HIV Related Stigma among Healthcare Providers: Opportunities for Education and Training

Amanda B. Spence(Georgetown University), Cuiwei Wang(Georgetown University), Katherine G. Michel(Georgetown University), Joanne Michelle F. Ocampo(Columbia University), Michael Kharfen(Government of the District of Columbia), Daniel Merenstein(Georgetown University), Lakshmi Goparaju(Georgetown University), Seble Kassaye(Georgetown University)
Journal of the International Association of Providers of AIDS Care (JIAPAC)
January 1, 2022
Cited by 42Open Access
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Abstract

Background: HIV-stigma can influence engagement in care and viral suppression rates among persons living with HIV (PLWH). Understanding HIV-provider level stigma and its associated factors may aid in development of interventions to improve engagement in care. Methods: We assessed HIV-related stigma, provider knowledge, and practices and beliefs among healthcare providers using an online survey tool. Generalized linear modeling was used to determine factors associated with HIV-stigma score. Results: Among 436 participants, the mean age was 42.3 (SD 12.3), 70% female, 62% white, 65% physicians, and 44% worked at an academic center. The mean HIV Health Care Provider Stigma Scale (HPASS) score was 150.5 (SD 18.9, total = 180 [higher score = less stigma]) with factor subscale scores of 67.1 (SD 8.2, total = 78) prejudice, 51.3 (SD 9.7, total = 66) stereotyping, and 32.1 (SD 5, total = 36) discrimination. Female sex and comfort with talking about sex and drug use had 4.97 (95% CI 0.61, 9.32) and 1.99 (95% CI 0.88, 3.10) estimated higher HPASS scores. Disagreement/strong disagreement versus strong agreement with the statement that PLWH should be allowed to have babies and feeling responsible for talking about HIV prevention associated with −17.05 (95% CI −25.96, −8.15) and −2.16 (95% CI −3.43, −0.88) estimated lower HPASS scores. Conclusions: The modifiable factors we identified as associated with higher HIV related stigma may provide opportunities for education that may ameliorate these negative associations.


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