HIV and diabetes treatment adherence: premedical students' perspectives.
OBJECTIVE
This study explored how future physicians who are early on in their training conceptualize treatment adherence issues for a disease with a high societal stigma (e.g. HIV/AIDS) versus a disease with little to no societal stigma (e.g. diabetes).


METHODS
We surveyed 121 first and second year students enrolled in a BS/MD program. After observing a videotaped interview of a person with HIV/AIDS, students were asked to identify and resolve ethical dilemmas regarding treatment adherence, which were presented in the interview. This process was repeated for a videotaped interview of a person with diabetes. Students' responses to both interviews were compared.


RESULTS
Analysis of qualitative comments indicated that students had difficulty identifying treatment adherence issues for high and low stigmatized diseases. Regarding the students' abilities to identify psychosocial factors and dilemmas for people with HIV, multiple concerns were identified, whereas most students had difficulty identifying psychosocial concerns for the person with diabetes. Most students had difficulty differentiating psychosocial dilemmas from ethical ones.


CONCLUSIONS
Results suggest that premedical students have difficulty identifying and resolving psychosocial and ethical dilemmas for individuals with differently stigmatized diseases. Their ability to understand and resolve treatment adherence issues is limited. Despite the fact that most students knew someone with diabetes, they had more difficulty identifying psychosocial issues associated with diabetes compared to HIV. Findings support the need for education and training in psychosocial/ethical issues related to HIV and diabetes for students to help them better serve patient populations with diseases that bear low and high societal stigma.
Borges
N J
NJ
Department of Community Health, Boonshoft School of Medicine Wright State University, Office of Academic Affairs, Dayton, OH, USA. nicole.borges@wright.edu
Aultman
J M
JM
D000293:Adolescent; D003920:Diabetes Mellitus / Q000523:psychology / Q000628:therapy*; D004516:Education, Premedical; D004992:Ethics, Medical; D005260:Female; D015658:HIV Infections / Q000523:psychology / Q000628:therapy*; D006801:Humans; D008297:Male; D010349:Patient Compliance / Q000523:psychology*; D010817:Physician-Patient Relations / Q000941:ethics; D011287:Prejudice; D011340:Problem Solving; D036301:Qualitative Research; D014481:United States