Background
Public stigma towards people living with HIV (PLWH) in healthcare settings remain to be a key barrier to optimal health service. This study examined the individual, interpersonal, community and societal factors contributing to public stigma against HIV-infected pregnant women and their newborns by healthcare workers.
Methods
A cross-sectional study was conducted in 1592 healthcare facilities providing maternal and pediatric medical care in Guangdong Province. A total of 22899 healthcare workers providing service for pregnant women or newborns completed an online questionnaire in November 2021. Based on Corrigan’s stigma theory and the social-ecological model, data was collected on discrimination, prejudices, stereotypes as well as individual, interpersonal, community/societal factors. Structural equation model was used to examine influencing factors of healthcare workers’ discrimination.
Results
High levels of discrimination (6.8–67.5%), prejudices (24.9–77.3%) and stereotypes (14.4–78.0%) were reported among healthcare workers. The proposed structural equation model fitted the data well (χ2/df ratio = 51.797; RMSEA = 0.047; GFI = 0.919). The standardized coefficients of prejudices and stereotypes on discrimination were 0.31 (p < 0.05) and 0.23 (p < 0.05), respectively. However, prejudices (p = 0.069) were not directly associated with stereotypes. The standardized coefficients of HIV-related knowledge, experiencing secondary stigma related to caring for PLWH and health facility policies and procedures on discrimination were − 0.13 (p < 0.05), 0.02 (p < 0.05) and 0.17 (p < 0.05), respectively.
Conclusions
HIV-related discrimination, prejudices and stereotypes against HIV-infected pregnant women and their newborns among healthcare workers are prevalent. These findings suggest the need for health administrative departments to implement anti-discrimination interventions focused on modifying behaviors among healthcare workers. Emphasis should be placed on individual and interpersonal levels, including the provision of educational opportunities, appropriate training, and psychological support.