Clinical trial NCT06509113: A Pilot Study of an Online HIV Stigma Training for Nursing Students in Iran
Official title: Reducing Stigmatizing Attitudes and Behaviors of Nursing Students in Simulated Clinical Visits of Patients Living With HIV in Iran
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Stigma, Social
HIV Infections
Keywords: Stigma
HIV
Training
Iran
Student
Nursing
Lead sponsor: University of California, San Francisco
Sponsor class: OTHER
Collaborators: name: Ponce Health Sciences University
name: Kerman University of Medical Science
name: Fogarty International Center of the National Institute of Health
First posted: 2024-07-19
Enrollment: 70
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: The investigators will develop a 4-module online HIV stigma reduction training with simulated patients for nursing students in the intervention arm. This training includes three case scenarios: a male who injects drugs, a male who has sex with men, and a female sex worker, all with HIV. Interviews with people living with HIV (PLWH) and focus groups with nursing students and faculty will refine the content. The control group will receive a course on HIV epidemiology without stigma-specific content. To assess efficacy, 70 nursing students will initially have a clinical encounter with a simulated patient on a non-HIV topic. A week later, they will have an HIV visit and complete stigma and empathy scales. Participants will then be randomized into two groups: one receiving stigma training and the other, HIV epidemiology training. Afterward, they will have another HIV-related clinical encounter and complete the scales again.
Primary purpose: OTHER

Brief summary: In this study, the investigators will assess the feasibility, acceptability, and preliminary efficacy of online HIV stigma training in reducing stigmatizing attitudes and behaviors of nursing students in simulated clinical visits of patients living with HIV compared to an online HIV epidemiology training with no specific content on stigma.

Detailed description: Iran has the highest burden of HIV in the Middle East. However, only 42% of Iranians living with HIV are diagnosed and 28% on antiretroviral therapy. The largest gap in the continuum of HIV care is diagnosis. Due to sociocultural and religious beliefs, HIV- associated stigma and drug use stigma are exceedingly high, and sex outside of marriage, or sex of man with another man are considered to be "sinful" behaviors. These intersectional stigmas (stigma towards drug use, sexism, and homophobia) in addition to HIV stigma are major barriers for many people at risk for or living with HIV to engage in HIV testing or treatment. Our prior studies found that health providers have limited clinical encounters with people living with HIV (PLWH) and have no HIV stigma training. This lack of training can lead to stigmatizing attitudes and behaviors towards people at risk for HIV or PLWH. The highest HIV stigmatizing behaviors was reported in nurses and physician assistants. These data, coupled with the extreme marginalization of key populations at high risk for HIV in Iran, call for the development of new ways to train nurses to reduce HIV-related stigma in clinical settings. The investigators propose to develop, and field test an HIV stigma online training including simulated patients living with HIV for nursing school students. In a randomized controlled trial, the investigators will assess the feasibility, acceptability, and preliminary efficacy of the online HIV stigma training in reducing stigmatizing attitudes and behaviors of nursing students in simulated clinical visits of patients living with HIV compared to an online HIV epidemiology training with no specific content on stigma. Successful development of the HIV stigma training and simulated patients at risk for or living with HIV will set the stage for developing a larger trial of nurses and other health providers which can lead to an effective and scalable training program to reduce HIV-related stigma in clinical settings and improve engagement in HIV testing and care services. The investigators from the University of California San Francisco (UCSF), will lead and co-investigate the project, respectively. They will collaborate with teams from Kerman University of Medical Sciences (KMU), Iran, and Ponce Health Sciences University (PHSU) in the USA.

Eligibility criteria: Inclusion Criteria:

* Currently nursing students in their year 3 or 4 of training
* Kerman Medical University (KMU) nursing schools

Exclusion Criteria:

* Nursing student in their year 1 and 2
* Students of other fields and other universities

Primary outcomes:
measure: Stigma score
timeFrame: Up to 4 weeks before and after intervention
measure: Behavioral manifestations of HIV stigma
timeFrame: Up to 4 weeks before and after intervention
measure: Empathy score
timeFrame: Up to 4 weeks before and after intervention
Secondary outcomes:
measure: The attitudes and behaviors of nursing students after the online HIV stigma training
timeFrame: Three months after the intervention
Other outcomes:
Locations:
city: Kerman
country: Iran, Islamic Republic of
facility: Skill labs at the nursing school of Kerman Medical University
Study officials:
affiliation: University of California, San Francisco
name: Ali Mirzazadeh, PhD
role: PRINCIPAL_INVESTIGATOR
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