AIDS Stigma among Health Professionals in Puerto Rico

描述（由申请人提供）：与艾滋病毒/艾滋病相关的耻辱对艾滋病毒/艾滋病患者（PLWHA）的生活构成了挑战。当对艾滋病感染者的生活有重要影响的人（如卫生专业人员）表现出这种情况时，情况会更糟。对于代表治疗的第一线接触和有效治疗策略知识基础的医生来说尤其如此。当医生将艾滋病污名化时，获得有效治疗的机会就会受到阻碍。研究小组以前在波多黎各进行的研究表明，保健专业人员，特别是医生，对艾滋病毒/艾滋病的歧视程度很高。迫切需要经过科学检验的减少这种耻辱的策略，并应在他们的专业培训期间提供这些策略，因为他们愿意学习关于医生在患者生活中的作用的新想法。尽管如此，对减少艾滋病毒/艾滋病污名的已发表文献的审查表明，缺乏针对医科学生的经过科学检验的干预措施。本研究是一项为期五年的R01研究，旨在通过随机对照试验，修订和检验一项干预措施对减少医学生对HIV/AIDS的耻辱感的效果。本研究的具体目的是：目的1：修订并实施基于社会认知理论的干预措施，以减少医学生在最后一年的培训中对艾滋病毒/艾滋病的耻辱感，并评估其可接受性。目的2：评估干预措施在干预后立即、6个月和12个月时减少艾滋病毒/艾滋病污名态度和行为的效果。目的3：评估所提出的耻辱感改变机制，特别是艾滋病毒信息、识别耻辱感和与艾滋病患者互动的技能，以及这些技能的自我效能感，是否能解释干预后耻辱感的减少。这些目标将通过一项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/艾滋病的耻辱感。这一试点干预措施已经过测试，在减少艾滋病毒/艾滋病的耻辱感方面显示出有希望的结果，我们的耻辱感测量结果在统计上显着减少。在第二阶段，将在500名医学生样本中实施干预，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、干预后6个月和干预后12个月接受定量问卷的过程和影响评估。这项研究将涉及针对波多黎各医科学生的第一个减少艾滋病毒/艾滋病耻辱的干预措施，将通过随机样本和长期变化评估进行实验测试。减少这一人群对艾滋病毒/艾滋病的耻辱感可以促进提供无耻辱感的服务，并为未来的干预措施提供框架。

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.