scholarly journals ISQUA18-1138Applying Structured Quality Improvement Methods to Reduce HIV-related Stigma and Discrimination in Healthcare Facilities: Implementation of the Southeast Asia Stigma Reduction Learning Network

2018 ◽  
Vol 30 (suppl_2) ◽  
pp. 19-20
Author(s):  
D Ikeda ◽  
K Srithanaviboonchai ◽  
L Nyblade ◽  
B Agins
Keyword(s):  
Quality Improvement ◽  
Southeast Asia ◽  
Stigma Reduction ◽  
Healthcare Facilities ◽  
Learning Network ◽  
Stigma And Discrimination ◽  
Related Stigma

scholarly journals A quality improvement approach to the reduction of HIV-related stigma and discrimination in healthcare settings

2019 ◽  
Vol 4 (3) ◽  
pp. e001587 ◽  
Author(s):  
Daniel J Ikeda ◽  
Laura Nyblade ◽  
Kriengkrai Srithanaviboonchai ◽  
Bruce D Agins
Keyword(s):  
Quality Improvement ◽  
Southeast Asia ◽  
National Level ◽  
Scale Up ◽  
Lessons Learned ◽  
Routine Practice ◽  
People Living With Hiv ◽  
Stigma And Discrimination ◽  
Healthcare Settings ◽  
Related Stigma

HIV-related stigma and discrimination (S&D) in healthcare settings represents a potent barrier to achieving global aims to end the HIV epidemic, particularly in Southeast Asia (Cambodia, Lao People’s Democratic Republic, Thailand and Vietnam). Evidence-based approaches for measuring and reducing S&D in healthcare settings exist, but their incorporation into routine practice remains limited, in part due to a lack of attention to how unique organisational practices—beyond the knowledge and attitudes of individuals—may abet and reinforce S&D. Application of a quality improvement (QI) approach in which facilities leverage routine measurement of S&D among healthcare workers and people living with HIV, team-based learning, root cause analysis, and tests of change offers a novel means through which to address S&D in local contexts and develop interventions to address individual-level and organisation-level drivers of S&D. To support the adoption of a QI approach to S&D reduction, the Southeast Asia Stigma Reduction QI Learning Network was launched with Ministries of Health from Cambodia, Lao PDR, Thailand and Vietnam, to co-develop strategies for implementing QI activities in participating facilities. Since the inception of Network activities in 2017, Ministry-led QI activities to address S&D have been implemented in 83 facilities and 29 provinces across participating countries. Moreover, 27 strategies and interventions have been tested to date and are being evaluated for scale up by participating facilities, spanning multiple drivers and organisational domains. Lessons learned through Network activities offer national-level and facility-level HIV programmes best practices for implementing a QI approach to S&D reduction.

scholarly journals Increased Work Experience Associated with Less Stigmatizing Attitudes towards People Living with HIV among Thai Healthcare Personnel

2021 ◽  
Vol 18 (18) ◽  
pp. 9830
Author(s):  
Kriengkrai Srithanaviboonchai ◽  
Porntip Khemngern ◽  
Jarun Chuayen ◽  
Taweesap Siraprapasiri
Keyword(s):  
Work Experience ◽  
Role Models ◽  
Professional Staff ◽  
Healthcare Personnel ◽  
People Living With Hiv ◽  
Staff Support ◽  
Stigma Reduction ◽  
Healthcare Facilities ◽  
Related Stigma ◽  
Stigmatizing Attitudes

