HIV-related stigma persists among U.S. health care providers

  • Geter A & al.
  • AIDS Patient Care STDS
  • 1 Oct 2018

  • curated by Liz Scherer
  • Clinical Essentials
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Takeaway

  • Limited or no HIV stigma training among providers coupled with historically negative portrayals of at-risk, people living with HIV (PLWH), and persons seeking HIV prevention/care services are important drivers of HIV-related stigma.

Why this matters

  • Stigmatizing provider attitudes, especially at the primary care level, act as barriers to HIV prevention, treatment, and care-seeking behavior.
  • Adopt policies that help normalize HIV testing (e.g., opt-out testing, less focus on risk-based testing only).

Key results

  • 6 studies; sample size range, 14-651 providers.
  • Attitudes/beliefs/behaviors (n=6): factors varied by sex, race, religion, provider category, clinical setting.
    • White, male, primary care physicians with limited/no HIV-stigma training in past 12 months were most stigmatizing.
    • Stigmatizing beliefs linked to negative portrayals of at-risk, PLWH, persons seeking prevention/care.
  • Patient care quality (n=3): fear of acquiring HIV through occupational exposure reduced care quality, increased care refusal, anxiety.
    • Fear was higher among physicians with limited awareness/access to preexposure prophylaxis.
  • Education/training (n=2): limited opportunity for clinical education/practice for non-HIV specialty providers facilitated HIV stigma.

Study design

  • Systematic review examining HIV-related stigma by U.S. health care providers.
  • Funding: None disclosed.

Limitations

  • Limited sample, nongeneralizable.
  • Social desirability, personal bias.
  • Geographical bias.
  • Data limited to U.S.

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