HIV stigmatization among healthcare providers: Review of the evidence and implications for HIV care

Abstract

HIV-related stigmatization is associated with a number of adverse consequences among HIV-positive individuals. Given the direct role healthcare providers play in promoting and maintaining the overall health of HIV-positive individuals, it is important to understand the extent to which stigmatization among healthcare providers exists and the potential effects that such negative attitudes and behavior may have on the well-being of HIV-positive patients. This chapter provides a review of the literature on stigmatization among healthcare providers, with a focus on studies that report information on stigmatizing healthcare experiences from the patient's perspective. We describe the potential effects of stigmatization on the well-being of HIV-positive patients, offer a methodological critique of the existing literature, and provide directions for future research and training interventions. Overall, findings confirm that HIV-positive patients experience stigmatization within healthcare settings in the form of negative demeanor from providers, as well as more overt examples, including patient avoidance, lowered quality of care, and treatment refusal. Review findings also confirm that provider stigmatization remains a concern for HIV-positive patients and may exert negative effects on medical care. In reviewing the literature, we suggest directions for research that informs the development of interventions to assist healthcare providers and HIV-positive patients in creating more positive treatment experiences and health outcomes.