HIV-related stigma in health facilities has been suggested as a primary target for HIV-related stigma reduction. The objective of this study was to describe negative attitudes among Thai healthcare personnel (HCP) toward PLHIV. This nationwide probability sampled survey was conducted in 2019 in 12 provinces in Thailand and Bangkok, the capital. Participants were considered to have stigmatizing attitudes toward PLHIV if they had a stigmatizing view in response to at least one of the four questions. Eighty-two percent of the 3056 respondents had at least one stigmatizing attitude. Younger HCP, ages < 30 (AOR = 1.60; 95%CI: 1.18–2.18) and 30–39 (AOR = 1.60; 95%CI: 1.21–2.12) were more likely to have stigmatizing attitudes towards PLHIV compared to those aged 50 and older. Being support staff, support-clinical (AOR = 1.89; 95%CI: 1.44–2.49) and support-nonclinical (AOR = 1.71; 95%CI: 1.24–2.36) as opposed to professional staff also increased the likelihood of having stigmatizing attitudes. Stigma was also more likely to be present in HCPs who did not work at HIV-focused clinics (AOR = 1.97; 95%CI: 1.57–2.48). HCP who had more work experience, especially related to PLHIV care, were less likely to have stigmatizing attitudes. These personnel could be good peer educators or role models for a stigma reduction campaign within their healthcare facilities.

scholarly journals Impact of ‘HIV-related stigma-reduction workshops’ on knowledge and attitude of healthcare providers and students in Central India: a pre-test and post-test intervention study

BMJ Open ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. e033612 ◽  
Author(s):  
Anna Machowska ◽  
Babu Lal Bamboria ◽  
Courtney Bercan ◽  
Megha Sharma
Keyword(s):  
Intervention Study ◽  
Healthcare Providers ◽  
Central India ◽  
Post Intervention ◽  
Stigma Reduction ◽  
Knowledge And Attitudes ◽  
Stigma And Discrimination ◽  
Related Stigma ◽  
Knowledge And Attitude ◽  
The Impact

IntroductionPeople living with HIV and AIDS (PLWHA) experience stigma and discrimination throughout their life. The consequences of stigma and discrimination are severe when enacted by healthcare providers (HCPs), and result in a delay in or poor adherence to treatment. Studies have demonstrated the presence of stigmatising behaviours among HCPs, yet only a few have presented the impact of interventions on the knowledge and attitude of practising (clinicians and nurses) and future (students) HCPs.ObjectivesTo evaluate knowledge, attitudes and infection risk perceptions related to HIV/AIDS among practising and future HCPs in central India. In addition, the impact of the ‘HIV-related stigma-reduction workshop’ using a pre-intervention and post-intervention study design was evaluated.Settings and participantsThe study was conducted in 2016 at two tertiary-care hospitals and three healthcare colleges in central India. Overall, 650 HCPs (75 clinicians and 211 nurses) and students (205 medical, 123 nursing and 36 Diploma in Medical and Laboratory Technology (DMLT)) voluntarily participated in the study.InterventionThe educational intervention comprised of training in epidemiology, the transmission and treatment of the HIV infection, the rights of PLWHA, the duties of HCPs and the use of standard precautions.ResultsAt pre-intervention, DMLT students had the lowest and clinicians the highest knowledge scores (24% and 45%, respectively). The stigmatised attitude was reflected in all groups, the lowest among clinicians (21%) and the highest among DMLT students (34%). Improvement in the post-intervention knowledge scores was the highest in medical students (36%) and the lowest among clinicians (16%). The participants’ attitudes improved between 3% and 17% across all groups.ConclusionsSignificant post-intervention improvements were seen in both knowledge and attitudes in all groups. Students had a higher tendency to improve than HCPs. Further long-term studies are needed to evaluate the sustainability of the improvements in knowledge and attitudes of the participants.

scholarly journals Targeted Assessment for Prevention: A Statewide Collaborative

2020 ◽  
Vol 41 (S1) ◽  
pp. s401-s401
Author(s):  
Cindy Hou ◽  
Shannon Davila ◽  
Mary Miller ◽  
Ashlee Hiester ◽  
Katherine Hosmer ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Infection Prevention ◽  
Local Level ◽  
Central Line ◽  
Interdisciplinary Teams ◽  
System Level ◽  
Healthcare Associated Infection ◽  
Hospital System ◽  
Healthcare Facilities ◽  
Clostridioides Difficile

