Extent of HIV stigma among HIV positive healthcare workers: A mixed methods approach

Type Thesis or Dissertation - Doctor of Philosophy in Nursing
Title Extent of HIV stigma among HIV positive healthcare workers: A mixed methods approach
Author(s)
Publication (Day/Month/Year) 2013
Abstract
Regardless of practice settings, healthcare workers (HCWs) in Sub-Saharan Africa are
either infected or affected by HIV/AIDS. This mixed methods study measured the extent of
HIV/AIDS stigma and the relationship between stigma and sociodemographic variables in a
sample of 76 HIV positive HCWs. Qualitative aspects (n=20) explored how HIV positive HCWs
manage personal health, stigma experiences in the workplace, and the HCWs role in reducing
stigma in the workplace. Overall, HIV positive HCWs in this study experienced low stigma levels
(Mean= 7.88, SD 12.90). Subscale means ranged from 0.09 (SD 0.28) for workplace stigma to
0.39 (SD 0.62) for verbal abuse. Stigma was negatively and significantly correlated with years of
work experience (χ
2
6.97, df= 1, p = 0.01), annual salary (χ
2
4.02, = df= 1, p = 0.05), years living
with HIV (χ
2
5.07, df = 1, p =0.02) and positively and significantly correlated with employment
category (χ
2
9.32, = df= 1, p = 0.00). None of the sociodemographic variables were predictive of
stigma in this sample. Two negative themes emerged blame and lack of knowledge. Five positive
themes emerged related to stigma experiences: living positively, optimism, empathy, support, and
changes over time. Normalizing, leading by example and empowerment were three themes that
v
emerged on ways of reducing stigma. Disclosing HIV status, awareness of an HIV/AIDS
workplace policy, and having access to treatment, stigma reduction training, and workplace
support groups may have contributed to the low stigma scores. Qualitative findings corroborated
quantitative findings and corresponded to the six domains of the stigma instrument (HASI-P).
Stigma reduction efforts should incorporate socioecological approaches; expand beyond the
individual level and address interpersonal, institutional, community, and public policy levels of
influence.

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