XIX International AIDS Conference


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THAD0104 - Oral Abstract

Reducing stigma among Indian nursing students: a brief intervention involving local PLHIV networks

Presented by Maria L. Ekstrand (United States).

M.L. Ekstrand1, S. Bharat2, J. Ramakrishna3, S. Shah1, S. Perumpil4, K. Srinivasan5

1University of California, San Francisco, Medicine, San Francisco, United States, 2Tata Institute of Social Sciences, Mumbai, India, 3National Institute of Mental Health and Neurosciences, Health Education, Bengaluru, India, 4St John's National Academy of Health Sciences, Nursing, Bengaluru, India, 5St John's National Academy of Health Sciences, St John's Research Institute, Bengaluru, India

Background: AIDS stigma inflicts hardship and suffering on People-Living-with-HIV (PLHIV), reducing the likelihood of HIV testing, treatment and disclosure. Stigma can be particularly harmful in health care settings. This study was designed to examine and reduce AIDS stigma among nurses and nursing students in India.
Methods: We interviewed 369 nurses in Mumbai and Bangalore, assessing stigma, endorsement of coercive measures and discrimination toward PLHIV. Based on these results, we developed, implemented and evaluated a 2-session stigma reduction intervention, co-facilitated by PLHIV, for 50 intervention and 50 control nursing students.
Results: Casual transmission misconceptions were common, with 28% of nurses believing HIV could be transmitted by sharing a glass and 26% HIV by sharing toilets with PLHIV. 70% agreed that people who were infected via sex/drugs deserved their infections. Almost all (96-99%) endorsed mandatory testing for sex workers and surgery patients and most stated that HIV-infected men (77%) and women (73%) should not be allowed to get married and that HIV-infected women should not be allowed to have children (76%). 88% said they would treat PLHIV differently from other patients, taking unnecessary precautions when drawing blood. significantly more participants worried about acquiring HIV at work (41%) than in their personal lives (14%, p< 0.001). Multiple regression analyses showed that worries about occupational transmission, negative feelings toward PLHA and transmission misconceptions were significantly associated with AIDS stigma.
Nursing students showed similar misconceptions and stigma levels as the nurses. Following the intervention, students showed significant pre-post decrease in all stigma scores, including blame, endorsement of coercive measures, and intent to discriminate (all p< 0.01). In contrast, pre-post scores among control students remained the same.
Conclusions: These findings demonstrate high levels of AIDS stigma in these health-care settings, that may be reduced by a brief intervention using a human rights framework, focusing on underlying variables and involving PLHIV.

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