AIDS Stigma among Health Professionals in Puerto Rico

描述(由申请人提供)：与艾滋病毒/艾滋病有关的耻辱对艾滋病毒/艾滋病患者的生活构成了挑战。当在PLWHA生活中很重要的人，如卫生专业人员表现出这种情况时，情况会变得更糟。对于医生来说尤其如此，他们是治疗的第一线接触者，也是了解治疗该疾病的有效策略的基础。当医生污蔑PLWHA时，获得有效治疗的途径可能会受到阻碍。研究小组之前在波多黎各进行的研究表明，卫生专业人员，特别是医生，表现出很高的艾滋病毒/艾滋病污名。迫切需要经过科学检验的减少这种耻辱的战略，应该在他们的专业培训期间提供这些战略，因为他们愿意学习关于医生在病人生活中所扮演的角色的新想法。尽管如此，对已发表的关于减少艾滋病毒/艾滋病污名的文献的回顾表明，缺乏针对医学生的经过科学测试的干预措施。这项为期五年的R01研究旨在通过随机对照试验修订和测试减少医学生中艾滋病毒/艾滋病污名的干预措施的有效性。这项研究的具体目标是：目标1：修订和实施基于社会认知理论的干预措施，以减少艾滋病毒/艾滋病污名，并评估其在医学生最后一年培训中的可接受性。目的2：评价干预后即刻、干预后6个月、干预12个月对降低艾滋病污名态度和行为的效果。目的3：评估拟议的污名改变机制，特别是艾滋病毒信息，识别污名和与PLWHA相互作用的技能，以及这些技能的自我效能，是否解释干预后污名的减少。这些目标将通过分两个阶段实施的随机对照试验来实现。在第一阶段，我们将根据我们之前的研究修改现有的干预措施，以减少卫生专业人员对艾滋病毒/艾滋病的污名。这一试点干预措施已经过测试，并显示出在减少艾滋病毒/艾滋病污名方面有希望的结果，我们的污名测量在统计上显著减少。在第二阶段，干预将在500名医学生中实施，他们将被随机分配到干预组(n=250)和对照组(n=250)，并在干预前、干预后立即、干预后6个月和干预后12个月接受过程和影响评估。这项研究将首次针对波多黎各的医科学生开展减少艾滋病毒/艾滋病污名的干预措施，并将通过随机抽样和长期变化评估进行实验测试。在这一群体中减少艾滋病毒/艾滋病污名可以促进提供无污名服务，并为今后的干预措施提供一个框架。 这项研究将需要针对拉丁裔医学生的第一项减少艾滋病毒/艾滋病污名的干预措施，将通过随机抽样和长期变化评估进行实验测试，因为我们在已出版的科学文献中找不到其他的干预措施。如果被证明有效，它将被传播，并将有助于在波多黎各的几个医疗培训计划以及其他适用的西班牙语情景中减少艾滋病的耻辱。在这一群体中减少对艾滋病毒/艾滋病的污名可以促进提供无污名服务，研究表明，这种服务可以改善艾滋病毒/艾滋病患者的生活。

DESCRIPTION (provided by applicant): The stigma related to HIV/AIDS poses a challenge to the lives of people living with HIV/AIDS (PLWHA). These are worsened when people who are important in the lives of PLWHA manifest it, such as health professionals. This is particularly true for physicians who represent the first line of contact for treatment and the basis of knowledge of effective strategies to treat the disease. When physicians stigmatize PLWHA access to effective treatment can be hindered. Previous studies carried out by the research team in Puerto Rico show that health professionals, particularly physicians, manifest high levels of HIV/AIDS stigma. Scientifically tested strategies to reduce such stigma are urgently needed and should be provided during their professional training since they are open to learning new ideas about the physician's role in the lives of people who are ill. Still, a review of the published literature on HIV/AIDS stigma reduction evidences a lack of scientifically tested interventions targeting medical students. This five-year R01 study aims to revise and test the efficacy of an intervention to reduce HIV/AIDS stigma among medical students through a randomized control trial. The specific aims of the proposed research are: Aim 1: Revise and implement an intervention based on Social Cognitive Theory to reduce HIV/AIDS stigma and evaluate its acceptability among medical students in their last year of training. Aim 2: Evaluate the intervention's efficacy in reducing HIV/AIDS stigma attitudes and behaviors immediately after the intervention, at six months, and 12 months time. Aim 3: Evaluate whether proposed mechanisms of stigma change, specifically HIV information, skills for identifying stigma and interacting with PLWHA, and self-efficacy for such skills, explain stigma reduction after the intervention. These aims will be carried out though a randomized control trial implemented in two stages. In Stage 1, we will revise an existing intervention to reduce HIV/AIDS stigma among health professionals based on our previous research. This pilot intervention has been tested and shows promising results in reducing HIV/AIDS stigma with statistically significant reductions in our stigma measurements. In stage two, the intervention will be implemented among a sample of 500 medical students who will be randomly assigned to intervention (n=250) and control groups (n=250) and subjected to a process and impact evaluation administering a quantitative questionnaire before, immediately after, at six months, and 12 months after the intervention. This study will entail the first HIV/AIDS stigma reduction intervention targeting medical students in Puerto Rico that will be experimentally tested with random samples and long term assessment of change. Reducing HIV/AIDS stigma among this population can foster the provision of stigma free services and provide a framework for future interventions. This study will entail the first HIV/AIDS stigma reduction intervention targeting Latino medical students that will be experimentally tested with random samples and long term assessment of change, as we have been unable to find others in the published scientific literature. If proven effective it will be disseminated and will contribute to AIDS stigma reduction among several medical training programs in Puerto Rico, and other applicable Spanish speaking scenarios. Reducing HIV/AIDS stigma among this population can foster the provision of stigma free services which research has shown to better the lives of people with HIV/AIDS.