethnic disparities, however, significant gaps in its measurement preclude in-depth study. Thus, this research aims to develop and evaluate the psychometric properties of long and short forms of the Multilevel Resilience Resource Measure for African American/Black A...
Article
There has been substantial progress in research on the roles of stigma and discrimination in African Americans' health. Yet, Black-White health disparities persist. Research must, therefore, build on and address the heterogeneity that exists in stigma- and discrimination-related pathways, experiences, interventions, and research methodology. Specif...
Article
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 prop...
Article
Full-text available
Pre-exposure prophylaxis (PrEP) is a medication that prevents HIV acquisition, yet PrEP uptake has been low among people who inject drugs. Stigma has been identified as a fundamental driver of population health and may be a significant barrier to PrEP care engagement among PWID. However, there has been limited research on how stigma operates in rur...
Article
Full-text available
Stigma changes over time: it waxes and wanes through history, is manifested within humans who develop over time and is tied to statuses (such as attributes, illnesses and identities) that have varying courses. Despite the inherent fluidity of stigma, theories, research and interventions typically treat associations between stigma and health as stag...
Preprint
Assisted partner notification (APN) is recommended as a public health strategy to increase HIV testing in people exposed to HIV. Yet its adoption globally remains at an early stage. This qualitative study sought the opinions of HIV health service providers regarding the appropriateness and feasibility of implementing APN in Indonesia where such ser...
Article
The USA incarcerates more people than any other nation in the world. Exposure to the criminal legal system has been associated with a myriad of health outcomes but less is understood about what drives these associations. We argue that stigma due to criminal legal involvement, what we call criminal legal stigma, likely has a larger role in the assoc...
Article
Full-text available
Expanding PrEP access necessitates training that supports healthcare providers’ progression along the PrEP implementation cascade, moving from PrEP awareness to prescription. We surveyed 359 USA providers about PrEP training content and format recommendations. We examined the association between cascade location and training recommendations. Most p...
Article
Background: Endometriosis is a chronic gynecological condition impacting 1 in 10 women of reproductive age. Research with adult women documents high levels of disruptions in academic, professional, family, and social lives due to pain. Less research has been conducted with college-aged populations. Although stigma has been noted as a key factor in...
Article
Full-text available
Because the public health response to the disproportionate HIV burden faced by Black sexual minority men (BSMMM) has focused on sexual risk reduction and disease prevention, other vital components of sexual health (e.g., intimacy, pleasure, benefits of sex) have been often overlooked. Sex-positive describes a more open, holistic approach toward sex...
Article
Full-text available
Social biases may influence providers’ judgments related to pre-exposure prophylaxis (PrEP) and patients’ consequent PrEP access. US primary and HIV care providers (n = 370) completed an experimental survey. Each provider reviewed one fictitious medical record of a patient seeking PrEP. Records varied by patient race (Black or White) and risk behav...
Article
Background Personal disclosure of opioid use disorder (OUD) recovery can lead to relationship outcomes such as social support, which is associated with greater treatment retention, or stigma, which is associated with risk of treatment dropout. Although disclosure may have important impacts on the relationships and ensuing recovery trajectories of p...
Article
Full-text available
Some people with HIV (PWH) test positive multiple times without initiating antiretroviral therapy (ART). We surveyed 496 ART-eligible PWH following routine HIV testing at three clinics in Soweto and Gugulethu, South Africa in 2014–2015. Among repeat positive testers (RPTs) in this cohort, we compared rates of treatment initiation by prior treatment...
Technical Report
Full-text available
The Addiction Policy Forum in partnership with the University of Delaware and North Dakota’s Recovery Reinvented Initiative in the Office of the Governor conducted a statewide survey to better understand the prevalence of substance use disorder (SUD) stigma in North Dakota. The study found that stigma across the state has improved over the last t...
Article
BACKGROUND Lesbian, gay, bisexual, transgender, and queer and questioning (LGBTQ) youth experience poor physical and mental health outcomes relative to their non-LGBTQ peers. School health professionals (SHPs), such as school nurses, play a key role in addressing LGBTQ student health needs. However, few studies examine school health needs of LGBTQ...
Article
Black sexual minority men in the southern United States continue to experience pronounced disparities related to the human immunodeficiency virus (HIV) and other sexually transmit- ted infections (STI). HIV/STI stigma undermines outcomes along the HIV and STI care continuums, and exacerbates HIV/STI disparities. Identifying who is at greater risk o...
