The Influence of Transmission-Based and Moral-Based HIV Stigma Beliefs on Intentions to Discriminate Among Ward Staff in South Indian Health Care Settings
HIV stigma is comprised of several beliefs, including transmission fears and moral judgments against affected communities. We examined the relationships among HIV-related stigma beliefs, endorsement of coercive measures for people living with HIV (PLWH), and intentions to discriminate. We sought to...
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| Veröffentlicht in: | AIDS and behavior 2023, Vol.27 (1), p.189-197 |
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| creator | Steward, Wayne T. Srinivasan, Krishnamachari Raj, Tony Heylen, Elsa Nyblade, Laura Mazur, Amanda Devadass, Dhinagaran Pereira, Matilda Ekstrand, Maria L. |
| description | HIV stigma is comprised of several beliefs, including transmission fears and moral judgments against affected communities. We examined the relationships among HIV-related stigma beliefs, endorsement of coercive measures for people living with HIV (PLWH), and intentions to discriminate. We sought to understand to what degree the different stigma beliefs shape support for restrictive policies and discriminatory intentions. Data were drawn from the baseline assessment of DriSti, a cluster randomized controlled trial of an HIV stigma reduction intervention in Indian healthcare settings (NCT02101697). Participants completed measures assessing transmission fears and moral judgments of HIV, endorsement of coercive measures against PLWH (public disclosure of HIV status, refusal of healthcare services, marriage and family restrictions, required testing, and sharing of HIV information in a clinic), and intentions to discriminate against PLWH in professional and personal settings. We utilized multivariate regression modeling with backward elimination to identify the coercive measures and behavioral intentions most strongly associated with moral judgments. 1540 ward staff members completed the assessment. Participants had relatively high perceptions of transmission fears (
M
= 1.92,
SD
= 0.79) and moral judgments (
M
= 1.69,
SD
= 0.83); endorsed more intentions to discriminate in professional (
M
= 6.54,
SD
= 2.28) than personal settings (
M
= 2.07,
SD
= 1.49), and endorsed approximately half of all coercive measures (
M
= 9.47,
SD
= 2.68). After controlling for transmission fears, perceptions of stronger moral judgments against PLWH were significantly associated with higher endorsement of coercive measures related to refusing services (
β
= 0.10,
t
= 4.14,
p
|
| doi_str_mv | 10.1007/s10461-022-03755-w |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2684097483</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2684097483</sourcerecordid><originalsourceid>FETCH-LOGICAL-c419t-f613c85828f9995275f9478be62b03ff078c4ce6137510abfc1c03910f598f0c3</originalsourceid><addsrcrecordid>eNp9kc1uEzEUhUcIRH_gBVggS2zYDPXPeGwv25Q2kYpYJMDScjzXqasZu9geVbwKT1tDApVYsLKv_J1zfe9pmjcEfyAYi7NMcNeTFlPaYiY4bx-eNceEC9Yyyrvn9Y4VbgXp-VFzkvMdxlj1Qr1sjhgXoqecHjc_N7eAVsGNMwQLKDq0SSbkyefsY2gvTIYBmTCgTzGZ8VAvV1_RuvjdZNAFjB5cRjFUlwKhVFVGJaJLn23ykw-mADqfYtihbyYNVWecQz6gdZzLbRUN3gS0BDPWamESoDWU4sMuv2peODNmeH04T5svVx83i2V78_l6tTi_aW1HVGldT5iVXFLplFKcCu5UJ-QWerrFzDkspO0sVEpwgs3WWWIxUwQ7rqTDlp027_e-9yl-nyEXXae3MI4mQJyzpr3ssBKdZBV99w96F-cU6u80FX0vpaScV4ruKZtizgmcvq-bMOmHJlj_Sk7vk9M1Of07Of1QRW8P1vN2guGv5E9UFWB7INensIP01Ps_to96RqPU</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2766888255</pqid></control><display><type>article</type><title>The Influence of Transmission-Based and Moral-Based HIV Stigma Beliefs on Intentions to Discriminate Among Ward Staff in South Indian Health Care Settings</title><source>MEDLINE</source><source>SpringerLink Journals</source><source>Sociological Abstracts</source><creator>Steward, Wayne T. ; Srinivasan, Krishnamachari ; Raj, Tony ; Heylen, Elsa ; Nyblade, Laura ; Mazur, Amanda ; Devadass, Dhinagaran ; Pereira, Matilda ; Ekstrand, Maria L.</creator><creatorcontrib>Steward, Wayne T. ; Srinivasan, Krishnamachari ; Raj, Tony ; Heylen, Elsa ; Nyblade, Laura ; Mazur, Amanda ; Devadass, Dhinagaran ; Pereira, Matilda ; Ekstrand, Maria L.