Reducing stigmatizing attitudes and behaviors of nursing students in simulated clinical visits of patients living with HIV in Iran

在伊朗艾滋病毒感染者的模拟临床就诊中减少护生的污名化态度和行为

• 批准号: 10542953
• 负责人: Ali Mirzazadeh
• 金额: $ 29.24万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-02-17 至 2026-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10542953
• 关键词: AIDS prevention; Attitude; Behavior; Caring; Case Study; Clinical; Clinical Skills; Code; Coupled; Data; Development; Diagnosis; Drug usage; Educational Intervention; Empathy; Epidemiology; Feedback; Female; Frequencies; Friends; Future; Goals; HIV; HIV diagnosis; Health Personnel; Health care facility; Homophobia; Human immunodeficiency virus test; Intervention; Interview; Iran; Marriage; Maternal Health; Medical; Middle East; Needle Sharing; Nurses; Nursing Schools; Nursing Students; Participant; Patients; Persons; Pharmaceutical Preparations; Physician Assistants; Physicians; Population; Populations at Risk; Random Allocation; Randomized; Randomized, Controlled Trials; Religious Belief; Reporting; Research; Risk; Sexism; Stigmatization; Students; Training; Training Activity; Training Programs; Universities; Unsafe Sex; Video Recording; Visit; adolescent health; antiretroviral therapy; arm; care systems; clinical encounter; clinical training; effective intervention; effectiveness testing; experience; field study; high risk; improved; learned behavior; male; man; marginalization; men; pilot test; response; sex; social culture; social stigma; testing services; tool

Project Summary/Abstract Iran has the highest burden of HIV in the Middle East. However, only 42% of Iranians living with HIV are diagnosed and 28% on antiretroviral therapy. The largest gap in the continuum of HIV care is diagnosis. Due to sociocultural and religious beliefs, HIV-associated stigma and drug use stigma are exceedingly high, and sex outside of marriage, or sex of man with another man are considered to be “sinful” behaviors. These intersectional stigmas (stigma towards drug use, sexism, and homophobia) in addition to HIV stigma are major barriers for many people at risk for or living with HIV to engage in HIV testing or treatment. Our prior studies found that health providers have limited clinical encounters with people living with HIV (PLWH) and have no HIV stigma training. This lack of training can lead to stigmatizing attitudes and behaviors towards people at risk for HIV or PLWH. The highest HIV stigmatizing behaviors was reported in nurses and physician assistants. These data, coupled with the extreme marginalization of key populations at high risk for HIV in Iran, call for the development of new ways to train nurses to reduce HIV-related stigma in clinical settings. We propose to develop, and field test an HIV stigma online training including simulated patients living with HIV for nursing school students. In a randomized controlled trial, we will assess the feasibility, acceptability, and preliminary efficacy of the online HIV stigma training in reducing stigmatizing attitudes and behaviors of nursing students in simulated clinical visits of patients living with HIV compared to an online HIV epidemiology training with no specific content on stigma. Successful development of the HIV stigma training and simulated patients at risk for or living with HIV will set the stage for developing a larger trial of nurses and other health providers which can lead to an effective and scalable training program to reduce HIV-related stigma in clinical settings and improve engagement in HIV testing and care services.

项目概要/摘要 伊朗是中东地区艾滋病毒负担最高的国家，但只有 42% 的伊朗艾滋病毒感染者感染艾滋病毒。 艾滋病毒治疗过程中最大的差距是诊断。 社会文化和宗教信仰、与艾滋病毒相关的耻辱和吸毒的耻辱非常高，而且性 婚姻之外的性行为或男人与另一个男人的性行为被认为是“有罪”的行为。 除了艾滋病毒耻辱之外，耻辱（对吸毒、性别歧视和恐同的耻辱）也是主要障碍 我们之前的研究发现，许多有感染艾滋病毒风险或感染艾滋病毒的人都参与了艾滋病毒检测或治疗。 卫生服务提供者与艾滋病毒感染者 (PLWH) 的临床接触有限，并且没有艾滋病毒耻辱感 缺乏培训可能会导致对艾滋病毒或艾滋病高危人群的侮辱态度和行为。 这些数据显示，艾滋病病毒感染者的污名化行为最严重的是护士和医生助理。 加之伊朗艾滋病毒高危重点人群的极端边缘化，呼吁发展 我们建议开发并推广培训护士以减少临床环境中与艾滋病毒相关的耻辱的新方法。 测试艾滋病毒耻辱在线培训，包括为护士学校的学生模拟艾滋病毒感染者。 随机对照试验，我们将评估在线艾滋病毒的可行性、可接受性和初步疗效 在模拟临床就诊中减少护生污名化态度和行为的污名化培训 艾滋病毒感染者与没有关于耻辱的具体内容的在线艾滋病毒流行病学培训进行了比较。 艾滋病毒耻辱培训和模拟有艾滋病毒风险或感染艾滋病毒的患者的成功开发将设定 为对护士和其他卫生服务提供者进行更大规模试验而开发的阶段，这可以导致有效和 可扩展的培训计划，以减少临床环境中与艾滋病毒相关的耻辱并提高艾滋病毒检测的参与度 和护理服务。