Knowledge, empathy, and willingness to counsel patients with HIV among Indonesian pharmacists: a national survey of stigma

Figures & data

Table 1. Sociodemographic characteristics of the final-year pharmacy students and pharmacists participating in the survey.

Independent variables		Total (N = 1263)	Final-year pharmacy students (N = 1013)	Pharmacists (N = 250)
Age, mean (SD)		24.68 (5.3)	22.94 (1.83)	34.75 (7.69)
Age, N (%)	18–27 years	1022 (80%)	991	31
	28–37 years	112 (8%)	18	94
	≥38 years	129 (12%)	4	125
Sex, N (%)	Male	255 (20%)	207	48
	Female	1008 (80%)	806	202
Religious affiliation, N (%)	Without religious affiliation	522 (41%)	297	225
	Religious affiliation	741 (59%)	716	25
Type of HIV information source, N (%)	Education	951 (75%)	860	91
	Trained by the government	144 (11%)	0	144
	Online	118 (10%)	116	2
	Never	50 (4%)	37	13
Frequency meeting with HIV patient, N (%)	Never	788 (62%)	781	7
	1 or 2 times	353 (28%)	225	128
	Often	122 (10%)	7	115
Preference of counseling, N (%)	Face-to-face	608 (48%)	438	170
	Online counseling	655 (52%)	575	80
Degree of willingness to give counseling, mean (SD)		58.30 (24.19)	55.09 (23.78)	70.46 (21.78)
Total empathy, mean (SD)		73.12 (5.31)	72.06 (5.39)	77.40 (1.35)
Total HIV treatment knowledge, mean (SD)		14.39 (2.05)	14.14 (2.01)	15.39 (1.87)
Total stigma, mean (SD)		20.95 (4.61)	21.02 (4.65)	20.66 (4.41)

Note: N = number; SD: standard deviation.

Table 2. Results of the HIV treatment knowledge questionnaire presented as percentage of incorrect answers for final-year pharmacy students and pharmacists.

No	Questions	Final-year pharmacy students (%)	Pharmacists (%)	p Value
1	Once the HIV viral load results are “undetectable”, HIV medications should be stopped	37.7	13.6	.000*
2	If HIV medications are not taken at the right time of day, HIV drug resistance can occur	17.7	13.2	.033*
3	HIV is cured when the HIV viral load blood test result is “undetectable”	35.3	10.4	.000*
4	Condoms during sex are not needed when the HIV+ blood test results are at “undetectable” levels	16.1	18.4	.200
5	It is better to take a half dose of HIV medications than stopping the HIV combination medications completely	45.4	28.4	.000*
6	One can get infected with a drug-resistant type of HIV	32.9	40.0	.000*
7	HIV medications can cause unpleasant side effects (e.g., nausea, diarrhea, vomiting)	3.3	0.8	.017*
8	If sexual partners are both HIV-positive condoms are no longer needed	19.0	21.2	.421
9	Treatments are available to reduce HIV medication side effects	6.7	11.2	.034*
10	Recreational drugs (e.g., ecstasy) can affect the effectiveness of HIV medications	10.9	12.0	.607
11	Providing HIV medications to a pregnant woman reduces the baby’s risk of being infected with HIV	24.4	8.4	.000*
12	There currently exists an HIV vaccine that prevents HIV infection	44.2	11.2	.000*
13	HIV medications can be taken at a different time of day on weekends or holiday	16.8	17.6	.757
14	Over-the-counter herbal pills could make HIV medications less effective	53.3	54.0	.844
15	It is best to stop HIV medications as soon as you feel better	2.8	0.4	.025*
16	Missing a few doses of HIV pills can increase the amount of HIV virus in the body	16.6	10.4	.015*
17	After a few months, it becomes less important to take HIV medications at the right time of day	4.8	0.4	.001*
18	HIV medications help the body’s immune system get stronger (CD4 increase)	11.1	4.8	.003*
19	When HIV medications work well, the HIV viral load increases	38.6	36.0	.449
20	Taking antibiotic medication protects a person from getting infected with HIV	18.5	11.2	.006*
21	Physical exercise (e.g., yoga, tai chi) can help reduce stress levels in HIV patients	2.2	4.0	.099

Table 3. Results of the empathy questionnaire, reported as number of respondents reporting perceived positive and neutral responses for final-year pharmacy students and pharmacists.

