Stereotypes and discrimination contribute to HIV-related stigma among nursing staff

Since the earliest study about nursing faculty and students attitudes and beliefs about caring for people living with HIV/AIDS (PLHIV) in the early 1990’s, there have only been 17 additional studies. Knowledge in this area of study is still lacking to fill some gaps in understanding attitudes towards people living with the disease.

Primary investigators, Dr. Juan Leyva (Universitat Autonoma de Barcelona), Dr. Patrick Palmieri (Universidad Norbert Wiener and A.T. Still University), and Dr. Joan Edwards (Texas Woman’s University) sought to understand HIV-related attitudes of nursing faculty in three continents from six countries (Canada, Colombia, England, Peru, Spain, and the United States) and how it correlates to three dimensions of prejudice, stereotypes and discrimination.

The collaborators have published their research in an article, Attitudes toward caring for people living with HIV/AIDS: Across-sectional study of nursing faculty in six countries, in The Open AIDS Journal.

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“Although prior research largely focused on nursing students, the findings from this study will result in a stigma-reduction intervention for nursing faculty at schools of nursing” says Dr. Juan Levya. The two-year project was supported by the Center for Global Nursing at Texas Woman’s University.

Founding director, Dr. Joan Edwards, commented “this research was part of an international collaboration to advance positive social change in South America through nursing research.” The Center actively supports postdoctoral scholars and develops international researchers through mentored research projects in low- and middle-income countries.

The researchers found that HIV-related stigma about caring for PLHIV are slightly positive with notable differences between countries. Apart from Peru, and to a lesser extent neighboring Colombia, the results are consistent with other findings from a few smaller studies.

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The results can be explained, among other reasons, by the high HIV-related stigma in South America and the pervasive discrimination experienced by the LGBTQ community. Although myths and knowledge deficits about HIV/AIDS remain problematic, the results appear to be influenced by nationality in terms of prejudices, stereotypes, and discrimination.

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Faculty attitudes about caring for PLHIV can impact student attitudes and the care they provide. According to Dr. Palmieri, “nursing faculty attitudes can become part of an informal curriculum where implicit learning is impregnated with personal values.”

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The researchers note that in terms of HIV/AIDS education, faculty might not be comfortable teaching what they do not understand. The researchers conclude that theory-derived, evidence-informed interventions need to be developed to advance the knowledge and attitudes of nursing faculty about caring for people living with HIV. The researchers plan to attempt to address negative attitudes with a stigma-reduction intervention based on the information from similar studies.


Bentham Science Publishers

Journal Reference:

Attitudes Toward Caring for People Living with HIV/AIDS: A Cross-Sectional Study of Nursing Faculty in Six Countries

Since the earliest study about nursing faculty and student attitudes about caring for people living with HIV/AIDS (PLHIV) in 1992, there have been less than 20 additional studies reported in the literature. Yet, PLHIV continues to report stigma and experience discrimination. Nursing faculty attitudes are part of the informal curriculum. Negativity about caring for PLHIV can adversely impact student perceptions as well as their care. Current research in this area is essentially non-existent.

To describe the attitudes of the university nursing faculty toward caring for PLHIV; and to identify the relationship between faculty attitudes and explanatory factors such as age, education, religion, nationality, teaching in a clinical setting, years of experience, and university attributes.


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This was a multicenter cross-sectional study with nonrandomized electronic purposeful sampling. The Healthcare Provider HIV/AIDS Stigma Scale (HPASS) is a 30-item scale with three subscales: Prejudice, stereotype, and discrimination. The English and Spanish versions of the HPASS exhibit stable psychometric properties for cross-cultural research. The HPASS was delivered to university nursing faculty in six countries across three continents.

A sample of 368 nursing faculty completed the HPASS. The mean composite score was 2.41 (SD = 0.69), six-point scale with lower scores indicating more positive attitudes, with subscale scores: Stereotypes 2.55 (SD = 0.84), discrimination 2.28 (SD = 0.74), and prejudices 2.41 (SD = 0.63). Peruvian faculty had the highest scores while Canadian had the lowest. Significant correlations were observed between attitudes and the three subscales, and between the three subscales and the composite score.

Attitudes of the nursing faculty toward caring for PLHIV were slightly positive to slightly negative depending on the region and country. Knowledge deficiencies about HIV persist, incorrect beliefs are common, and attitudes appear to be influenced by culture. The correlation between subscales justifies continued research to implement targeted interventions. Education about HIV/AIDS can address knowledge deficits while structured interactions with PLHIV can facilitate experiential learning.

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