Improving education about HIV transmission among health workers could reduce stigmatizing attitudes

Another generation of stigma? Assessing healthcare student perceptions of HIV-positive patients in Mwanza, Tanzania.

Aggarwal S, Lee DH, Minteer WB, Fenning RT, Raja SK, Bernstein ME, Raman KR, Denny SP, Patel PA, Lieber M, Farfel AO, Diamond CA. AIDS Patient Care STDS. 2017 Feb;31(2):87-95. doi: 10.1089/apc.2016.0175. Epub 2017 Jan 18.

HIV-related stigma remains a persistent global health concern among people living with HIV/AIDS (PLWA) in developing nations. The literature is lacking in studies about healthcare students' perceptions of PLWA. This study is the first effort to understand stigmatizing attitudes toward HIV-positive patients by healthcare students in Mwanza, Tanzania, not just those who will be directly treating patients but also those who will be indirectly involved through nonclinical roles, such as handling patient specimens and private health information. A total of 208 students were drawn from Clinical Medicine, Laboratory Sciences, Health Records and Information Management, and Community Health classes at the Tandabui Institute of Health Sciences and Technology for a voluntary survey that assessed stigmatizing beliefs toward PLWA. Students generally obtained high scores on the overall survey instrument, pointing to low stigmatizing beliefs toward PLWA and an overall willingness to treat PLWA with the same standard of care as other patients. However, there are gaps in knowledge that exist among students, such as a comprehensive understanding of all routes of HIV infection. The study also suggests that students who interact with patients as part of their training are less likely to exhibit stigmatizing beliefs toward PLWA. A comprehensive course in HIV infection, one that includes classroom sessions focused on the epidemiology and routes of transmission as well as clinical opportunities to directly interact with PLWA-perhaps through teaching sessions led by PLWA-may allow for significant reductions in stigma toward such patients and improve clinical outcomes for PLWA around the world.

Abstract access  [1]

Editor’s notes: This paper reports on a survey of students who were undergoing training in Clinical Medicine, Laboratory Sciences, Health Records and Information Management, Nursing, and Community Health in Mwanza, Tanzania. The survey aimed to explore attitudes about people living with HIV. The authors report that their results illustrate low stigmatizing beliefs towards people living with HIV. However, around a quarter believed that HIV is a punishment for bad behaviour. A third believed that people who acquired HIV from drug use or sex deserved to become infected. Further to this, nearly three quarters believed that individuals who were HIV positive could have avoided infection if they wanted to. A quarter believed that people living with HIV have been promiscuous. There were no differences in response by gender but students under 24 were more likely to have negative attitudes. The authors suggest that this could be due to lower education levels than the older students, although they had not measured this. Students studying Clinical Medicine were less likely to have negative attitudes. On a positive note the students reported that they would treat people living with HIV as equal with other people.

The students displayed some lack of knowledge about routes of HIV infection beyond sex and drug use, especially mother-to-child HIV transmission. The authors suggest that better education in this area may reduce the negative attitudes about people living with HIV, reported by many of the students. Overall, this survey reveals some gaps in education, that if addressed could reduce stigma by health workers against people living with HIV.

Africa [6]
United Republic of Tanzania [7]
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