</creatorcontrib><description>HIV stigma is comprised of several beliefs, including transmission fears and moral judgments against affected communities. We examined the relationships among HIV-related stigma beliefs, endorsement of coercive measures for people living with HIV (PLWH), and intentions to discriminate. We sought to understand to what degree the different stigma beliefs shape support for restrictive policies and discriminatory intentions. Data were drawn from the baseline assessment of DriSti, a cluster randomized controlled trial of an HIV stigma reduction intervention in Indian healthcare settings (NCT02101697). Participants completed measures assessing transmission fears and moral judgments of HIV, endorsement of coercive measures against PLWH (public disclosure of HIV status, refusal of healthcare services, marriage and family restrictions, required testing, and sharing of HIV information in a clinic), and intentions to discriminate against PLWH in professional and personal settings. We utilized multivariate regression modeling with backward elimination to identify the coercive measures and behavioral intentions most strongly associated with moral judgments. 1540 ward staff members completed the assessment. Participants had relatively high perceptions of transmission fears (
M
= 1.92,
SD
= 0.79) and moral judgments (
M
= 1.69,
SD
= 0.83); endorsed more intentions to discriminate in professional (
M
= 6.54,
SD
= 2.28) than personal settings (
M
= 2.07,
SD
= 1.49), and endorsed approximately half of all coercive measures (
M
= 9.47,
SD
= 2.68). After controlling for transmission fears, perceptions of stronger moral judgments against PLWH were significantly associated with higher endorsement of coercive measures related to refusing services (
β
= 0.10,
t
= 4.14,
p
< 0.001) and sharing patients’ HIV status in clinics (
β
= 0.07,
t
= 3.04,
p
= 0.002), as well as with stronger behavioral intentions to discriminate in professional settings (
β
= 0.05,
t
= 2.20,
p
= 0.022). HIV stigma interventions for hospital-based ward staff in India need to focus on both transmission fears and moral judgments that underlie prejudicial beliefs. While the moral judgments are not technically related to risk in a hospital setting, our findings suggest that personnel will continue to discriminate in their professional work so long as these beliefs bear on their decisions and actions.</description><identifier>ISSN: 1090-7165</identifier><identifier>EISSN: 1573-3254</identifier><identifier>DOI: 10.1007/s10461-022-03755-w</identifier><identifier>PMID: 35776252</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Attitude of Health Personnel ; Discrimination ; Disease transmission ; Fear & phobias ; Health behavior ; Health care ; Health Psychology ; Health services ; HIV ; HIV Infections ; Hospitals ; Human immunodeficiency virus ; Humans ; Infectious Diseases ; Information dissemination ; Inpatient care ; Intention ; Judgments ; Medical personnel ; Medicine ; Medicine & Public Health ; Moral judgment ; Morality ; Morals ; Original Paper ; Public Health ; Social Stigma ; Stigma</subject><ispartof>AIDS and behavior, 2023, Vol.27 (1), p.189-197</ispartof><rights>The Author(s) 2022</rights><rights>2022. The Author(s).</rights><rights>The Author(s) 2022. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c419t-f613c85828f9995275f9478be62b03ff078c4ce6137510abfc1c03910f598f0c3</citedby><cites>FETCH-LOGICAL-c419t-f613c85828f9995275f9478be62b03ff078c4ce6137510abfc1c03910f598f0c3</cites><orcidid>0000-0001-7587-2899</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10461-022-03755-w$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10461-022-03755-w$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,27321,27901,27902,33751,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35776252$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Steward, Wayne T.</creatorcontrib><creatorcontrib>Srinivasan, Krishnamachari</creatorcontrib><creatorcontrib>Raj, Tony</creatorcontrib><creatorcontrib>Heylen, Elsa</creatorcontrib><creatorcontrib>Nyblade, Laura</creatorcontrib><creatorcontrib>Mazur, Amanda</creatorcontrib><creatorcontrib>Devadass, Dhinagaran</creatorcontrib><creatorcontrib>Pereira, Matilda</creatorcontrib><creatorcontrib>Ekstrand, Maria L.