HIV/AIDS-related stigma and discrimination among healthcare providers in Western China: a population-based cross-sectional study.

BACKGROUND

The persistence of Human Immunodeficiency Virus (HIV) and/or Acquired Immune Deficiency Syndrome (AIDS)-related stigma and discrimination in healthcare settings remains a critical issue that urgently requires attention to effectively control HIV/AIDS epidemic. This study aimed to evaluate the extent of HIV/AIDS-related stigma and discrimination and explore the influencing factors among healthcare providers in western China, in order to inform decision-making regarding the reduction of stigma and discrimination intervention.

METHODS

A cross-sectional study was conducted between October 2023 and July 2024, and 24,646 (with a response rate of 98.6%) healthcare providers completed the survey using a concise and standardized instrument, including sociodemographic and work-related characteristics, healthcare institutional policies and guidelines, attitudes and opinions about people living with Human Immunodeficiency Virus (PLHIV), as well as discriminatory behaviors. Multivariate linear regression analysis was performed to assess the influencing factors of HIV/AIDS-related stigma and discrimination among healthcare providers.

RESULTS

The proportions of healthcare providers expressing concerns about dressing wounds and drawing blood were 65.1% and 60.3%, respectively. Approximately 40% of the participants believed that most PLHIV did not care if they infected others and had multiple sexual partners. Healthcare providers experienced more secondary stigma and discrimination in the provision of services to PLHIV than direct stigma and discrimination against PLHIV. 67.1% of the respondents agreed that PLHIV should be allowed to have babies if they wish. 71-98% indicated that their institutions had related policies and guidelines to protect HIV/AIDS patients from discrimination. HIV/AIDS-related discriminatory behaviors were higher among healthcare providers who had lower levels of education and training, worked in private or infectious disease hospitals or hospitals with inadequate policies, provided face to face services to PLHIV, and had higher levels of stigmatizing attitudes (P < 0.05).

CONCLUSIONS

HIV/AIDS-related stigma and discrimination among healthcare providers were prevalent in western China. The factors identified in the study which were associated with higher HIV/AIDS-related stigma and discrimination may provide valuable insights for mitigating these negative associations, and more coordinated and multifaceted approaches and interventions need to be implemented to effectively reduce HIV/AIDS-related stigma and discrimination in healthcare settings.