No	Item of Empathy Scale	Students (N)		Pharmacists (N)		p Value
		Perceived positive	Neutral	Perceived positive	Neutral
1	It is necessary for a healthcare practitioner to be able to comprehend someone else’s experiences	992	20	250	0	.000*
2	I am able to express my understanding of someone’s feelings	820	181	250	0	.000*
3	I am able to comprehend someone else’s experiences	971	39	250	0	.000*
4	I will not allow myself to be influenced by someone’s feelings when determining the best treatment	971	39	250	0	.000*
5	It is necessary for a healthcare practitioner to be able to express an understanding of someone’s feelings	996	17	250	0	.000*
6	It is necessary for a healthcare practitioner to be able to value someone else’s point of view	976	33	250	0	.000*
7	I believe that caring is essential to building a strong relationship with patients	218	212	250	0	.000*
8	I am able to view the world from another person’s perspective	838	163	250	0	.000*
9	Considering someone’s feelings is not necessary to provide patient-centered care	674	253	250	0	.000*
10	I am able to value someone else’s point of view	895	112	250	0	.000*
11	I have difficulty identifying with someone else’s feelings	150	340	250	0	.000*
12	To build a strong relationship with patients, it is essential for a healthcare practitioner to be caring	994	18	250	0	.000*
13	It is necessary for a healthcare practitioner to be able to identify with someone else’s feelings	965	45	250	0	.000*
14	It is necessary for a healthcare practitioner to be able to view the world from another person’s perspective	898	104	250	0	.000*
15	A healthcare practitioner should not be influenced by someone’s feelings when determining the best treatment	791	244	250	0	.000*

Note: Perceived positive reports the number of respondents who ticked very strongly or agree.

Table 4. Results of the HIV stigma questionnaire reported as percentage of respondents giving a negative response for the final-year pharmacy students and pharmacists.

No	Questions	Final-year pharmacy students %	Pharmacists %	p Value
1	People who have HIV/AIDS are cursed	1.8	2.0	.038*
2	It is safe for people who have HIV/AIDS to work with children (R)	30.7	14.0	.000*
3	People who have HIV/AIDS should be ashamed	7.4	7.2	.070
4	People who have HIV/AIDS have nothing to feel guilty about	26.1	24.8	.803
5	People who have HIV/AIDS should be isolated	1.2	0.4	.016*
6	I do not want to be friends with someone who has HIV/AIDS	4.8	1.2	.040*
7	People who have HIV/AIDS should not be allowed to work	10.1	0	.000*
8	A person with HIV/AIDS must have done something wrong and deserves to be punished	3.3	3.2	.442
9	People who have HIV/AIDS cannot be trusted	1.4	1.6	.404
10	People with HIV/AIDS must expect some restrictions on their freedom	22.4	11.2	.001*
11	Most people become HIV-positive by being weak or foolish	12.0	13.6	.517
12	People who have HIV/AIDS are dirty	3.4	0.8	.045*

Note: Negative response is the total percentage of strongly disagree to disagree.

Table 5. Results of the univariate and multivariate linear regression analysis on factors associated with HIV-stigma score.

Independent variables	Univariate			Multivariate
	β	Lower	Upper	β	Lower	Upper	p Value
Age (28–37 years, ≥38 years)	−l.021	−l0.547	0.247	−	−	−	−
Participant status	−l.030	−l0.992	0.286	0.133	0.510	2.497***	.003
Sex	0.019	−l0.421	0.848	−l0.003	−l0.651	0.591	.924
Religious affiliation	0.035	−l0.186	0.848	−l0.006	−l0.663	0.558	.866
Type of media to receive HIV information	−l.039	−l0.531	0.092	−l0.026	−l0.470	0.175	.369
Frequency meeting with HIV patient	−l.047	−l0.709	0.056	−l0.026	−l0.709	0.353	.511
Degree of willingness to give counseling	−l.277	−l0.063)	−l0.042	−l0.265	−l0.061	−l0.039***	.000
Total empathy	−l.159	−l0.186	−l0.091	−l0.139	−l0.171	−l0.068***	.000
Total HIV treatment knowledge	−l.099	−l0.345	−l0.098	−l0.087	−l0.322	−l0.068***	.003
Overall model				R^2 = 0.098 F = 17.157

***Significant.

Data availability statement

The data that support the finding of this study are available from the corresponding author, upon reasonable request.