Abstract:
The study aim is to explore the results of an HIV stigma intervention in five African health care settings. A case
study approach was used. The intervention consisted of bringing together a team of approximately 10 nurses and
10 people living with HIV or AIDS (PLHA) in each setting and facilitating a process in which they planned and
implemented a stigma reduction intervention, involving both information giving and empowerment. Nurses
(n¼134) completed a demographic questionnaire, the HIV=AIDS Stigma Instrument-Nurses (HASI-N), a selfefficacy
scale, and a self-esteem scale, both before and after the intervention, and the team completed a similar set
of instruments before and after the intervention, with the PLHA completing the HIV=AIDS Stigma Instrument for
PLHA (HASI-P). The intervention as implemented in all five countries was inclusive, action-oriented, and well
received. It led to understanding and mutual support between nurses and PLHA and created some momentum in
all the settings for continued activity. PLHA involved in the intervention teams reported less stigma and increased
self-esteem. Nurses in the intervention teams and those in the settings reported no reduction in stigma or increases
in self- esteem and self-efficacy, but their HIV testing behavior increased significantly. This pilot study indicates
that the stigma experience of PLHA can be decreased, but that the stigma experiences of nurses are less easy to
change. Further evaluation research with control groups and larger samples and measuring change over longer
periods of time is indicated.
