HIV/AIDS related stigma: Delivering appropriate nursing care

The expectations of gay with HIV/AIDS regarding nurses in Indonesia

OBJECTIVE

There has been a lack of literature available to nurses on care provision to gay individuals with HIV/AIDS. Research nurses' interaction with gay patients with HIV/AIDS is important for providing and improving such nursing care.

METHOD

This study used a qualitative descriptive design. Data was collected using depth interviews from 14 participants gay with HIV/AIDS in Indonesia, which were analyzed using thematic approach.

RESEARCH RESULTS

This research yielded three themes: (1) nurses' acceptance of gay with HIV/AIDS; (2) extensive knowledge among nurses about gay and HIV/AIDS; and (3) communication nurses are warm and without barrier.

CONCLUSION

Attitudes, knowledge, and communication are key issues impacting the nursing care of gay with HIV/AIDS. Attitude and other non-verbal communication should be considered by nurses when providing care. Value of culture should be considered by nurse when providing care for gay patient.

Fuzzy Modeling of the Enactment of Stigma by Healthcare Personnel Toward People Living with HIV in the Frame of Counterfactual Thinking: A Mixed-Method Approach

Existing research on HIV stigma has not thoroughly studied the healthcare providers' (HCP) judgment toward people living with HIV (PLHIV). The goal of this article is to conceptualize formation of stigma within attitudes of HCP through their judgmental process by using the Fairness Theory. The study is also aimed to develop a model for cognitive patterns of HCPs' stigmatizing judgments toward PLHIV by applying fuzzy logic. We applied a mixed method in two phases, including qualitative method and fuzzy analytical modeling. A sample of 17 physicians and 9 nurses from 6 hospitals in Tehran were recruited and saturation was achieved after 21 in-depth interviews. Then, the answers of six HCPs were selected for defining the fuzzy sets and membership functions' curve. Six patterns of HCPs' judgments emerged that were used for the fuzzy analysis. These patterns are outcomes of assessment on various aspects of fairness of stigmatization that is impacted by HCPs' counterfactual prototypes. Moral codes, hospital and medical rules, and also constraints imposed from the workplace environment are the references of counterfactual prototypes that affected the HCPs' judgment. Health policy makers can design more effective HIV stigma reduction interventions based on the six patterns of HCPs' judgment.

Religion and HIV/AIDS Stigma: Considerations for the Nursing Profession

Nurses' stigmatization of people living with HIV/AIDS hinders effective health care provisions for this sector of the population. Scientific literature on HIV/AIDS stigma has emphasized cognitive, individual, and interpersonal factors that are relevant to the understanding of the stigmatization process among health care professionals (e.g. a health care professional's accuracy in knowledge of the workings of the virus, effectiveness of emotion management, degree of proximity to the stigmatized group, etc.). However, researchers have also examined the socio-structural factors underlying stigma, and religion has consequently emerged as a social phenomenon that may foster it. The role of religion among professional nurses who specifically service people living with HIV/AIDS remains understudied. Focusing on evidence-based literature, we discuss the relationship between religion and HIV/AIDS stigma, explore potential implications of this relationship for the nursing profession, and make recommendations for stigma-reducing interventions.

Stigma in HIV-infected health care workers in Kenya: a mixed-method approach

HIV-related stigma decreases access to HIV testing, prevention, and treatment services. Our mixed methods study explored stigma as perceived, experienced, and managed in a sample of 76 HIV-infected health care workers in Kisumu, Kenya. Stigma was quantitatively measured using the HIV/AIDS Stigma Instrument for People Living with AIDS (HASI-P). Overall, subjects experienced low stigma levels (mean = 7.88, SD = 12.90; range = 0-61), and none of the sociodemographic variables were predictive of stigma. Transcript analysis of 20 qualitative interviews revealed two negative themes (blame, lack of knowledge) and five positive themes (living positively, optimism, empathy, support, changes over time). Three themes emerged on reducing stigma (normalizing, empowerment, leading by example). Disclosure, access to treatment, stigma reduction training, workplace support groups, and awareness of an HIV workplace policy may have contributed to low stigma scores. Qualitative findings corroborated quantitative findings and corresponded to the six domains of the HASI-P.

Comparison of geographic methods to assess travel patterns of persons diagnosed with HIV in Philadelphia: how close is close enough?

Travel distance to medical care has been assessed using a variety of geographic methods. Network analyses are less common, but may generate more accurate estimates of travel costs. We compared straight-line distances and driving distance, as well as average drive time and travel time on a public transit network for 1789 persons diagnosed with HIV between 2010 and 2012 to identify differences overall, and by distinct geographic areas of Philadelphia. Paired t-tests were used to assess differences across methods, and analysis of variance was used to assess between-group differences. Driving distances were significantly longer than straight-line distances (p<0.001) and transit times were significantly longer than driving times (p<0.001). Persons living in the northeast section of the city traveled greater distances, and at greater cost of time and effort, than persons in all other areas of the city (p<0.001). Persons living in the northwest section of the city traveled farther and longer than all other areas except the northeast (p<0.0001). Network analyses that include public transit will likely produce a more realistic estimate of the travel costs, and may improve models to predict medical care outcomes.

AIDS and the stigma of sexual promiscuity: Thai nurses' risk perceptions of occupational exposure to HIV

This paper examines the culturally shaped meanings of AIDS and perceptions of accidental occupational exposure to HIV among a group of twenty nurses in Bangkok, Thailand. The findings are based on data collected as a part of a larger mixed-methods study that examined how perceptions of risk behaviours (including sexual promiscuity) shape health workers' perceptions of patients living with HIV/AIDS. Nurses' narratives revealed that despite acknowledgement of the low probability of occupational exposure to HIV, the fear of HIV infection remained and was largely driven by the enormity of the anticipated social (rather than the health) consequences of being HIV-positive. The perceived certainty of social ostracism was reinforced by participants' observations of the social rejection experienced by people living with HIV/AIDS both within and outside clinical settings. For female nurses, the dominant social perception that women living with HIV/AIDS were violators of gender norms, and thus 'guilty' victims, was an issue central to their self-identities. Ways of improving care for people living with HIV in the light of the nurses' concerns and future research are discussed.