Article
Introduction Methadone and buprenorphine/naloxone medications are among the most effective treatment options for opioid use disorders, yet many people remain misinformed about their benefits and hold negative perceptions about the use of medications to treat opioid use disorders. Such perceptions, especially negative perceptions based on misinforma...
Article
It has become commonplace to adapt the terminology used to reference mental illness in stigma measures to avoid further stigmatizing people who have experienced a mental health problem. However, to our knowledge, no study has examined the effect of modifying terminology in stigma measures on levels of stigma endorsement or on the relationship betwe...
Conference Paper
Substance-free recovery housing has emerged as a promising long-term treatment modality for substance use disorder; and while gender has proven an important predictive factor in other treatment contexts, it remains understudied in this arena. Compared to men, women are more likely to enter treatment with more complex diagnoses (e.g., co-occurring d...
Article
Full-text available
The genesis of the concept of intersectionality was a call to dismantle interlocking systems of oppression – racial, sexual, heterosexual, and class-based – in order to realise liberation of Black women and other women of colour. Intersectionality holds the radical potential to amplify collective efficacy, community solidarity, and liberation. The...
Article
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...
Article
Background: The unprecedented rapid development of COVID-19 vaccines has faced SARS-CoV- (COVID-19) vaccine hesitancy, which is partially fueled by the misinformation and conspiracy theories propagated by anti-vaccine groups on social media. Research is needed to better understand the early COVID-19 anti-vaccine activities on social media. Method...
Article
Objective To better understand rectal STI screening practices for Black gay, bisexual and other men who have sex with men (BGBMSM). Findings Although 15% of BGBMSM lab tested positive for a rectal STI, the majority of these (94%) were asymptomatic. Though all participants reported their status as HIV negative/unknown, 31 of 331 (9.4%) tested posit...
Article
Future healthcare professionals are an important group for interventions to eliminate HIV stigma in the health workforce. Researchers examined HIV stigma and its relationship with healthcare discipline, HIV knowledge, and religiosity among nursing, medical, and midwifery students (N = 505) in three regions of Indonesia. In a multivariable linear mo...
Article
Full-text available
Resilience may help people living with HIV (PLWH) overcome adversities to disease management. This study identifies multilevel resilience resources among African American/Black (AA/B) PLWH and examines whether resilience resources differ by demographics and neighborhood risk environments. We recruited participants and conducted concept mapping at t...
Chapter
Part 1 of this first-of-its-kind 3-part series can help show how to break down the cycles of ignorance, shame, and toxic stress that harm children who identify as LGBTQ+ and improve their chances of leading happy, healthy adult lives. https://shop.aap.org/pediatric-collections-lgbtq-support-and-care-part-1-combatting-stigma-and-discrimination/
Chapter
Part 1 of this first-of-its-kind 3-part series can help show how to break down the cycles of ignorance, shame, and toxic stress that harm children who identify as LGBTQ+ and improve their chances of leading happy, healthy adult lives. https://shop.aap.org/pediatric-collections-lgbtq-support-and-care-part-1-combatting-stigma-and-discrimination/
Article
HIV discrimination has served as a barrier to addressing the HIV epidemic and providing effective HIV treatment and care. Measuring HIV discrimination, particularly covert HIV discrimination, has proven to be complex. Adapted from a previous scale, we developed a perpetuated HIV micro-aggressions scale to assess covert forms of discriminatory belie...
Article
Conspiracy theories have been proliferating during the COVID-19 pandemic. Evidence suggests that belief in conspiracy theories undermines engagement in pro-health behaviors and support for public health policies. Moreover, previous work suggests that inoculating messages from opinion leaders that expose conspiracy theories as false before people ar...
Article
Full-text available
Assisted HIV partner notification services provide a safe and effective way for people living with HIV (PLHIV) to inform their partners about the possibility of exposure and to offer them testing, treatment, and support. This study examined whether or not PLHIV in prison might be willing to participate in assisted HIV partner notification services...
Article
We sought to examine how self-perception of risk for HIV and HIV status information avoidance are related to HIV testing uptake and engagement in routine health care among Black men who have sex with men (BMSM)—the group at highest risk for HIV in the USA. To do so, we used generalized linear modeling and serial mediation modeling to assess data fr...
Article
Substance use problems undermine HIV treatment and secondary prevention efforts. Research is needed to better understand predictors of substance use among people living with HIV (PLWH). We examined whether internalized stigma and enacted HIV stigma are associated with three indicators of substance use among PLWH, including numbers of (1) substances...
