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.

KEYWORDS:

• Egypt
• HIV stigma
• healthcare setting
• low-HIV prevalence setting
• stigma intervention

Acknowledgements

The authors would like to thank the team of the National AIDS program in Egypt for overall support for the project. The authors would also like to thank the patient relations' office at Oum El Masreyn General Hospital and a team at Al Mounira General Hospital for coordinating and managing data collection in the hospitals; Dr Shadia Abdelrahim, contractor at the US Naval Medical Research Unit No.3 and a team of social workers for conducting the interviews. In addition, the authors would like to show appreciation to Dr Kaiser Reinhardt from the US Naval Medical Research Unit and Dr Joan Kraft from the Centers for Disease Control and Prevention (CDC) for their valuable input on the methodology and analysis of the data and Anna-Leena Orsama from the Technical Research Centre of Finland for reviewing an earlier draft of this manuscript.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

The study was supported by the Ford Foundation [grant number 1110-0351].