HIV Stigma Reduction Interventions Among Health Care Providers and Students in Different Countries: A Systematic Review

Abstract

Background: Health care providers’ stigmatizing attitudes are obstacles to patients’ well-being and quality of life. Dealing with HIV-related stigma and understanding the impact of feasible interventions on reducing stigmatizing attitudes among health care providers are considered important strategies to improve the quality of HIV care, patient-provider relationships, and provide supportive and safe care services. Objectives: The aim of this study was to systematically review interventions to reduce HIV-related stigma among health care providers. Methods: This systematic review was performed using Medline, CINAHL, ERIC, and APA PsycInfo, Health Source: Nursing/Academic Edition to search for quasi-experimental studies and randomized controlled trials (RCTs) designed to reduce HIV stigma among health care providers. The quality of eligible research studies was independently appraised by two reviewers. Results: A total of 774 studies were screened, 100 articles were assessed for the eligibility, and 10 studies met the inclusion criteria. All interventions effectively reduced HIV-related stigma. Elements of successful interventions including knowledge modules, peer education, patients’ testimonials, Photovoice-informed stigma reduction training, stigma-free space intervention, and popular opinion leaders. Interventions were assessed and compared in terms of contents, delivery modes, HIV stigma measurements, follow-up, and limitations. Conclusions: This systematic review supports the effectiveness of in-person educational interventions at reducing HIV-related stigma among health care providers across countries. Comparisons of delivery modes of interventions indicated that educational interventions delivered by patients’ testimonials and peer education strategies are more promising than lecture-based teaching methods. Further studies are needed to assess long-term effects of interventions on clinical behaviors and practices.

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Xylazine-Associated Wounds and Related Health Concerns Among People Who Use Drugs: Reports From Front-Line Health Workers in 7 US States

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Stigma and fear of getting sick in the care of people living with HIV: an exploratory systematic review

“…This same situation could be evidenced in the studies by Barrington et al and Feyissa et al, who reported that patients were afraid to go to clinics where the PLHIV care units were clearly labeled as "HIV centres" and allowed the patients to be identified like HIV positive by other people only for the fact to go to these centres [18,19] Discrimination by healthcare personnel is part of structural stigma, but this review considered it a separate entity. This kind of discrimination may include denial of services, dehumanizing treatment, or violation of confidentiality, which is facilitated by drivers such as lack of knowledge of the pathology, its mode of transmission and treatment, as well as fear of contagion [50][51][52][53][54]. In the quantitative studies included in this review, it was observed that the behaviors perceived by PLWH, coming from healthcare workers, were mainly negative labels, cynical questions, delay in care, refusal of care, and dissemination of serological status without authorization [21,22].…”