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Glob Public Health. 2019 Nov;14(11):1598-1611. doi: 10.1080/17441692.2019.1633378. Epub 2019 Jul 11.

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

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Department of Global and Sociocultural Studies, Florida International University , Miami , USA.
School of Behavioral and Brain Sciences, Ponce Health Sciences University , Ponce , Puerto Rico.
Center for AIDS Prevention Studies, University of California , San Francisco , USA.
Department of Medicine, University of Puerto Rico , San Juan , Puerto Rico.
Department of Social Sciences, University of Puerto Rico , San Juan , Puerto Rico.


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.


HIV/AIDS; behaviours; intersectionality; physicians; stigma

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