Article
Substance use disorders (SUDs) among young people have been linked with a range of adverse health consequences that can be successfully mitigated with early SUD treatment. According to the Social Identity Theory of Cessation Maintenance (SITCM), psychosocial processes including self-perceptions and benefit finding evolve with treatment, influencing...
Article
Background: Black men who have sex with men (BMSM) are disproportionately affected by sexually transmitted infections (STI), including chlamydia and gonorrhea. Transactional sex is one hypothesized risk factor for STI acquisition in BMSM. Methods: We estimated the association of transactional sex with incident chlamydia/gonococcal infection amon...
Article
Full-text available
Since the beginning of the HIV epidemic stigma has served as a strong barrier to effectively delivering HIV prevention and treatment. Due in part to its complex nature, stigma is difficult to address and novel methods of understanding stigma are needed. Based on formative and empirical research with N = 236 primarily Black men living with HIV, a HI...
Article
Lesbian, gay, bisexual, transgender, queer/questioning (LGBTQ) youth face disparities in bullying victimization are associated with higher rates of physical injury, psychological distress, and even suicide. Innovative strategies to address bullying victimization are needed to prevent adverse physical and mental health outcomes, including those enga...
Article
Full-text available
The HIV epidemic in the United States has disproportionately burdened Black men who have sex with men (MSM), particularly in the South. While pre-exposure prophylaxis (PrEP) has high demonstrated efficacy, uptake is low among Black MSM. We utilized a sample of 345 HIV-negative or unknown HIV status Black MSM from Atlanta, Georgia. Bivariate and mul...
Article
Objective: Determine the psychometric properties of the CIASS scale for Colombian patients living with chronic diseases. Method: A Spanish version of the scale was distributed to a sample of 230 patients (33.2% male, aged 18–98 years) diagnosed with chronic diseases. A confirmatory factor analysis was performed using unweighted least squares to det...
Article
Full-text available
Relational processes (i.e., disclosure, stigma, social support) experienced by youth with substance use disorders (SUDs) and their caregivers may act as barriers to, or facilitators of, recovery but are understudied. Single-session qualitative semi-structured interviews were conducted with 19 patients and 15 caregivers recruited by clinicians from...
Article
Full-text available
Stigma is a well-documented barrier to health seeking behavior, engagement in care and adherence to treatment across a range of health conditions globally. In order to halt the stigmatization process and mitigate the harmful consequences of health-related stigma (i.e. stigma associated with health conditions), it is critical to have an explicit the...
Article
Full-text available
Abstract Health-related stigma remains a major barrier to improving health and well-being for vulnerable populations around the world. This collection on stigma research and global health emerged largely as a result of a 2017 meeting on the “The Science of Stigma Reduction” sponsored by the US National Institutes of Health (NIH). An overwhelming co...
Article
Full-text available
Partner services provide a safe and humane way for people living with HIV (PLWH) to alert their sex and/or drug-injecting partners to the possibility of HIV exposure and the need for HIV testing, yet little is known about the ethical challenges of delivering partner services in prisons. In this article, we consider 7 key ethical and methodological...
Presentation
Full-text available
This study is utilizing a longitudinal design to collect self-reported quantitative measures of participants’ recovery capital (i.e., perceived stress, social support, and internalized stigma) and substance use behaviors. Participants are tracked monthly beginning with a baseline survey, followed by 9 follow-up surveys that take place both while pa...
Article
Background and aim: Experience of stigma towards methadone maintenance treatment (MMT) may be a barrier to use of this treatment by people with opioid use disorder. We evaluated the factor structure, internal reliability, construct, and criterion validity of a theory-based stigma measure, the Methadone Maintenance Treatment Stigma Mechanisms Scale...
Article
Objective: Failure to initiate antiretroviral therapy (ART) and achieve virologic suppression are significant barriers to the United Nations 90-90-90 goals. Identifying resilience resources, or modifiable strength-based factors, among people living with HIV is critical for successful HIV treatment and prevention. Design: Prospective cohort study...
Article
Background: Due to shame and fear of discrimination, individuals in, or seeking, recovery from alcohol and other drug (AOD) problems often struggle with whether, when, and to whom to disclose information regarding their AOD histories and recovery status. This can serve as a barrier to obtaining needed recovery support. Consequently, disclosure may...
