Reducing AIDS stigma among health professionals in South India

减少印度南部卫生专业人员对艾滋病的耻辱

• 批准号: 8882082
• 负责人: Maria L. Ekstrand
• 金额: $ 50.47万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-07-15 至 2016-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8882082
• 关键词: AIDS prevention; Accounting; Acquired Immunodeficiency Syndrome; Address; Attitude; Behavior; Behavioral; Collaborations; Communities; Computers; Counseling; Data; Developing Countries; Discrimination; Freedom; Fright; Goals; HIV; HIV Infections; HIV Seropositivity; Health; Health Personnel; Health Professional; Healthcare; Hospitals; Human immunodeficiency virus test; India; Individual; Infection; Institution; Intervention; Interview; Life; Life Style; Literature; Medical; Mental Health; Methodology; Modeling; Nurses; Nursing Students; Occupations; Participant; Patients; Pattern; Pharmaceutical Preparations; Policies; Policy Maker; Prevention; Prevention program; Provider; Public Health; Quality of life; Randomized Controlled Trials; Regimen; Reporting; Research; Research Personnel; Science; Sexual Partners; Site; Source; Tablets; Testing; Time; Treatment Efficacy; Vulnerable Populations; Woman; Women' s Health; Work; base; design; experience; fight against; follow-up; improved; innovation; international center; member; physical conditioning; programs; public health relevance; social; social cognitive theory; social stigma; theories; touchscreen; transmission process; treatment program; ward; willingness

DESCRIPTION (provided by applicant): AIDS stigma has long been recognized as a significant barrier in the worldwide fight against HIV. In India, as well as elsewhere, AIDS stigma has repeatedly been shown, not only to inflict hardship and suffering on people with HIV, but also to interfere with decisions to seek HIV counseling and testing, limit HIV-infected individuals willingness to disclose their status to others, and to deter infected individuals from seeking and adhering to medical treatment for HIV-related problems. Members of marginalized groups often experience additional stigma, forcing them to hide their lifestyles and making it more difficult to attend AIDS-related prevention and treatment programs. Although several stigma researchers have called for rigorously evaluated, theory-based stigma reduction interventions, few such programs are in place. Our proposed research aims to fill this gap. This collaborative application builds on findings from our decade-long collaborative research program in South India as well as on research conducted by the International Center for Research on Women (ICRW). Our data show that health professionals often represent a crucial source of AIDS stigma in India, highlighting the need to develop and test interventions in health care settings. ICRW has developed and implemented such an intervention, which has been found acceptable and feasible. A modified version reduced stigma among Indian nursing students in our pilot intervention. The efficacy of this promising intervention is now ready to be formally evaluated in a randomized controlled trial with nursing students and ward attendants; the two types of health care providers who showed the greatest levels of AIDS stigma in our preliminary work. In order for an intervention to have a significant and lasting impact, it also needs to be sustainable, and consider aspects such as staff time constraints. We thus propose to use an innovative delivery model to accomplish these goals: 1. Adapt the ICRW health care provider stigma reduction intervention for partial tablet PC-based delivery, using interactive touch screen methodology and video vignettes tailored to participant job type. 2. Conduct a cluster randomized controlled trial to evaluate the efficacy of this intervention in 24 institutions on a) the endorsement of coercive policies and intentions to discriminate toward HIV+ patients; b) instrumental and symbolic stigma; two factors which have been found to drive the manifestations of stigma in this setting.

描述（由申请人提供）：艾滋病耻辱长期以来一直被认为是全世界抗击艾滋病毒的重大障碍。在印度和其他地方，艾滋病是一种耻辱 已多次被证明，不仅给艾滋病毒感染者带来困难和痛苦，而且还干扰寻求艾滋病毒咨询和检测的决定，限制艾滋病毒感染者向他人透露其状况的意愿，并阻止感染者寻求和坚持治疗艾滋病毒相关问题的医疗。边缘化群体的成员常常遭受额外的耻辱，迫使他们隐藏自己的生活方式，并使他们更难 参加艾滋病相关的预防和治疗项目。尽管一些耻辱研究人员呼吁采取严格评估的、基于理论的减少耻辱干预措施，但很少有这样的计划到位。我们提出的研究旨在填补这一空白。该合作应用程序建立在我们在印度南部长达十年的合作研究项目的研究成果以及国际妇女研究中心 (ICRW) 进行的研究的基础上。我们的数据显示，卫生专业人员往往是印度艾滋病耻辱的重要根源，这凸显了在卫生保健机构中制定和测试干预措施的必要性。 ICRW 制定并实施了这样的干预措施，该干预措施已被认为是可接受且可行的。在我们的试点干预中，修改后的版本减少了印度护理学生的耻辱感。这种有前途的干预措施的功效现已准备好在一项由护生和病房服务员参与的随机对照试验中进行正式评估；在我们的初步工作中，两类医疗保健提供者表现出最严重的艾滋病耻辱感。为了使干预措施产生重大而持久的影响，它还需要具有可持续性，并考虑员工时间限制等方面。因此，我们建议使用创新的交付模式来实现这些目标： 1. 使用交互式触摸屏方法和针对参与者工作类型定制的视频片段，将 ICRW 医疗保健提供者耻辱减少干预措施调整为部分基于平板电脑的交付。 2. 进行一项整群随机对照试验，以评估该干预措施在 24 个机构中的功效：a) 支持强制政策和歧视 HIV+ 患者的意图； b) 工具性和象征性的耻辱；在这种情况下，有两个因素被发现会导致耻辱的表现。