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AIDS Care. 2017 Apr;29(4):524-531. doi: 10.1080/09540121.2016.1224314. Epub 2016 Aug 31.

The role of people living with HIV as patient instructors - reducing stigma and improving interest around HIV care among medical students.

Author information

1
a Faculty of Medicine , University of Toronto , Toronto , ON , Canada.
2
b Ontario HIV Treatment Network , Toronto , ON , Canada.
3
c Dalla Lana School of Public Health , University of Toronto , Toronto , ON , Canada.
4
d Department of Infectious Diseases , University of Toronto , Toronto , ON , Canada.
5
e Standardized Patient Program , University of Toronto , Toronto , ON , Canada.
6
f Toronto People With AIDS Foundation , Toronto , ON , Canada.
7
g Nine Circles Community Health Centre , Winnipeg , MB , Canada.
8
h Department of Psychology , Ryerson University , Toronto , ON , Canada.
9
i Sunnybrook Health Sciences Centre , Toronto , ON , Canada.
10
j Faculty of Medicine , University of Toronto , Toronto , ON , Canada.
11
k Collaboration for HIV Medical Education , Toronto , ON , Canada.

Abstract

People living with HIV/AIDS (PHAs) are increasingly recognized as experts in HIV and their own health. We developed a simulated clinical encounter (SCE) in which medical students provided HIV pre- and post-test counselling and point-of-care HIV testing for PHAs as patient instructors (PHA-PIs) under clinical preceptor supervision. The study assessed the acceptability of this teaching tool with a focus on assessing impact on HIV-related stigma among medical students. University of Toronto pre-clerkship medical students participated in a series of SCEs facilitated by 16 PHA-PIs and 22 clinical preceptors. Pre- and post-SCE students completed the validated Health Care Provider HIV/AIDS Stigma Scale (HPASS). HPASS measures overall stigma, as well as three domains within HIV stigma: stereotyping, discrimination, and prejudice. Higher scores represented higher levels of stigma. An additional questionnaire measured comfort in providing HIV-related care. Mean scores and results of paired t-tests are presented. Post-SCE, students (n   =   62) demonstrated decreased overall stigma (68.74 vs. 61.81, p   <   .001) as well as decreased stigma within each domain. Post-SCE, students (n   =   67) reported increased comfort in providing HIV-related care (10.24 vs. 18.06, p   <   .001). Involving PHA-PIs reduced HIV-related stigma among medical students and increased comfort in providing HIV-related care.

KEYWORDS:

HIV/AIDS; Medical education; community-based research; stigma; testing and counselling

PMID:
27577683
DOI:
10.1080/09540121.2016.1224314
[Indexed for MEDLINE]
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