Abstract
Background: Stigmatizing attitudes among healthcare providers are an important barrier to accessing services among people living with HIV (PLHIV). This cross-sectional study aimed to assess the status and correlates of HIV-related stigma among healthcare providers in Kerman, Iran. Methods: Using a validated and pilot-tested stigma scale questionnaire, we measured HIV-related stigma among 400 healthcare providers recruited from three teaching hospitals (n=363), private sectors (n=28), and the only voluntary counseling and testing (VCT) center (n=9) in Kerman city. Data were gathered using self-administered questionnaires at participants’ workplace during Fall 2016. To examine the correlates of stigmatizing attitudes, we constructed bivariable and multivariable linear regression models. Results: The mean ± standard deviation (SD) of stigma score was 25.95 ± 7.20 out of the possible 50, with higher scores reflecting more stigmatizing attitudes. Paramedics, nurses’ aides, and housekeeping staff had the highest, and VCT personnel had the lowest average stigma scores, respectively. Multivariable regression analyses showed that prior experience of working with PLHIV (β=-2.48; P=.03), exposure to HIV-related educational courses (β=-2.03; P=.02), and <10 years of work experience (β=-2.70; P<.001) were associated with lower stigma scores. Conclusion: Our findings highlight the need for health managers to provide training opportunities for healthcare providers, including programs that focus on improving HIV-related knowledge for healthcare providers. Enforcing policies that aim to reduce HIV-related stigma and discrimination among healthcare providers in Iran are urgently needed.
Highlights
Worldwide, over 36 million are people living with HIV (PLHIV); ~60% of whom are linked to healthcare services.[1]
We studied the stigmatizing attitudes of healthcare providers toward people living with HIV (PLHIV) in the southeast of Iran and found them to be prevalent
Prior experience of working with PLHIV (β = -2.48, P = .03), having passed educational courses related to HIV and other bloodborne diseases (β = -2.03, P = .02), and work experience of less than 10 years were significant correlates of lower stigma scores (β = -2.70, P < .001)
Summary
Over 36 million are people living with HIV (PLHIV); ~60% of whom are linked to healthcare services.[1]. In the conservative context of the Middle East and North Africa, the adverse health outcomes of HIV-related stigma are significant and have led to low rates of HIV disclosure and case identifications.[8] In Iran, for example, despite the expansion of care and treatment services for PLHIV in recent years, only about 30% of the estimated number of PLHIV in the country (~61 000) have been identified and connected to HIV care and treatment services.[9] A failure that could be partly explained by the profound levels of HIV-related stigma experienced by PLHIV within their family, friends, workspace and the healthcare system that may drive them underground and leave them undetected.[10,11]
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