</creatorcontrib><title>The Influence of Transmission-Based and Moral-Based HIV Stigma Beliefs on Intentions to Discriminate Among Ward Staff in South Indian Health Care Settings</title><title>AIDS and behavior</title><addtitle>AIDS Behav</addtitle><addtitle>AIDS Behav</addtitle><description>HIV stigma is comprised of several beliefs, including transmission fears and moral judgments against affected communities. We examined the relationships among HIV-related stigma beliefs, endorsement of coercive measures for people living with HIV (PLWH), and intentions to discriminate. We sought to understand to what degree the different stigma beliefs shape support for restrictive policies and discriminatory intentions. Data were drawn from the baseline assessment of DriSti, a cluster randomized controlled trial of an HIV stigma reduction intervention in Indian healthcare settings (NCT02101697). Participants completed measures assessing transmission fears and moral judgments of HIV, endorsement of coercive measures against PLWH (public disclosure of HIV status, refusal of healthcare services, marriage and family restrictions, required testing, and sharing of HIV information in a clinic), and intentions to discriminate against PLWH in professional and personal settings. We utilized multivariate regression modeling with backward elimination to identify the coercive measures and behavioral intentions most strongly associated with moral judgments. 1540 ward staff members completed the assessment. Participants had relatively high perceptions of transmission fears (
M
= 1.92,
SD
= 0.79) and moral judgments (
M
= 1.69,
SD
= 0.83); endorsed more intentions to discriminate in professional (
M
= 6.54,
SD
= 2.28) than personal settings (
M
= 2.07,
SD
= 1.49), and endorsed approximately half of all coercive measures (
M
= 9.47,
SD
= 2.68). After controlling for transmission fears, perceptions of stronger moral judgments against PLWH were significantly associated with higher endorsement of coercive measures related to refusing services (
β
= 0.10,
t
= 4.14,
p
< 0.001) and sharing patients’ HIV status in clinics (
β
= 0.07,
t
= 3.04,
p
= 0.002), as well as with stronger behavioral intentions to discriminate in professional settings (
β
= 0.05,
t
= 2.20,
p
= 0.022). HIV stigma interventions for hospital-based ward staff in India need to focus on both transmission fears and moral judgments that underlie prejudicial beliefs. While the moral judgments are not technically related to risk in a hospital setting, our findings suggest that personnel will continue to discriminate in their professional work so long as these beliefs bear on their decisions and actions.</description><subject>Attitude of Health Personnel</subject><subject>Discrimination</subject><subject>Disease transmission</subject><subject>Fear & phobias</subject><subject>Health behavior</subject><subject>Health care</subject><subject>Health Psychology</subject><subject>Health services</subject><subject>HIV</subject><subject>HIV Infections</subject><subject>Hospitals</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Infectious Diseases</subject><subject>Information dissemination</subject><subject>Inpatient care</subject><subject>Intention</subject><subject>Judgments</subject><subject>Medical personnel</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Moral judgment</subject><subject>Morality</subject><subject>Morals</subject><subject>Original Paper</subject><subject>Public Health</subject><subject>Social 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Influence of Transmission-Based and Moral-Based HIV Stigma Beliefs on Intentions to Discriminate Among Ward Staff in South Indian Health Care Settings</title><author>Steward, Wayne T. ; Srinivasan, Krishnamachari ; Raj, Tony ; Heylen, Elsa ; Nyblade, Laura ; Mazur, Amanda ; Devadass, Dhinagaran ; Pereira, Matilda ; Ekstrand, Maria L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c419t-f613c85828f9995275f9478be62b03ff078c4ce6137510abfc1c03910f598f0c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Attitude of Health Personnel</topic><topic>Discrimination</topic><topic>Disease transmission</topic><topic>Fear & phobias</topic><topic>Health behavior</topic><topic>Health care</topic><topic>Health Psychology</topic><topic>Health services</topic><topic>HIV</topic><topic>HIV Infections</topic><topic>Hospitals</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Infectious Diseases</topic><topic>Information dissemination</topic><topic>Inpatient care</topic><topic>Intention</topic><topic>Judgments</topic><topic>Medical personnel</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Moral judgment</topic><topic>Morality</topic><topic>Morals</topic><topic>Original Paper</topic><topic>Public Health</topic><topic>Social Stigma</topic><topic>Stigma</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Steward, Wayne T.</creatorcontrib><creatorcontrib>Srinivasan, Krishnamachari</creatorcontrib><creatorcontrib>Raj, Tony</creatorcontrib><creatorcontrib>Heylen, Elsa</creatorcontrib><creatorcontrib>Nyblade, Laura</creatorcontrib><creatorcontrib>Mazur, Amanda</creatorcontrib><creatorcontrib>Devadass, Dhinagaran</creatorcontrib><creatorcontrib>Pereira, Matilda</creatorcontrib><creatorcontrib>Ekstrand, Maria L.