Reducing HIV stigma among healthcare providers in India using a partly tablet-administered intervention

The DriSti trial

Bibliographic Data

ID19440209
AuthorsMaria L Ekstrand (0000-0001-7587-2899, Division of Prevention Sciences, Department of Medicine, University of California, San Francisco, CA, USA, corresponding author), Tony Raj (0000-0003-3959-4718, Division of Medical Informatics, St. John’s Research Institute, Bangalore, India), Elsa Heylen (0000-0002-0518-5804, Division of Prevention Sciences, Department of Medicine, University of California, San Francisco, CA, USA), Laura Nyblade (0000-0001-8067-4192, RTI International), Dhinagaran Devdass (Division of Medical Informatics, St. John’s Research Institute, Bangalore, India), Matilda Pereira (Division of Medical Informatics, St. John’s Research Institute, Bangalore, India), Amanda Mazur (Division of Prevention Sciences, Department of Medicine, University of California, San Francisco, CA, USA), Krishnamachari Srinivasan (0000-0003-1009-9094, Division of Mental Health and Neurosciences, Department of Psychiatry, St. John’s Research Institute, Bangalore, India)
Year2020
Volume32
Issuesup2
Pages14-22
Publication date2020-05-13
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueAIDS Care (JOURNAL)
Journal identifiersISSN: 0954-0121 • E-ISSN: 1360-0451
PublisherInforma UK Limited (PUBLISHER • GB)
DOI10.1080/09540121.2020.1739221
PMID32151146
OpenAlexW3011351738
LanguageEN
Citations received7
References cited24

HIV stigma has long been recognized as a significant barrier in the worldwide fight against HIV. Across cultures, stigma has been shown to cause psychological distress and act as a barrier to engagement in care. Health professionals can serve as a crucial source of HIV stigma, with drivers that include fears and transmission misconceptions and pre-existing negative attitudes towards marginalized groups. To increase their impact, stigma reduction interventions need to be scalable and sustainable as well as adaptable to different cultural contexts. The DriSti intervention was designed to meet these needs through an easily adaptable, mostly tablet-administered, interactive intervention delivered to ward staff (n = 1,557) and nursing students (n = 1,625) in 62 Indian institutions, using a cRCT design, with wait-list controls. Six-month outcome analyses, showed significant reductions in misconceptions (p < .001) and worry about acquiring HIV at work (p < .001). Intervention participants also reported significantly greater reductions in endorsement of coercive policies (p < .001) and in the number of situations in which they intended to discriminate against PLWH (p < .001) than control participants. This brief, scaleable intervention could be adapted for similar populations in the region, using different mHealth platforms and thus has important implications for current global stigma reduction initiatives and training curricula

Anxiety · Distress · Family medicine · Health care · mHealth · Political science · Psychiatry · Psychological intervention · Social stigma · Worry · Adolescent Sexual and Reproductive Health · Clinical Psychology · HIV, Drug Use, Sexual Risk · HIV/AIDS Research and Interventions · Medicine · Nursing · Psychology