title: HIV stigma intervention in a low-HIV prevalence setting: a pilot study in an Egyptian healthcare facility.
abstract: This pilot study is the first to evaluate stigma-reduction intervention in a healthcare setting in Egypt and in the Middle East and North Africa region. It also contributes to knowledge on how to address stigma in low-HIV prevalence settings. A quasi-experimental study design was used to evaluate the effect of anti-HIV stigma intervention in one hospital in Egypt. A control hospital was selected and matched to the intervention hospital by type, size and location. The intervention focused on HIV-related stigma, infection control and medical ethics. Stigma was measured at baseline and at three months post-intervention. A standardized, 10-point scale was developed to measure stigmatizing attitudes and fear-based stigma among participants. Comparisons of overall and job-stratified stigma scores were made across the intervention and control hospitals, before and after the intervention, using two-sample t-test and multivariate regression analysis. Mean stigma scores did not reveal significant differences between the intervention and control hospitals at baseline. After intervention, the overall value-based and fear-based stigma scores were significantly lower in the intervention hospital compared to the control hospital (2.1 and 1.1 compared to 3.8 and 3.2, respectively; p < .001). Context-specific and culturally appropriate HIV stigma-reduction interventions in low-HIV prevalence settings can reduce fear-based and value-based stigma among physicians and nurses.
authors.affiliation: a Global Disease Detection and Response Program , US Naval Medical Research Unit No 3 , Cairo , Egypt.
authors.forename: Anna-Leena
authors.initials: AL
authors.lastname: Lohiniva
authors.affiliation: a Global Disease Detection and Response Program , US Naval Medical Research Unit No 3 , Cairo , Egypt.
authors.forename: Manal
authors.initials: M
authors.lastname: Benkirane
authors.affiliation: b National AIDS Program , Ministry of Health in Egypt , Cairo , Egypt.
authors.forename: Tarek
authors.initials: T
authors.lastname: Numair
authors.affiliation: c Oum El Masreyn General Hospital , Ministry of Health in Egypt , Giza , Egypt.
authors.forename: Abdelrahman
authors.initials: A
authors.lastname: Mahdy
authors.affiliation: c Oum El Masreyn General Hospital , Ministry of Health in Egypt , Giza , Egypt.
authors.forename: Hanan
authors.initials: H
authors.lastname: Saleh
authors.affiliation: c Oum El Masreyn General Hospital , Ministry of Health in Egypt , Giza , Egypt.
authors.forename: Amin
authors.initials: A
authors.lastname: Zahran
authors.affiliation: a Global Disease Detection and Response Program , US Naval Medical Research Unit No 3 , Cairo , Egypt.
authors.forename: Omar
authors.initials: O
authors.lastname: Okasha
authors.affiliation: a Global Disease Detection and Response Program , US Naval Medical Research Unit No 3 , Cairo , Egypt.
authors.forename: Maha
authors.initials: M
authors.lastname: Talaat
authors.affiliation: b National AIDS Program , Ministry of Health in Egypt , Cairo , Egypt.
authors.forename: Walid
authors.initials: W
authors.lastname: Kamal
mesh_terms: D000328:Adult; D003695:Delivery of Health Care / Q000458:organization & administration; D004534:Egypt / Q000453:epidemiology; D005239:Fear; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D006266:Health Education / Q000379:methods; D006761:Hospitals; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D015995:Prevalence; D016730:Program Development; D015397:Program Evaluation; D057545:Social Stigma; D013240:Stereotyping
keywords: Egypt; HIV stigma; healthcare setting; low-HIV prevalence setting; stigma intervention