Improving hospital-based quality of care by reducing HIV-related stigma: evaluation results from Vietnam.
Operations Research conducted at four hospitals in Vietnam sought to reduce HIV-related stigma and discrimination among hospital workers. The quasi-experimental study compared effects of focusing on 'fear-based' stigma (stemming from lack of knowledge) versus both fear-based and social stigma (stemming from moral judgments). Interventions included staff training (ranging from physicians to ward cleaners), hospital policy development, and supplies provision. At baseline (n = 795), reported stigma was substantial (e.g., about half of hospital workers indicated fear of casually touching PLHIV, and felt HIV was a punishment for bad behavior). By endline, stigma measures had improved significantly for both intervention groups (e.g., proportion reporting signs on beds indicating HIV status decreased from 51 to 24 % in Arm 1, and 31 to 7 % in Arm 2), with the combined intervention group showing greater effects. This study highlights successful strategies to reduce stigma, and thus, improve quality of care for PLHIV.
Population Council, 4301 Connecticut Ave, NW, Suite 280, Washington, DC, 20008, USA, jpulerwitz@popcouncil.org.
Julie
J
Pulerwitz
Khuat Thi Hai
KT
Oanh
Dayo
D
Akinwolemiwa
Kim
K
Ashburn
Laura
L
Nyblade
D000328:Adult; D001291:Attitude of Health Personnel; D005239:Fear; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000193:education / Q000523:psychology; D006761:Hospitals / Q000592:standards; D006801:Humans; D008297:Male; D008875:Middle Aged; D009874:Operations Research; D058996:Quality Improvement; D057545:Social Stigma; D014744:Vietnam