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Evaluating Physicians' Intention to Discriminate Against Patients Living with HIV in Malaysia
Ying Chew Tee1, Valerie A Earnshaw2, Frederick L Altice1,3,4
1Centre of Excellence for Research in AIDS, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Abstract:
People with HIV (PWH) in Malaysia experience high levels of stigma, which may act as a barrier to accessing healthcare. Stigma against PWH in medical settings is understudied in Malaysia. In the present study, we examine factors associated with physicians' intention to discriminate against PWH in Malaysia. A cross-sectional online survey was emailed to all 1431 physicians at two major university hospitals in Malaysia; 568 (39.6%) participants completed the survey and were included in this analysis. Measures included intention to discriminate against PWH, stigma-related constructs, and socio-demographic characteristics. Multivariate linear regression was used to identify factors associated with intention to discriminate against PWH. Participants were comprised of women (53.5%), Malays (43.1%), and Chinese (35.0%) with nearly 10 years of clinical experience. Most participants were from non-surgical specialties (77.6%). The final multivariate linear regression showed that physicians who expressed greater discriminatory intent against PWH also expressed more negative feelings toward PWH, more HIV-related shame, were more fearful of HIV, and believed that PWH do not deserve good care. Physicians from surgical-based specialties were also significantly more likely to endorse discriminatory intent toward PWH. Stigma and intentions to discriminate against a class of patients, including PWH, can undermine engagement in care, which is central to international HIV prevention and treatment strategies. Interventions that reduce stigma toward PWH among physicians are crucial to ensuring equitable and stigma-free healthcare.
Insights
Physicians in Malaysia show discriminatory intent towards people with HIV (PWH) due to negative feelings, fear, and shame. Surgical specialists were more likely to discriminate, highlighting the need for interventions to reduce stigma in healthcare settings.
Area of Science:
- Medical Sociology
- Public Health
- Healthcare Management
Background:
- Stigma against people with HIV (PWH) in Malaysia is a significant barrier to healthcare access.
- Stigma within medical settings in Malaysia remains understudied.
- Understanding physician attitudes is crucial for effective HIV care and prevention.
Purpose of the Study:
- To investigate factors associated with physicians' intention to discriminate against PWH in Malaysia.
- To identify specific attitudes and beliefs linked to discriminatory intent.
- To inform interventions aimed at reducing healthcare stigma for PWH.
Main Methods:
- A cross-sectional online survey distributed to 1431 physicians at two Malaysian university hospitals.
- 568 physicians completed the survey, providing data on discriminatory intent, stigma, and socio-demographics.
- Multivariate linear regression analysis was employed to identify significant factors.
Main Results:
- Physicians with higher discriminatory intent reported more negative feelings, HIV-related shame, and fear of HIV.
- Beliefs that PWH do not deserve good care were strongly associated with discriminatory intent.
- Physicians in surgical specialties demonstrated a significantly higher likelihood of discriminatory intent.
Conclusions:
- Physician stigma and discriminatory intent toward PWH can impede crucial HIV prevention and treatment strategies.
- Targeted interventions are essential to mitigate stigma among healthcare providers.
- Ensuring equitable, stigma-free healthcare for PWH requires addressing physician attitudes and biases.