Background: Infection preventionists (IPs) are the backbone of the quality and safety matrix of their organizations. Tools to help locate potential gaps can provide unique viewpoints from frontline staff. The CDC provides a Targeted Assessment for Prevention (TAP) strategy that identifies vulnerabilities in the prevention of healthcare-associated infection (HAIs). Methods: A statewide quality improvement organization, partnering with the CDC TAP team, administered TAP facility assessments for catheter-associated urinary tract infection (CAUTI), central-line–associated bloodstream infection (CLABSI), and Clostridioides difficile infection (CDI) to a collaborative of 15 acute-care and 2 long-term acute hospitals. More than 800 respondents filled out surveys based on their individualized perceptions of infection prevention practices. Results: The survey results yielded the following lagging indicators: lack of awareness of nursing and physician champions, need for competency-based training of clinical equipment, and feedback on device utilization. At the hospital system level, one improvement team focused on CDI, uncovered leading and lagging areas in general infrastructure, antibiotic stewardship, early detection and appropriate testing, contact precautions, and environmental cleaning. To culminate the TAP collaborative, the cohort of organizations, supported by interdisciplinary teams, participated in a full-day TAP workshop in which they reviewed detailed analyses of their HAI data and assessment results, shared best practices for infection prevention and planned for specific improvement projects using the plan-do-study-act model. Conclusions: Results of a statewide analysis of HAI prevention data and opportunities at a local level were reviewed. The TAP strategy can be used to target opportunities for improvement, to assess gaps in practice, and to develop and implement interventions for improving outcomes. Healthcare facilities and quality improvement organizations can drive infection prevention actions.Funding: NoneDisclosures: None

scholarly journals The role of unintended pregnancy in internalized stigma among women living with HIV in Kenya

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sara Chace Dwyer ◽  
Aparna Jain ◽  
Wilson Liambila ◽  
Charlotte E. Warren
Keyword(s):  
Unintended Pregnancy ◽  
Hiv Treatment ◽  
Outcome Variable ◽  
Internalized Stigma ◽  
Health Seeking ◽  
Logistic Regression Models ◽  
Stigma And Discrimination ◽  
Women Living With Hiv ◽  
Related Stigma ◽  
Living With Hiv

Abstract Background Kenya has successfully expanded HIV treatment, but HIV-related stigma and discrimination, and unintended pregnancy remain issues for many Kenyan women living with HIV. While HIV-related stigma can influence the health seeking behaviors of those living with HIV, less is known about how reproductive health outcomes influence internalized stigma among women living with HIV. Methods Baseline data only were used in this analysis and came from an implementation science study conducted in Kenya from 2015 to 2017. The analytic sample was limited to 1116 women who are living with HIV, between 18 to 44 years old, and have ever experienced a pregnancy. The outcome variable was constructed from 7 internalized stigma statements and agreement with at least 3 statements was categorized as medium/high levels of internalized stigma. Unintended pregnancy, categorized as unintended if the last pregnancy was mistimed or unwanted, was the key independent variable. Univariate and multivariate logistic regression models were used to assess the association between unintended pregnancy and internalized stigma. Associations between internalized stigma and HIV-related discrimination and violence/abuse were also explored. Results About 48% agreed with at least one internalized stigma statement and 19% agreed with at least three. Over half of women reported that their last pregnancy was unintended (59%). Within the year preceding the survey, 52% reported experiencing discrimination and 41% reported experiencing violence or abuse due to their HIV status. Women whose last pregnancy was unintended were 1.6 times (95% CI 1.2–2.3) more likely to have medium/high levels of internalized stigma compared to those whose pregnancy was wanted at the time, adjusting for respondents’ characteristics, experiences of discrimination, and experiences of violence and abuse. Women who experienced HIV-related discrimination in the past 12 months were 1.8 times (95% CI 1.3–2.6) more likely to have medium/high levels of internalized stigma compared to those who experienced no discrimination. Conclusions Results suggest that unintended pregnancy is associated with internalized stigma. Integrated HIV and FP programs in Kenya should continue to address stigma and discrimination while increasing access to comprehensive voluntary family planning services for women living with HIV.

