Stigma Reduction Training Improves Healthcare Provider Attitudes Toward, and Experiences of, Young Marginalized People in Bangladesh

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• 作者：Scott Geibel ; Ph.D. ; M.P.H.^a ; ^{sgeibel@popcouncil.org} ; Sharif M.I. Hossain ; M.B.B.S. ; M.P.H.^b ; Julie Pulerwitz ; Sc.D.^a ; Nargis Sultana ; M.P.S.^b ; Tarik Hossain ; M.S.S.^b ; Shongkour Roy ; M.S.^b ; Brady Burnett-Zieman ; M.P.H.^a ; Lucy Stackpool-Moore ; Ph.D. ; L.L.M. ; M.A.^c ; Barbara A. Friedland ; M.P.H.^d ; Reena Yasmin ; M.B.B.S.^e ; Najmus Sadiq ; M.B.B.S. ; M.S.S.^f ; Eileen Yam ; Ph.D. ; M.P.H.^a
• 关键词：Young people ; Youth ; Stigma ; Discrimination ; HIV ; Key populations ; Service provision ; Healthcare provider training
• 刊名：Journal of Adolescent Health
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：60
• 期：2_supp_S2
• 页码：S35-S44
• 全文大小：356 K
• 卷排序：60

文摘

Working with health providers to reduce HIV stigma in the healthcare setting is an important strategy to improve service utilization and quality of care, especially for young people who are sexually active before marriage, are sexual minorities, or who sell sex. A stigma reduction training program for health providers in Bangladesh was evaluated.MethodsA cohort of 300 healthcare providers were given a self-administered questionnaire, then attended a 2-day HIV and sexual and reproductive health and rights training (including a 90-minute session on stigma issues). Six months later, the cohort repeated the survey and participated in a 1-day supplemental training on stigma, which included reflection on personal values and negative impacts of stigma. A third survey was administered 6 months later. A cross-sectional survey of clients age 15–24 years was implemented before and after the second stigma training to assess client satisfaction with services.ResultsProvider agreement that people living with HIV should be ashamed of themselves decreased substantially (35.3%–19.7%–16.3%; p < .001), as did agreement that sexually active young people (50.3%–36.0%–21.7%; p < .001) and men who have sex with men (49.3%–38.0%–24.0%; p < .001) engage in “immoral behavior.” Young clients reported improvement in overall satisfaction with services after the stigma trainings (63.5%–97.6%; p < .001).ConclusionsThis study indicates that a targeted stigma reduction intervention can rapidly improve provider attitudes and increase service satisfaction among young people. More funding to scale up these interventions is needed.