HIV-Related Stigma Among Healthcare Providers in the Deep South

Abstract

Stigma towards people living with HIV (PLWH) in healthcare settings is a barrier to optimal treatment. However, our understanding of attitudes towards PLWH from healthcare providers’ perspective in the United States is limited and out-of-date. We assessed HIV-related stigma among healthcare staff in Alabama and Mississippi, using online questionnaires. Participants included 651 health workers (60% White race; 83% female). Multivariate regression suggests that several factors independently predict stigmatizing attitudes: Protestant compared to other religions (β = 0.129, p≤0.05), White race compared to other races (β = 0.162, p ≤0.001), type of clinic (HIV/STI clinic: β = 0.112, p≤0.01), availability of post-exposure prophylaxis (yes: β = −.107, p≤0.05), and perceptions of policy enforcement (policies not enforced: β = 0.058, p = p≤0.05). These findings may assist providers wishing to improve the quality care for PLWH. Enforcement of policies prohibiting discrimination may be a useful strategy for reducing HIV-related stigma among healthcare workers.

Association between Perceived Discrimination in Healthcare Settings and HIV Medication Adherence: Mediating Psychosocial Mechanisms

“…Some healthcare institutions may further consider actual evaluation of implicit and explicit HIV-related biases in health care settings. A recent assessment of health care setting stigma among providers in Alabama 2 informed the adaptation and implementation of an intervention in which health care professionals and PLWH learned about HIV-related stigma and were equipped with the skills to address HIV-related stigma in the community and in the health care setting, which has shown promise in pilot assessments. 55 …”

“…1 Studies suggest that HIV-related discrimination is still prevalent in healthcare settings 2 and between 26% – 40% of PLWH report discrimination by a healthcare worker since becoming infected with HIV. 3–5 Stigma in this context may affect the quality of healthcare services by providers, utilization of services by individuals living with or at high risk for HIV infection, as well as have damaging psychosocial effects for PLWH.…”

Interpersonal Mechanisms Contributing to the Association Between HIV-Related Internalized Stigma and Medication Adherence

“…Within the U.S., the Deep South region has been characterized as the epicenter of the HIV epidemic, with HIV incidence and fatality rates reported to be the highest in the nation (2). Furthermore, conservative political and religious leanings combined with lower levels of education may facilitate a more hostile social environment for PLWH in the Deep South (3-6). …”

“…Despite the importance of adherence to ART, achieving high and consistent levels of adherence for many PLWH remains challenging (9-11). It may be useful to apply insights from social psychology to examine the role of specific interpersonal processes in medication adherence for PLWH, especially in the Deep South, where HIV-related stigma may be a very important social factor (2-6, 12). …”

Preparing every nurse to become an HIV nurse

“…This stigma often occurs when healthcare workers are unfamiliar with HIV, or are uncomfortable caring for patients because of exaggerated fears regarding risk of exposure in the workplace (Magnus et al, 2013; Pickles et al, 2009). Nurses and other healthcare providers sometimes see patients with HIV in a negative light, equating an HIV/AIDS diagnosis with perceived bad behaviors, including injection drug use, homosexuality, and promiscuity (Stringer et al, 2016). Thus, educators must develop curricula that offers students the opportunity to interact with persons working with, and living with HIV (Guth, et al, 2000).…”