Key and general population HIV-related stigma and discrimination in HIV-specific health care settings: results from the Stigma Index Brazil

AIDS Care ◽  
2021 ◽  
pp. 1-5
Author(s):  
Angelo Brandelli Costa ◽  
Jair B. de Moura Filho ◽  
Josineide M. Silva ◽  
Jorge A. Beloqui ◽  
Yura Espindola ◽  
...  
Keyword(s):  
Health Care ◽  
General Population ◽  
Health Care Settings ◽  
Stigma And Discrimination ◽  
Related Stigma ◽  
Specific Health

scholarly journals Is socio-economic status a determinant of HIV-related stigma attitudes in Zimbabwe? Findings from Project Accept

2016 ◽  
Author(s):  
Kudzanai Mateveke ◽  
Basant Singh ◽  
Alfred Chingono ◽  
E. Sibanda ◽  
Ian Machingura
Keyword(s):  
Social Isolation ◽  
Assessment Tool ◽  
Economic Status ◽  
Target Population ◽  
Low Ses ◽  
Voluntary Counseling And Testing ◽  
Socio Economic Status ◽  
Stigma And Discrimination ◽  
Related Stigma ◽  
The Impact

HIV related stigma and discrimination is a known barrier for HIV prevention and care. We aimed to assess the relationship between socio-economic status (SES) and HIV related stigma in Zimbabwe. This paper uses data from Project Accept, which examined the impact of community-based voluntary counseling and testing intervention on HIV incidence and stigma. Total of 2522 eligible participants responded to a psychometric assessment tool, which assessed HIV related stigma and discrimination attitudes on 4 point Likert scale. The tool measured three components of HIVrelated stigma: shame, blame and social isolation, perceived discrimination, and equity. Participants’ ownership of basic assets was used to assess the socio-economic status. Shame, blame and social isolation component of HIV related stigma was found to be significantly associated with medium [odds ratio (OR)=1.73, P<0.01] and low SES (OR=1.97, P<0.01), indicating more stigmatizing attitudes by participants belonging to medium and low SES in comparison to high SES. For HIV related stigma and discrimination programs to be effective, they should take into account the socio-economic context of target population.

scholarly journals EFFECT OF EDUCATION ON STIGMA AND DISCRIMINATION TOWARDS MENTAL ILLNESS: A MULTIVARIATE ANALYSIS OF COVARIANCE

2021 ◽  
Vol 21 (2) ◽  
pp. 329-337
Author(s):  
Mariana Tumin ◽  
Md Mizanur Rahman ◽  
Zulkifli Jantan
Keyword(s):  
Mental Illness ◽  
Mentally Ill ◽  
Education Level ◽  
Analysis Of Covariance ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Linear Effect ◽  
Stigma And Discrimination ◽  
Significant Difference ◽  
Related Stigma

People with mental illness often encounter stigma and discrimination. Mental illness-related stigma and discrimination represent the enormous obstacles that stand in the way of delivering mental health care. Little is known about stigma and discrimination toward mental illness in rural Sarawak. Thus, this study aimed to identify the stigma and discrimination towards mental illness among Sarawak’s rural community and the factors affecting them. A cross-sectional survey was carried out on 840 respondent adults aged 21 and above. A validated Community Attitude towards Mental Illness (CAMI) and Discrimination towards Mental Illness questionnaire was used for data collection. A Two-way Multiple Analysis of Covariance (Two-way MANCOVA) test was carried out to determine how much gender and education level influence stigma and discrimination towards mentally ill patients. Analysis showed that there was a statistically significant difference of standardised stigma and discrimination scores with education level (p<.001), but not with gender (p>.05). Age had a positive linear effect on both stigma and discrimination, whereas experience with mentally ill patients negatively affected both stigma and discrimination. Individuals with a lower level of education, older in age, and lesser experience in dealing with the mentally ill would have a higher level of stigma and discrimination towards mental illness. Thus, targeted and practical strategies need to be organised and implemented to combat mental illness-related stigma and discrimination.

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