AIDS Stigma among Health Professionals in Puerto Rico

波多黎各卫生专业人员中的艾滋病耻辱

基本信息

批准号：
7918092
负责人：
NELSON VARAS-DIAZ
金额：
$ 36.95万
依托单位：
UNIVERSITY OF PUERTO RICO RIO PIEDRAS
依托单位国家：
美国
项目类别：
财政年份：
2007
资助国家：
美国
起止时间：
2007-09-26 至 2012-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7918092
关键词：
AIDS/HIV problem Acquired Immunodeficiency Syndrome Address Adherence Affect Anti-Retroviral Agents Anxiety Attention Attitude Behavior Behavioral Cognitive Communities Consequences of HIV Control Groups Data Development Dimensions Disease Disease Progression Environmental Risk Factor Evaluation Fostering Future HIV HIV Infections Health Professional Impact evaluation Intervention Intervention Studies Latino Learning Length Life Literature Measurement Medical Medical Students Mental Depression Mental Health Participant Physician&apos s Role Physicians Play Population Prevention Process Publishing Puerto Rican Puerto Rico Quality of life Questionnaires Randomized Randomized Controlled Trials Reporting Research Role Sampling Self Efficacy Services Social Interaction Social Network Societies Source Staging Stigmata Stigmatization Testing Time Training Training Programs Treatment Efficacy Typology Visit Work base effective therapy efficacy testing intervention effect knowledge base novel physical conditioning research study self esteem skills social social cognitive theory social stigma theories tool

项目摘要

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.

描述（由申请人提供）：与艾滋病毒/艾滋病相关的耻辱对艾滋病毒/艾滋病感染者（PLWHA）的生活构成了挑战。当感染者生活中重要的人（例如卫生专业人员）出现这种情况时，情况会变得更糟。对于代表治疗第一线和治疗疾病的有效策略的知识基础的医生来说尤其如此。当医生污蔑艾滋病病毒感染者时，获得有效治疗的机会可能会受到阻碍。波多黎各研究小组先前进行的研究表明，卫生专业人员，特别是医生，表现出高度的艾滋病毒/艾滋病耻辱感。迫切需要经过科学检验的策略来减少这种耻辱，并且应该在他们的专业培训期间提供这些策略，因为他们愿意学习有关医生在病人生活中的作用的新想法。尽管如此，对已发表的有关减少艾滋病毒/艾滋病耻辱的文献的回顾表明，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 R01 研究旨在通过随机对照试验修改和测试干预措施的有效性，以减少医学生中艾滋病毒/艾滋病的耻辱感。拟议研究的具体目标是：目标 1：修订并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最后一年培训中的可接受性。目标 2：评估干预措施在干预后立即、六个月和 12 个月时减少艾滋病毒/艾滋病耻辱态度和行为的功效。目标 3：评估所提出的耻辱改变机制，特别是艾滋病毒信息、识别耻辱和与感染者互动的技能以及这些技能的自我效能是否可以解释干预后耻辱的减少。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，我们将根据我们之前的研究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。这项试点干预措施已经过测试，在减少艾滋病毒/艾滋病耻辱感方面显示出可喜的成果，统计上我们的耻辱感测量结果显着减少。在第二阶段，干预措施将在 500 名医学生样本中实施，这些学生将被随机分配到干预组（n = 250）和对照组（n = 250），并在之前进行定量调查问卷进行过程和影响评估，干预后立即、六个月和 12 个月。这项研究将首次针对波多黎各医科学生开展减少艾滋病毒/艾滋病耻辱感的干预措施，该干预措施将通过随机样本和长期变化评估进行实验测试。减少这一人群中艾滋病毒/艾滋病的耻辱感可以促进提供无耻辱感的服务，并为未来的干预措施提供框架。这项研究将首次针对拉丁裔医学生进行减少艾滋病毒/艾滋病耻辱的干预措施，该干预措施将通过随机样本进行实验测试并进行长期变化评估，因为我们无法在已发表的科学文献中找到其他干预措施。如果证明有效，它将在波多黎各的几个医疗培训项目和其他适用的西班牙语场景中进行传播，并有助于减少艾滋病的耻辱。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，研究表明这些服务可以改善艾滋病毒/艾滋病患者的生活。