Evaluation of a health setting-based stigma intervention in five African countries
AIDS Patient Care and STDs
School of Nursing, University of KwaZulu-Natal, Durban 4000, South Africa; College of Medicine, University of Malawi, Lilongwe, Malawi; College of Health Sciences, Muhimbili University, Dar es Salaam, Tanzania; Department of Nursing, Potchefstroom Campus, North-West University, Potchefstroom, South Africa; Department of Nursing, National University of Lesotho, Maseru, Lesotho; Department of Nursing, University of Swaziland, Mbabane, Swaziland; Department of Psychology, University of KwaZulu-Natal, Durban, South Africa; School of Nursing, University of California, San Francisco, San Francisco, CA, United States
The study aim is to explore the results of an HIV stigma intervention in five African health care settings. A case study approach was used. The intervention consisted of bringing together a team of approximately 10 nurses and 10 people living with HIV or AIDS (PLHA) in each setting and facilitating a process in which they planned and implemented a stigma reduction intervention, involving both information giving and empowerment. Nurses (n = 134) completed a demographic questionnaire, the HIV/AIDS Stigma Instrument-Nurses (HASI-N), a self-efficacy scale, and a self-esteem scale, both before and after the intervention, and the team completed a similar set of instruments before and after the intervention, with the PLHA completing the HIV/AIDS Stigma Instrument for PLHA (HASI-P). The intervention as implemented in all five countries was inclusive, action-oriented, and well received. It led to understanding and mutual support between nurses and PLHA and created some momentum in all the settings for continued activity. PLHA involved in the intervention teams reported less stigma and increased self-esteem. Nurses in the intervention teams and those in the settings reported no reduction in stigma or increases in self- esteem and self-efficacy, but their HIV testing behavior increased significantly. This pilot study indicates that the stigma experience of PLHA can be decreased, but that the stigma experiences of nurses are less easy to change. Further evaluation research with control groups and larger samples and measuring change over longer periods of time is indicated. © 2009 Mary Ann Liebert, Inc.
acquired immune deficiency syndrome; adult; Africa; article; clinical evaluation; controlled study; female; health care; health care quality; human; Human immunodeficiency virus infection; intervention study; major clinical study; male; medical information; nurse; questionnaire; rating scale; self concept; serodiagnosis; Adult; Africa; Female; Health Education; Health Knowledge, Attitudes, Practice; HIV Infections; Humans; Male; Prejudice; Stereotyping