BackgroundHIV-related stigma continues to negatively impact the health and well-being of people living with HIV, with deleterious effects on their care, treatment and quality of life. A growing body of qualitative research has documented the relationship between HIV-related stigma and health. This review aims to synthesize qualitative evidence that explored the intersections of stigma and health for people with HIV.MethodsA thematic summary was conducted that was guided by the qualitative metasummary technique developed by Sandelowski and Barraso. Literature searches yielded 8,622 references of which 55 qualitative studies were identified that illustrated HIV-related stigma in the context of health.ResultsThe metasummary classified qualitative findings into three overarching categories: conceptualizing stigma which identified key dimensions of HIV-related stigma; experiencing stigma which highlighted experiences of stigma in the health context, and managing stigma which described ways in which stigma is avoided or addressed. To better illustrate these connections, the qualitative literature was summarized into the following themes: stigma within health care settings, the role of stigma in caring for one’s health, and strategies to address HIV-related stigma in the health context. A number of health care practices were identified – some rooted in institutional practices, others shaped by personal perceptions held by practitioners – that could be stigmatizing or discriminatory towards people with HIV. There existed interconnections between enacted stigma and felt stigma that influenced health care utilization, treatment adherence, and overall health and well-being of people with HIV. Intersectional stigma also emerged as instrumental in the stigma experiences of people living with HIV. A number of strategies to address stigma were identified including social support, education, self-efficacy, resilience activities, and advocacy.ConclusionThis review of the qualitative evidence indicates that HIV-related stigma within health contexts is a broad social phenomenon that manifests within multiple social spheres, including health care environments. Findings from this review indicate that future stigma research should consider the social structures and societal practices – within and outside of health care environments – that perpetuate and reinforce stigma and discrimination towards people with HIV.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-2197-0) contains supplementary material, which is available to authorized users.

Purpose: This paper critically reflects on evidence relating to the development and delivery of apprenticeships and its potential implications for pre-registration healthcare education. Design: An iterative review of English language literature published after 1995 to date relating to apprentices and apprenticeships was undertaken. Twenty studies were identified for inclusion. Only three related to the most recent apprenticeship initiative in the United Kingdom (UK), and the majority were UK based. Findings: Three key themes were identified: entering an apprenticeship, the learning environment and perceptions of apprenticeships. Successful completion of an apprenticeship relies heavily on both understanding the role the apprentice is seeking to inhabit, as well as well-structured and comprehensive support whilst on the programme. These findings are then discussed with reference to professional body requirements and pre-registration education in healthcare. Practical Implications: Appropriate work experience and support for learning are critical to apprenticeship success and apprenticeships should be given equal status to traditional healthcare education routes. Value: The introduction of the Apprenticeship Levy in April 2017 (Finance Act, 2016), acknowledgement that all National Health Service (NHS) Trusts will be levy payers and the introduction of targets relating to apprenticeships for public sector employers have all contributed to growing interest in the apprenticeship agenda in health and social care.

Poor mental health of healthcare students is a cause for concern in many universities. Though previous research has identified mental health shame and self-compassion as critical in this student group, how these variables differ across different healthcare disciplines remains to be evaluated. Healthcare students (n = 344; counselling, occupational therapy, social work and nursing) completed measures regarding these variables. MANOVA and regression analyses were performed. (1) Counselling and nursing students were more depressed than occupational therapy students; (2) nursing students were more anxious than occupational therapy and social work students; (3) occupational therapy students had more positive attitudes towards mental health than the others; and (4) nursing students worried about their own reputation associated with their family more than counselling students. Self-compassion was the strongest predictor of mental health in all groups; however, the effect sizes varied: largest in nursing and smallest in social work students. Findings will help inform effective interventions for students in each healthcare discipline.

Purpose The purpose of this paper is to investigate apprenticeship developments in two National Health Service (NHS) organisations since the introduction of the apprenticeship levy in April 2017 and considers potential impact on social mobility. This is a pilot for a broader exploration of implementation of government apprenticeship policy in the NHS. Design/methodology/approach Following ethical approval, semi-structured interviews were conducted with two key informants with responsibility for education and training in their respective organisations. Interviews were recorded and transcribed verbatim. Thematic analysis was undertaken to identify major and sub-themes of the interviews. Findings Four major themes were identified – organisational readiness, the apprenticeship offer, opportunities for further development and potential problems with implementation. Both organisations were actively seeking opportunities to spend their levy and had developed local strategies to ensure this. The levy was being used to develop both new and existing staff, with leadership and management being particularly identified as an area of growth. Similarly, both organisations were using levy monies to develop the bands 1–4 roles, including the nursing associate. The affordability and bureaucracy of apprenticeships were seen as potential problems to the wider implementation of apprenticeships in the NHS. Practical implications Although the apprenticeship levy is being spent in the NHS, there are some challenges for employers in their delivery. The levy is offering new and existing staff the opportunity to undertake personal and professional development at a range of educational levels. This has the potential to increase and upskill the NHS workforce, improve social mobility and possibly lead to larger cultural and professional changes. Originality/value This paper offers an early insight into the implementation of apprenticeship policy in a large public sector employer such as the NHS.

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