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/艾滋病感染者（PLWHA）的生活构成了挑战。当艾滋病毒/艾滋病感染者生活中的重要人物，如卫生专业人员表现出这种情况时，情况就会恶化。对于那些代表治疗第一线接触者和治疗疾病有效战略知识基础的医生来说，情况尤其如此。当医生对艾滋病毒/艾滋病感染者进行污名化时，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，卫生专业人员，特别是医生，表现出很高的艾滋病毒/艾滋病耻辱感。迫切需要经科学检验的战略来减少这种耻辱感，并应在他们的专业培训期间提供，因为他们愿意学习关于医生在病人生活中的作用的新想法。尽管如此，对已发表的关于减少艾滋病毒/艾滋病污名化的文献的审查表明，缺乏针对医学生的经过科学检验的干预措施。这项为期五年的R 01研究旨在通过随机对照试验修订和测试干预措施的有效性，以减少医学生对艾滋病毒/艾滋病的污名。拟议的研究的具体目标是：目标1：修改和实施基于社会认知理论的干预措施，以减少艾滋病毒/艾滋病的耻辱感，并评估其在医学生的最后一年培训的可接受性。目标二：在干预后立即、6个月和12个月时评估干预在减少艾滋病毒/艾滋病污名态度和行为方面的有效性。目标3：评估是否建议的耻辱变化机制，特别是艾滋病毒信息，识别耻辱和与艾滋病毒感染者和艾滋病患者互动的技能，以及这些技能的自我效能，解释干预后减少耻辱。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/艾滋病污名方面显示出可喜的成果，我们的污名测量结果在统计上显著减少。在第二阶段，干预将在500名医学生的样本中实施，这些医学生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个月进行定量问卷调查。这项研究将涉及第一个艾滋病毒/艾滋病耻辱减少干预措施，针对医学生在波多黎各，将实验测试与随机样本和长期评估的变化。减少艾滋病毒/艾滋病在这一人群中的污名化，可以促进提供无污名化的服务，并为今后的干预措施提供一个框架。 这项研究将需要第一个艾滋病毒/艾滋病污名减少干预针对拉丁美洲医学生，将与随机样本和长期的变化评估进行实验测试，因为我们一直无法找到其他在已发表的科学文献。如果证明有效，将在波多黎各的几个医疗培训方案和其他适用的西班牙语方案中传播，并将有助于减少艾滋病的耻辱感。减少艾滋病毒/艾滋病在这一人群中的耻辱感，可以促进提供无耻辱感的服务，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.