Teaching HIV-specific content for pre-licensure nursing and health professions students: a review and synthesis

Abstract

Persistent Human Immunodeficiency Virus (HIV) prevalence rates remain a challenge, particularly because health care providers (HCP) are not fully prepared to engage in HIV care. This hesitancy to engage creates access to care barriers for people living with HIV (PLWH). We conducted a systematic review to identify educational interventions focused on developing HIV competencies in higher education across health science disciplines. We searched databases for primary studies focused on interventions. Using PRISMA guidelines, we identified 20 articles from 19 distinct studies. While there was an overwhelming body of literature that assessed knowledge, skills, and attitudes in health sciences students on HIV and AIDS, the low number of intervention studies was notable. With the exception of two studies, PLWH were not included in the interventions. This finding stands in sharp contrast to the well-established Greater Involvement of People Living with HIV and/or AIDS (GIPA) and Meaningful Engagement of People Living with HIV and/or AIDS (MEPA) principles. The primary means of the educational intervention was focused on delivering lectures to address HIV and AIDS knowledge for HCP. There was a significant lack of focus on historical, cultural, policy and legal contexts of HIV and AIDS care; theoretical justifications for the interventions were absent. No study focused on the impact of an intervention on the care provided to PLWH by HCP after graduation. There is an urgent need to develop long-term sustainable and scalable interventions that address the consistently identified lack of knowledge and skills, and stigmatizing attitudes of HCP and students.

Opening doors: A thematic analysis of the long-term impact of community-based research in the field of HIV

“…It has been argued [6] that capacity building among research partners is a hallmark of ethical, rigorous research. To date research has focused on short term changes in the knowledge, attitudes and practices of interventions with nurses in HIV care; [21] however, there is a paucity of research that examines the long-term capacity development of participants in community-based HIV research. Despite a long history of funding CBR, to our knowledge, no research exists that assesses the long-term impact of CBR in the field of HIV.…”

Nurses’ clinical practices reducing the impact of HIV-related stigmatisation in non-HIV-specialised healthcare settings: a protocol for a realist synthesis

“…First, the literature is scarce in recommendations for concrete and effective nursing practices to decrease the impact of HIV-related stigmatisation outside the HIV care network. 42 Therefore, we plan to focus, through realist interviews, on stakeholders’ positive (rather than negative) experiences of HIV-related stigmatisation in non-HIV-specialised healthcare settings. A second limitation could be antagonised points of view about what constitutes stigmatisation, depending on participants’ serological status.…”

“…33 34 Other strategies can be found in 11 literature review, which had inventoried at least one intervention aimed at reducing HIV-related stigmatisation implemented in Western countries. [35][36][37][38][39][40][41][42][43][44][45] However, identifying the ones that could be used in the specific context of nurses working in non-HIV-specialised healthcare settings similar to the one of Quebec remain hazardous. Indeed, the conclusions of these reviews are sometimes inconsistent, even contradictory.…”

“…Indeed, the conclusions of these reviews are sometimes inconsistent, even contradictory. For instance, Brown et al 42 Ma et al 45 and Phillips et al 46 found that having contact with PLHIV, such as hearing testimonials in professional training, was a promising avenue for reducing HIV-related stigmatisation by HCP. Although in line with Greater Involvement of People Living with HIV/AIDS principles, 47 this strategy is not demonstrated to be effective in a meta-analysis by Mak et al 41 Furthermore, while acknowledging that most interventions have favourable effects on stigmatisation-related outcomes, three of the 11 reviews found interventions that have only superficial and short-term effects, 35 39 for which results were hardly interpretable (eg, stigmatisation decreases in both intervention and control group), 45 or even that have increased stigmatisation.…”

“…For instance, Brown et al . 42 Ma et al 45 and Phillips et al 46 found that having contact with PLHIV, such as hearing testimonials in professional training, was a promising avenue for reducing HIV-related stigmatisation by HCP. Although in line with Greater Involvement of People Living with HIV/AIDS principles, 47 this strategy is not demonstrated to be effective in a meta-analysis by Mak et al .…”