Beyond negative attitudes: Examining HIV/AIDS stigma behaviors in clinical encounters

Abstract

HIV/AIDS related stigma remains a major global health issue with detrimental consequences for the treatment and health of people with HIV/AIDS (PWHA), especially when manifested by health professionals. Research on HIV/AIDS stigma has successfully documented negative attitudes towards PWHA among health professionals. However, fewer studies have examined how stigma is manifested behaviorally by health professionals during clinical interactions. Therefore, this study aimed to: (1) examine the behavioral manifestations of HIV/AIDS stigma among physicians in training during clinical interactions, and (2) document the interrelation between HIV/AIDS stigma attitudes and behaviors. We implemented an experimental design using Standardized Patient (SP) simulations, observational techniques, and quantitative questionnaires. The sample consisted of 66 physicians in training in Puerto Rico who engaged in SP encounters with two scenarios: (1) PWHA infected via illegal drug use (experimental condition), and (2) a person with a common cold (control condition). Results evidenced statistically significant differences between both simulations (p = .047), with a higher number of stigma behaviors manifested in the experimental condition. HIV/AIDS stigma attitudes were not correlated with stigma behaviors. Negative emotions associated with drug use were positively associated with drug-related stigmatizing behaviors.

A bibliometric analysis of global research output on health and human rights (1900–2017)

“…There are still many disadvantaged nations or marginalized groups of people, globally and within countries, who do not enjoy rights to health. There are hundreds of millions of refugees in the Middle East [ 72 , 73 ], children in Africa [ 74 , 75 ], abused women all over the world [ 76 , 77 ], and HIV affected people [ 78 – 80 ] who are still deprived of the basic human right to healthcare and health services. Researchers have an important role to play in achieving HHR by pointing to important neglected health topic or health needs of marginalized people, globally and within countries.…”

HIV/AIDS stigma manifestations during clinical interactions with MSM in Puerto Rico

“…Therefore, they need to address stigma associated with HIV/AIDS and MSM as major factors in the training of future health professionals. This stigma related training should not be supplemental to their usual curricula, but rather as a central aspect of physician/patient interaction training which is required of medical schools (Calabrese et al, 2018;Varas-Díaz et al, 2017). The ongoing HIV/AIDS epidemic among MSM, and the concerns over stigma manifestations during clinical interactions, highlight the importance of medical schools as important scenarios for stigma reduction training.…”

“…Understanding how stigma may be behaviorally manifested during clinical interactions remains a challenge for stigma research; particularly due to the methodological complexities it entails (Varas-Díaz et al, 2017). Furthermore, despite the documented interrelation of homophobia and HIV/AIDS stigmatizing attitudes among Puerto Rican health care workers, research has yet to address how these may interact and become manifested in the behaviors of physicians (Varas-Díaz, Malavé, & Cintrón-Bou, 2008).…”

HIV and Depression: Examining Medical Students Clinical Skills

“…referring the patient to psychiatric/psychological treatment, exploring mental health history). (21,24,25). Three experts on HIV related research, observational research techniques, and SP protocol development used the inventory to code five previously recorded interactions using our developed SP case.…”