HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
Int J Health Policy Manag. 2020 Apr 1;9(4):163-169. doi: 10.15171/ijhpm.2019.92.
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.
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.
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.
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.
医疗服务提供者的污名化态度是艾滋病毒感染者（PLHIV）获得服务的一个重要障碍。本横断面研究旨在评估伊朗克尔曼医疗服务提供者中与艾滋病毒相关的污名状况及其相关因素。
我们使用经过验证和试点测试的污名量表问卷，从三所教学医院（n=363）、私营部门（n=28）和克尔曼市唯一的自愿咨询和检测（VCT）中心（n=9）招募了 400 名医疗服务提供者，以衡量与艾滋病毒相关的污名。数据是在 2016 年秋季在参与者的工作场所使用自我管理的问卷收集的。为了研究污名化态度的相关性，我们构建了双变量和多变量线性回归模型。
污名评分的平均值±标准偏差（SD）为 25.95±7.20，满分 50 分，分数越高表示污名化态度越严重。护理员、护士助理和家政人员的平均污名评分最高，而 VCT 人员的平均污名评分最低。多变量回归分析表明，与 PLHIV 一起工作的经验（β=-2.48；P=.03）、接触与艾滋病毒相关的教育课程（β=-2.03；P=.02）和工作经验不足 10 年（β=-2.70；P<.001）与较低的污名评分相关。
我们的研究结果强调卫生管理人员为医疗服务提供者提供培训机会的必要性，包括关注提高医疗服务提供者与艾滋病毒相关知识的计划。迫切需要在伊朗实施旨在减少医疗服务提供者中与艾滋病毒相关的污名和歧视的政策。
