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Nurses' Experience with HIV Stigma in Five African Countries


Background: While HIV-related stigma has become better understood since the beginning of he HIV/AIDS pandemic, it nevertheless remains a pervasive problem in the prevention and treatment of HIV and AIDS in Africa. Nurses are at the forefront of HIV service delivery, and in many African countries nurses constitute the majority of the health care workers. There is a need to consider the implications of HIV stigma for nurses, but there is a dearth of evidence on nurses' experience with HIV stigma. The objective of this study was to explore the contributions of personal characteristics, job characteristics, and HIV/AIDS stigma on nurses' quality of life.

Methods: The study was conducted on site at clinical facilities in five southern African countries (Lesotho, Malawi, South Africa, Swaziland and Tanzania). Using secondary analysis of time 1 data, 1,388 nurses were surveyed using a brief demographic survey, the Quality of Work Life survey, the Medical Outcome Study Short Form 36, and the HIV/AIDS Stigma Instrument (HASI-N). Factor analysis was used in the parent study in the development of the HASI-N to explore concepts, build theory, and/or confirm and test hypotheses about nurses stigmatizing patients and nurses being stigmatized. Multiple regression correlation analysis was used to study the relationship between the predictor variables and criterion variable. ANOVA was used to compare and evaluate the differences amongst the demographic variables.

Results: There is a significant negative correlation between stigma and job satisfaction, and there is significant correlation between years of nursing experience and stigma specifically for nurses stigmatizing patients. More stigma is reported if the nurse has a family member or relative who is HIV+. Nurses residing in peri-urban areas reported more stigma than those in urban or rural areas. Overall, the results show that both job satisfaction and nurses being stigmatized affect their physical health and mental health.

Conclusions: This study added new information demonstrating that HIV stigma experienced by nurses affects their mental health and slightly their physical health, and this may contribute to the nursing shortage in sub-Saharan Africa.

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