</creatorcontrib><collection>Springer Nature 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Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>AIDS and behavior</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Steward, Wayne T.</au><au>Srinivasan, Krishnamachari</au><au>Raj, Tony</au><au>Heylen, Elsa</au><au>Nyblade, Laura</au><au>Mazur, Amanda</au><au>Devadass, Dhinagaran</au><au>Pereira, Matilda</au><au>Ekstrand, Maria L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Influence of Transmission-Based and Moral-Based HIV Stigma Beliefs on Intentions to Discriminate Among Ward Staff in South Indian Health Care Settings</atitle><jtitle>AIDS and behavior</jtitle><stitle>AIDS Behav</stitle><addtitle>AIDS Behav</addtitle><date>2023</date><risdate>2023</risdate><volume>27</volume><issue>1</issue><spage>189</spage><epage>197</epage><pages>189-197</pages><issn>1090-7165</issn><eissn>1573-3254</eissn><abstract>HIV stigma is comprised of several beliefs, including transmission fears and moral judgments against affected communities. We examined the relationships among HIV-related stigma beliefs, endorsement of coercive measures for people living with HIV (PLWH), and intentions to discriminate. We sought to understand to what degree the different stigma beliefs shape support for restrictive policies and discriminatory intentions. Data were drawn from the baseline assessment of DriSti, a cluster randomized controlled trial of an HIV stigma reduction intervention in Indian healthcare settings (NCT02101697). Participants completed measures assessing transmission fears and moral judgments of HIV, endorsement of coercive measures against PLWH (public disclosure of HIV status, refusal of healthcare services, marriage and family restrictions, required testing, and sharing of HIV information in a clinic), and intentions to discriminate against PLWH in professional and personal settings. We utilized multivariate regression modeling with backward elimination to identify the coercive measures and behavioral intentions most strongly associated with moral judgments. 1540 ward staff members completed the assessment. Participants had relatively high perceptions of transmission fears (
M
= 1.92,
SD
= 0.79) and moral judgments (
M
= 1.69,
SD
= 0.83); endorsed more intentions to discriminate in professional (
M
= 6.54,
SD
= 2.28) than personal settings (
M
= 2.07,
SD
= 1.49), and endorsed approximately half of all coercive measures (
M
= 9.47,
SD
= 2.68). After controlling for transmission fears, perceptions of stronger moral judgments against PLWH were significantly associated with higher endorsement of coercive measures related to refusing services (
β
= 0.10,
t
= 4.14,
p
< 0.001) and sharing patients’ HIV status in clinics (
β
= 0.07,
t
= 3.04,
p
= 0.002), as well as with stronger behavioral intentions to discriminate in professional settings (
β
= 0.05,
t
= 2.20,
p
= 0.022). HIV stigma interventions for hospital-based ward staff in India need to focus on both transmission fears and moral judgments that underlie prejudicial beliefs. While the moral judgments are not technically related to risk in a hospital setting, our findings suggest that personnel will continue to discriminate in their professional work so long as these beliefs bear on their decisions and actions.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>35776252</pmid><doi>10.1007/s10461-022-03755-w</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-7587-2899</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
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| ispartof | AIDS and behavior, 2023, Vol.27 (1), p.189-197 |
| issn | 1090-7165 1573-3254 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2684097483 |
| source | MEDLINE; SpringerLink Journals; Sociological Abstracts |
| subjects | Attitude of Health Personnel Discrimination Disease transmission Fear & phobias Health behavior Health care Health Psychology Health services HIV HIV Infections Hospitals Human immunodeficiency virus Humans Infectious Diseases Information dissemination Inpatient care Intention Judgments Medical personnel Medicine Medicine & Public Health Moral judgment Morality Morals Original Paper Public Health Social Stigma Stigma |
| title | The Influence of Transmission-Based and Moral-Based HIV Stigma Beliefs on Intentions to Discriminate Among Ward Staff in South Indian Health Care Settings |
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