HIV/AIDS discrimination in the Asia Pacific

The effects of a training program for reducing nurses' discrimination towards PLWHAs

Performing a training program for reducing nurses' discrimination towards AIDS clients, and then evaluating the effect of the training model and analyzing the influencing factors of the training effect to form a long-run training model. 150 clinical nurses were selected to attend the program to reduce nurses' discrimination towards AIDS clients. The program included 3 steps: knowledge education, psychological intervention, and behavior correcting. Before the program, we conducted pre-research to learn the current situation, including existing discrimination and training needs. Selected nurses were asked to complete questionnaires before and 6 months after training, and the trainees were from several hospitals in Haikou. The research period was from March to September 2020. The scores for AIDS-related knowledge, discrimination attitudes, and nursing standard behavior before training were (49.69 ± 3.80), (47.01 ± 3.70), and (35.98 ± 3.01), respectively, and the scores from 6 months after training were (59.01 ± 3.88), (52.19 ± 4.98), and (38.12 ± 2.98), respectively. Correlation analysis revealed that the scores for the nurses' AIDS-related knowledge and behavior were positively correlated (R = 0.31, P < .05); however, there was no correlation found between attitude and behavior (P > .05); no significant differences were observed in the 3 scores among nurses in different departments and nurses with different working durations. There was a significant difference detected among nurses in their experience caring for AIDS clients (F = 3.80, P < .05). The nurses with higher education levels also showed a significant difference compared to those with low education levels on their knowledge and behavior scores ([F = 3.49, P < .05] and [F = 4.68, P < .05], respectively). AIDS-related knowledge training and psychological intervention can effectively reduce the discriminatory attitudes of nurses towards AIDS clients.

Disclosure behaviour and experienced reactions in patients with HIV versus chronic viral hepatitis or diabetes mellitus in Germany

Disclosure is a prerequisite to receive disease-specific social support. However, in the case of a stigmatised disease, it can also lead to discrimination. We aimed to assess disclosure rates of HIV patients and the reactions they encountered in comparison to patients with chronic viral hepatitis or diabetes mellitus and patients' general perception of disease-specific discrimination. We constructed a self-report questionnaire, anonymously assessing the size of the social environment, the persons who had been informed, and the experienced reactions as perceived by the disclosing patients, to be rated on 1-4 point Likert scales. In addition, patients were asked whether they perceive general discrimination in Germany. One hundred and seventy-one patients were asked to participate. Five rejected, thus questionnaires from 83 patients with HIV, 42 patients with chronic viral hepatitis B (n = 9) or C (n = 33), and 41 patients with insulin-dependent diabetes mellitus (type I n = 14, type II n = 27) were analysed. Whereas the size of the social environment did not differ, HIV-infected patients were least likely to disclose their disease (60.7%, SD ± 31.9) to their social environment as compared to patients with chronic viral hepatitis (84.2 ± 23.3%, p<0.0001), or diabetes mellitus (94.4 ± 10.3%, p<0.0001), respectively. Within the HIV patient group, the mean disclosure rate was highest to partners (90.9%), followed by the public environment (65.2%), friends (59.4%) and family members (43.8%). HIV patients experienced supportive reactions after 79.3 ± 26.4% of disclosures, which was the case in 91.4 ± 19.6% and 75.7 ± 36.1% of patients with hepatitis or diabetes mellitus, respectively. 69.5% of HIV patients stated to perceive general discrimination in Germany. We conclude that HIV patients had experienced supportive reactions after the majority of disclosures, but the low rate points out that their information strategy had been very selective. Societal discrimination of HIV patients is still an issue and needs to be further addressed.