Nemli Salih Atakan, Abdollahpour Ranjbar Hamed, Turan Bulent
Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Izmir Katip Celebi University, Izmir, Turkey.
Department of Psychology, Istinye University, Istanbul, Turkey.
BMC Med Educ. 2025 Feb 11;25(1):220. doi: 10.1186/s12909-025-06768-w.
BACKGROUND: HIV-related stigma within the health care system is a major barrier preventing people living with HIV (PLWH) from accessing and continuing treatment. Psychosocial factors such as political orientation, personality characteristics, and personal moral values of health care providers have not been adequately investigated. Furthermore, a deeper understanding of the mechanisms and effects of these drivers on social distancing from PLWH is needed. The present study aims to fill these gaps in the literature by examining the stigmatizing attitudes of medical students from the perspective of the inevitability of prejudice. METHOD: We sampled 609 medical students in Türkiye. Political orientation, stereotyping attitudes, stigmatizing attitudes, emotional reactions toward PLWH, and social distance from PLWH were assessed via self-reported questionnaires. Multiple regression analysis and serial mediation analysis were used. RESULTS: Political conservatism correlated significantly with negative stereotypes (r =.29, p <.01) and negative intergroup emotions (r =.35, p =.01). Notably, negative stereotypes were strongly associated with social distancing (r =.41, p <.01). Serial mediation analysis indicated that the total effect of political conservatism on social distancing was significant. The serial indirect association between higher political conservatism and higher social distancing from PLWH was significant (β = 0.07, SE = 0.01, 95% CI [0.05, 0.10]). This association was mediated first by endorsing negative stereotypes about PLWH and then by negative intergroup emotions toward PLWH. CONCLUSIONS: The findings suggest that interventions targeting stereotyping and negative intergroup emotions could reduce discriminatory attitudes and behaviors of medical students, thereby enhancing healthcare delivery to PLWH. Policy measures can focus on the integration of stigma-reduction training and intergroup sensitivity programs in medical education curricula. Furthermore, it may help to address discrimination in the healthcare system and beyond by enhancing understanding of structural and societal factors that drive HIV-related stigma.
背景：医疗保健系统中与艾滋病病毒相关的污名是阻碍艾滋病病毒感染者（PLWH）获得和持续接受治疗的主要障碍。医疗保健提供者的政治取向、人格特征和个人道德价值观等社会心理因素尚未得到充分研究。此外，需要更深入地了解这些驱动因素对与PLWH保持社交距离的机制和影响。本研究旨在通过从偏见不可避免性的角度审视医学生的污名化态度，填补文献中的这些空白。 方法：我们在土耳其对609名医学生进行了抽样。通过自我报告问卷评估政治取向、刻板印象态度、污名化态度、对PLWH的情绪反应以及与PLWH的社交距离。使用了多元回归分析和系列中介分析。 结果：政治保守主义与负面刻板印象（r = 0.29，p < 0.01）和负面群体间情绪（r = 0.35，p = 0.01）显著相关。值得注意的是，负面刻板印象与社交距离密切相关（r = 0.41，p < 0.01）。系列中介分析表明，政治保守主义对社交距离的总体影响显著。较高的政治保守主义与对PLWH更高的社交距离之间的系列间接关联显著（β = 0.07，SE = 0.01，95% CI [0.05, 0.10]）。这种关联首先通过认可对PLWH的负面刻板印象，然后通过对PLWH的负面群体间情绪来介导。 结论：研究结果表明，针对刻板印象和负面群体间情绪的干预措施可以减少医学生的歧视性态度和行为，从而加强对PLWH的医疗服务。政策措施可以侧重于将减少污名培训和群体间敏感性计划纳入医学教育课程。此外，通过增强对驱动与艾滋病病毒相关污名的结构和社会因素的理解，可能有助于解决医疗保健系统及其他领域的歧视问题。
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