Fuzzy Modeling of the Enactment of Stigma by Healthcare Personnel Toward People Living with HIV in the Frame of Counterfactual Thinking: A Mixed-Method Approach

Abstract

Existing research on HIV stigma has not thoroughly studied the healthcare providers' (HCP) judgment toward people living with HIV (PLHIV). The goal of this article is to conceptualize formation of stigma within attitudes of HCP through their judgmental process by using the Fairness Theory. The study is also aimed to develop a model for cognitive patterns of HCPs' stigmatizing judgments toward PLHIV by applying fuzzy logic. We applied a mixed method in two phases, including qualitative method and fuzzy analytical modeling. A sample of 17 physicians and 9 nurses from 6 hospitals in Tehran were recruited and saturation was achieved after 21 in-depth interviews. Then, the answers of six HCPs were selected for defining the fuzzy sets and membership functions' curve. Six patterns of HCPs' judgments emerged that were used for the fuzzy analysis. These patterns are outcomes of assessment on various aspects of fairness of stigmatization that is impacted by HCPs' counterfactual prototypes. Moral codes, hospital and medical rules, and also constraints imposed from the workplace environment are the references of counterfactual prototypes that affected the HCPs' judgment. Health policy makers can design more effective HIV stigma reduction interventions based on the six patterns of HCPs' judgment.

Gamified Educational Learning Path on HIV/AIDS Stigma and Discrimination (REDXIR): Design, Development and Pilot Study

“…Finding the root causes of stigmatized attitudes and discriminatory behavior is complicated. Discriminatory behavior among healthcare providers toward PLHIV can be categorized into predefined behavioral patterns rooted in the sociocultural context of the people and also in interaction with the context and situation of the works place (5). Hence, UN-AIDS 2016-2021 Strategy, adopted in October 2015, has a clear target of eliminating HIV-related discrimination, with a particular focus on healthcare, the workplace, and education settings (6).…”

Determinants Model in Reducing HIV-Related Stigma in Health care Workers: A Systematic Review

“…This is in conjunction with the research result done by Nyblade et al, 2018, which stated that health care workers have a stigma and differentiates PLWHA. On health-care facilities, the manifestation of the stigma was widely documented [10], from direct rejection of treatment, below standard treatment, verbal and physical abuse, to a more soft form of rejection such as making them wait longer or surrenders the care to the more junior member of the health-care team [11]. It can be concluded that stigma is the main obstacle in treating those who are seeking preventive measure and to uphold their own quality of life [6].…”