title: Addressing HIV stigma in protected medical settings.
abstract: Previous studies suggest that the implementation of universal precaution (UP) plays a role in reducing HIV stigma. In this study we investigate the efficacy of a stigma reduction intervention on UP compliance and explore whether UP compliance could potentially influence HIV stigma reduction in medical settings. A randomized controlled intervention trial was conducted in two provinces of China with 1760 healthcare service providers recruited from 40 county-level hospitals. Longitudinal analyses included data collection at baseline, 6-, and 12-month follow-up assessments. Using a hierarchical modeling approach, we estimated the intervention effect for each provider's UP compliance and its potential mediating role on HIV stigma with the bootstrapping method. A significant intervention effect on UP compliance was observed at both the 6- and 12-month follow-up assessments. The intervention effect on provider avoidance intent was partially mediated by the provider's own UP compliance at the two follow-up points. This study provides evidence that UP compliance should be part of HIV stigma reduction programs, especially in resource-restrained countries. Findings suggest that a protected work environment may be necessary but not sufficient to address HIV stigma in medical settings.
authors.affiliation: a Center for Community Health , Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles , Los Angeles , CA , USA.
authors.forename: Li
authors.initials: L
authors.lastname: Li
authors.affiliation: a Center for Community Health , Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles , Los Angeles , CA , USA.
authors.forename: Li-Jung
authors.initials: LJ
authors.lastname: Liang
authors.affiliation: a Center for Community Health , Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles , Los Angeles , CA , USA.
authors.forename: Chunqing
authors.initials: C
authors.lastname: Lin
authors.affiliation: b National Center for AIDS/STD Control and Prevention , Chinese Center for Disease Control and Prevention , Beijing , People's Republic of China.
authors.forename: Zunyou
authors.initials: Z
authors.lastname: Wu
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002681:China; D004192:Discrimination, Psychological; D005260:Female; D005500:Follow-Up Studies; D019983:Guideline Adherence / Q000706:statistics & numerical data; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology*; D006282:Health Personnel; D006739:Hospital Administration; D006761:Hospitals; D006801:Humans; D007318:Inservice Training / Q000379:methods*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D017064:Process Assessment, Health Care; D015397:Program Evaluation; D057545:Social Stigma; D011795:Surveys and Questionnaires; D016635:Universal Precautions
keywords: China; HIV; Universal precautions; intervention; stigma