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Reducing HIV-related stigma in health care settings: a randomized controlled trial in China
Li Li1, Zunyou Wu, Li-Jung Liang
1Semel Institute for Neuroscience and Human Behavior, Center for Community Health, University of California at Los Angeles, CA 90024, USA. lililili@ucla.edu
Objectives:
The objective of the intervention was to reduce service providers' stigmatizing attitudes and behaviors toward people living with HIV.
Methods:
The randomized controlled trial was conducted in 40 county-level hospitals in 2 provinces of China between October 2008 and February 2010. Forty-four service providers were randomly selected from each hospital, yielding a total of 1760 study participants. We randomized the hospitals to either an intervention condition or a control condition. In the intervention hospitals, about 15% of the popular opinion leaders were identified and trained to disseminate stigma reduction messages.
Results:
We observed significant improvements for the intervention group in reducing prejudicial attitudes (P < .001), reducing avoidance intent towards people living with HIV (P < .001), and increasing institutional support in the hospitals (P = .003) at 6 months after controlling for service providers' background factors and clinic-level characteristics. The intervention effects were sustained and strengthened at 12 months.
Conclusions:
The intervention reduced stigmatizing attitudes and behaviors among service providers. It has the potential to be integrated into the health care systems in China and other countries.
