HIV/AIDS and intersectional stigmas: Examining stigma related behaviours among medical students during service delivery

ABSTRACT

HIV/AIDS stigma remains a major global health issue with detrimental consequences for people with HIV/AIDS (PWHA), especially when manifested by health professionals. Research on HIV/AIDS stigma has documented negative attitudes towards PWHA among health professionals. However, fewer studies have examined how HIV/AIDS stigma is manifested behaviourally during clinical interactions and how it interacts with other stigmas (i.e. drug use, sexism, homophobia). This study aimed to: (1) examine behavioural manifestations of HIV/AIDS stigma among medical students during clinical interactions, and (2) explore HIV/AIDS stigma intersectionality with other stigmas. We implemented an experimental design using Standardised Patient (SP) simulations, observational techniques, and quantitative questionnaires. A total of 237 medical students engaged in SP encounters with three experimental scenarios: (1) PWHA infected via illegal drug use, (2) PWHA infected via unprotected heterosexual relations, (3) PWHA infected via unprotected homosexual relations. They also interacted with a person with common cold (control condition). Results evidenced statistically significant differences between the experimental and control simulation, with higher number of stigma behaviours manifested towards experimental conditions. Results also evidence higher HIV/AIDS stigma towards MSM when compared to the drug user and heterosexual woman SP’s. We discuss the implications of these findings for training of medical students.

KEYWORDS:

• HIV/AIDS
• stigma
• behaviours
• physicians
• intersectionality

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This research was funded by the National Institute of Drug Abuse [grant number 1K02DA035122]. Dr. Rivera-Segarra was supported by the National Institutes on Minority Health and Health Disparities, Research Center for Minority Institutions (G12MD007579), and the American Psychological Association’s Office of Ethnic Minority Affairs. Dr. Marinilda Rivera Díaz was supported by the University of California (UCLA-HASTTP R25 DA035692) and the University of Puerto Rico’s Post-Doctoral Master in Clinical and Translational Research (NIH Award Number: R25MD007607). This article does not represent the opinion of the National Institutes of Health or any of the other entities supporting the individual researchers.