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: 9109458
• 负责人: Maria L. Ekstrand
• 金额: $ 49.4万
• 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 2018-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9109458
• 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）：长期以来，艾滋病的污名被认为是与艾滋病毒斗争的重要障碍。在印度以及其他地方，艾滋病污名 一再表现出来，不仅是为了给艾滋病毒造成艰辛和苦难，而且要干扰寻求艾滋病毒咨询和测试的决定，限制了感染艾滋病毒的人愿意向他人披露自己的地位，并阻止受感染的人寻求和遵守与艾滋病毒相关问题的医疗治疗。边缘化群体的成员经常会遭受额外的污名，迫使他们隐藏自己的生活方式，并使更难难以 参加与艾滋病有关的预防和治疗计划。尽管一些污名化的研究人员要求对经过严格评估，基于理论的污名降低干预措施，但很少有这样的程序。我们提出的研究旨在填补这一空白。这项合作申请基于我们在印度南部长达十年的合作研究计划以及国际妇女研究中心（ICRW）进行的研究。我们的数据表明，卫生专业人员通常代表印度的艾滋病污名的至关重要来源，强调了在医疗保健环境中开发和测试干预措施的必要性。 ICRW已经开发并实施了这种干预措施，该干预被认为可以接受和可行。在我们的飞行员干预中，改良版本减少了印度护理学生的污名。现在，这种有希望的干预措施的功效已经准备好在与护理学生和病房服务员的随机对照试验中进行正式评估；两种类型的医疗保健提供者在我们的初步工作中表现出最大程度的艾滋病污名。为了使干预产生重大持久的影响，它也需要具有可持续性，并考虑诸如员工时间限制之类的方面。因此，我们建议使用创新的交付模型来实现这些目标：1。使用互动式触摸屏方法和针对参与者工作类型量身定制的Interactive Touch Screen方法论和视频小插图，适应了基于部分平板电脑的ICRW卫生保健提供者的污名化干预措施。 2。进行簇随机对照试验，以评估该干预措施在24个机构中的疗效A）认可强制性政策和歧视HIV+患者的意图； b）器乐和象征性的污名；在这种情况下，发现有两个因素驱动污名表现的因素。