title: Ethical beliefs related to HIV and AIDS among nursing students in South Africa and the United States: a cross-sectional analysis.
abstract: BACKGROUND
  The ethical issues associated with HIV and AIDS are challenging and complex because of beliefs about HIV and AIDS, stigma surrounding the epidemic, lack of knowledge, and fear. Both South Africa and the United States have a nursing code of ethics which endorses a nurse's responsibility to maintain a patient's right to confidentiality, involvement in decision-making, autonomy, and informed consent. However, nursing students may inappropriately handle ethical challenges in practice related to HIV and AIDS.
  
  
  OBJECTIVE
  The objective of this study was to determine the ethical beliefs held by nursing students regarding testing, confidentiality, serostatus disclosure, and the environment of care related to HIV and AIDS in South Africa and the United States.
  
  
  METHODS
  This study utilized a descriptive, correlational design with a cross-sectional time dimension. Data were collected during March-April 2007 in South Africa and the United States.
  
  
  METHODS
  136 nursing students in South Africa and 198 nursing students in the United States participated in the study. The participants included nursing students in enrolled and professional bridging programs in South Africa and from traditional and accelerated baccalaureate entry programs in the United States. In both countries, the participants were mostly female and heterosexual. In South Africa, participants were mostly black (93.3%) while in the United States the participants were mostly white (76.6%). Over 95% of eligible nursing students participated in the study in both countries.
  
  
  RESULTS
  After evaluating the findings in the context of ethical standards, 0% of the 198 nursing students in the US had beliefs that were fully supportive of the nursing standards of ethical practice regarding caring for HIV-positive persons, while only 11.5% of the South African participants were fully supportive. Despite their identified lack of training in HIV and AIDS nursing, nursing students in South Africa were much more willing to protect patient confidentiality than nursing students in the United States.
  
  
  CONCLUSIONS
  Nursing students' beliefs and attitudes related to HIV and AIDS are not congruent with the ethical principles guiding nursing. To facilitate support for the ethical principles of nursing in the context of HIV and AIDS, nursing students need guided experiences to assess personal attitudes and beliefs about HIV and AIDS and direct care opportunities to destigmatize the epidemic in order to meet the ethical standards of nursing practice.
authors.affiliation: Duke University, School of Nursing, 307 Trent Drive, DUMC 3322, Durham, NC 27710, USA. michael.relf@duke.edu
authors.forename: Michael V
authors.initials: MV
authors.lastname: Relf
authors.forename: Katherine
authors.initials: K
authors.lastname: Laverriere
authors.forename: Caitlin
authors.initials: C
authors.lastname: Devlin
authors.forename: Theresa
authors.initials: T
authors.lastname: Salerno
mesh_terms: D003430:Cross-Sectional Studies; D004993:Ethics, Nursing; D015658:HIV Infections / Q000451:nursing*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D013019:South Africa; D013338:Students, Nursing / Q000523:psychology*; D014481:United States