A total facility approach to reducing HIV stigma in health facilities: implementation process and lessons learned.
AIDS
; 34 Suppl 1: S93-S102, 2020 09 01.
Article
in En
| MEDLINE
| ID: mdl-32881798
ABSTRACT
OBJECTIVES:
To describe development and implementation of a three-stage 'total facility' approach to reducing health facility HIV stigma in Ghana and Tanzania, to facilitate replication.DESIGN:
HIV stigma in healthcare settings hinders the HIV response and can occur during any interaction between client and staff, between staff, and within institutional processes and structures. Therefore, the design focuses on multiple socioecological levels within a health facility and targets all levels of staff (clinical and nonclinical).METHODS:
The approach is grounded in social cognitive theory principles and interpersonal or intergroup contact theory that works to combat stigma by creating space for interpersonal interactions, fostering empathy, and building efficacy for stigma reduction through awareness, skills, and knowledge building as well as through joint action planning for changes needed in the facility environment. The approach targets actionable drivers of stigma among health facility staff fear of HIV transmission, awareness of stigma, attitudes, and health facility environment.RESULTS:
The results are the three-stage process of formative research, capacity building, and integration into facility structures and processes. Key implementation lessons learned included the importance of formative data to catalyze action and shape intervention activities, using participatory training methodologies, involving facility management throughout, having staff, and clients living with HIV facilitate trainings, involving a substantial proportion of staff, mixing staff cadres and departments in training groups, and integrating stigma-reduction into existing structures and processes.CONCLUSION:
Addressing stigma in health facilities is critical and this approach offers a feasible, well accepted method of doing so.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Attitude of Health Personnel
/
HIV Infections
/
Health Personnel
/
Social Stigma
Type of study:
Qualitative_research
Aspects:
Implementation_research
Limits:
Humans
Country/Region as subject:
Africa
Language:
En
Journal:
AIDS
Journal subject:
SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS)
Year:
2020
Document type:
Article
Publication country:
ENGLAND
/
ESCOCIA
/
GB
/
GREAT BRITAIN
/
INGLATERRA
/
REINO UNIDO
/
SCOTLAND
/
UK
/
UNITED KINGDOM