Manifestation of HIV Stigma among Service Providers

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Despite the fact that HIV-related stigma has been identified as a major impediment to HIV prevention, care and quality of life among people at risk for or living with HIV/AIDS, stigma, as a complex phenomenon, is poorly understood. This also means a less than optimum understanding of how it manifests among service providers, a group that greatly impacts the health and well-being of these individuals. This exploratory, qualitative study used an Ecological Framework as its theoretical foundation and a phenomenological research design to explore manifestation of stigma. In-depth data was collected from twenty-one service providers, including clinicians, nurses, and frontline staff that work directly with this population to understand how social and individual stigma at the provider level act as deterrent to accessing HIV-related services by this group. Study participants were recruited using convenience and snow-ball sampling methods and the data was analyzed using a grounded theory process. Major themes identified included fear of contagion, provider demeanor, labeling, inequitable and untimely care, and stigmatizing behaviors. Participant recommendations were: implicit bias training for service providers; biopsychosocial aspects of HIV training for service providers; service providers’ engagement in policy committees at various system levels to advocate for change; and establishing policies around anti-discrimination, nomenclature, and the way we define groups. This study aims to guide future large-scale, explanatory, quantitative studies.