THAD0104 - Oral Abstract Session
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
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.
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.
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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