Article
Purpose This article aims to (1) evaluate whether bullying typology predicts violent injury; (2) longitudinally examine whether violent injury trajectories differ across bullying typology as children age; and (3) longitudinally determine whether children who consistently reported perpetration or victimization (i.e., reported bullying at fifth, seve...
Article
Full-text available
People with HIV (PWH) in Malaysia experience high levels of stigma, which may act as a barrier to accessing healthcare. Stigma against PWH in medical settings is understudied in Malaysia. In the present study, we examine factors associated with physicians’ intention to discriminate against PWH in Malaysia. A cross-sectional online survey was emaile...
Article
Purpose: To evaluate the relationship between sociodemographics and the prevalence of bullying victimization and perpetration using single-item and multiple-item measures. Methods: Longitudinal survey data were obtained from 4297 children at fifth, seventh, and tenth grade in three U.S. cities. Bullying victimization and perpetration were measur...
Article
Background: HIV-related stigma among people living with HIV (PLHIV) is associated with worse health outcomes. We used longitudinal data from a multi-site cohort in South Africa to assess changes over time in stigma after HIV diagnosis and determine whether antiretroviral therapy (ART) initiation is associated with stigma reduction. Methods: We a...
Article
Full-text available
We use a socioecological model of health to define resilience, review the definition and study of resilience among persons living with human immunodeficiency virus (PLWH) in the existing peer-reviewed literature, and discuss the strengths and limitations of how resilience is defined and studied in HIV research. We conducted a review of resilience r...
Article
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 st...
Chapter
The articles included in this collection on bullying provide a wide lens through which to view this complexity.
Chapter
The articles included in this collection on bullying provide a wide lens through which to view this complexity.
Article
Full-text available
1 Introduction Cross‐sectional evidence suggests that internalized HIV stigma is associated with lower likelihoods of antiretroviral therapy (ART) initiation and HIV‐1 RNA suppression among people living with HIV (PLWH). This study examined these associations with longitudinal data spanning the first nine months following HIV diagnosis and explored...
Article
Full-text available
The UNAIDS 90-90-90 treatment targets aim to dramatically increase the number of people who initiate antiretroviral therapy (ART) by 2020. Greater understanding of barriers to ART initiation in high prevalence countries like South Africa is critical. Qualitative semi-structured interviews were conducted with 30 participants in Gugulethu Township, S...
Data
Data S1. PrEP background information, claims, and primary measures.
Article
A growing population of youth who acquired HIV from their mothers are surviving into adulthood. This group is unique in that they experience both internalized stigma (due to their HIV status) and associative stigma (due to their mothers’ HIV status). Results of a cross-sectional survey of 250 perinatally HIV-infected South African youth suggests th...
Article
Full-text available
Introduction Despite healthcare providers’ growing awareness of pre‐exposure prophylaxis (PrEP), prescription rates remain low. PrEP is an efficacious HIV prevention strategy recommended for use with condoms but still protective in their absence. Concern about the impact of PrEP on condom use and other risk behaviour is, nonetheless, among the barr...
Article
Youth living with socially devalued characteristics (e.g., minority sexual orientation, race, and/or ethnicity; disability; obesity) experience frequent bullying. This stigma-based bullying undermines youths' wellbeing and academic achievement, with lifelong consequences. The National Academies of Sciences, Engineering, and Medicine recommends deve...
Article
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....
Article
Full-text available
Sexual stereotypes may adversely affect the health of Black men who have sex with men (MSM). Greater understanding of the nature and nuances of these stereotypes is needed. This online, survey-based study used an inductive, intersectional approach to characterize the sexual stereotypes ascribed to Black MSM by the U.S. general public, their distinc...
Article
Full-text available
Background: Peer victimization is common among youth and associated with substance use. Yet, few studies have examined these associations longitudinally or the psychological processes whereby peer victimization leads to substance use. The current study examined whether peer victimization in early adolescence is associated with alcohol, marijuana,...
Article
Bullying of lesbian, gay, bisexual, and transgender (LGBT) youth is prevalent in the United States, and represents LGBT stigma when tied to sexual orientation and/or gender identity or expression. LGBT youth commonly report verbal, relational, and physical bullying, and damage to property. Bullying undermines the well-being of LGBT youth, with impl...
Article
Full-text available
African and Caribbean Black women in Canada have new HIV infection rates 7 times higher than their white counterparts. This overrepresentation is situated in structural contexts of inequities that result in social, economic and health disparities among African and Caribbean Black populations. Economic insecurity is a distal driver of HIV vulnerabil...