Exploring barriers and facilitators in implementing the Health4All module for HIV stigma reduction in Malaysia...

Stigma and discrimination in healthcare settings remain significant barriers to achieving the global goal of ending the AIDS epidemic by 2030. Despite progress, interventions to address these issues are limited in Malaysia, where Health4All module being one of the few implemented in healthcare settings to reduce HIV-related stigma. This study explores the barriers and facilitators to its implementation, aiming to enhance its effectiveness in addressing stigma within these environments.

Using the Delphi method, expert opinions from public health and primary care sectors were collected over three iterative rounds to identify and prioritize barriers and facilitators to implementing the Health4All module. Data were obtained via email, with each round refining the previous findings. The implementation was facilitated by strong leadership, adequate funding, clinic champions, established HIV teams, and active staff engagement. Key barriers included workforce shortages, high turnover, recruitment challenges among key populations, language and content limitations, and online training constraints such as technical issues and limited interaction. Despite these challenges, cost-effective online delivery and targeted incentives improved uptake, emphasizing the critical influence of organizational, individual, and systemic factors on successful implementation. The findings provide a valuable foundation for future efforts to enhance healthcare practices and outcomes.