Indonesian Nurses' HIV Knowledge, Religiosity, Individual Stigma Attitudes and Workplace HIV-Stigma

Nurses work in the frontline of the healthcare system and are the largest category of health care professionals who care for people living with HIV (PLWH). Thus, nurses are potential leaders in the effort to reduce stigma. The purpose of this study is to determine the extent to which the nurses’ background (age, gender, monthly income, work experience, and educational background), AIDS care factors (HIV and AIDS care training, perceived competence to care for PLWH, and perceived workplace stigma), HIV knowledge, and religious factors (religious identification, religiosity, and hospital religious affiliation) affect their stigmatizing attitudes to PLWH. This study used a cross-sectional correlation design. The questionnaire included demographic information, HIV knowledge, religiosity, stigmatizing attitudes toward PLWH, and perceived workplace stigma. Three religiously affiliated hospitals (Catholic, Protestant, and Islamic) and one general hospital were purposively selected to include nurses with diverse religions in Jakarta, Indonesia. A convenience sample of 396 nurses were recruited, approximately 100 from each hospital. The mean age was 35.4 years, 89% were female, 73% had a nursing diploma and only 35% had HIV/AIDS care training. The sample was religiously diverse, including 53.5% Muslims, 29.5% Protestants and 17% Catholics. Compared to previous studies in other countries, religiosity and stigmatizing attitudes toward PLWH were high but perceived workplace stigma was low. There were significant correlations between nurses’ HIV knowledge and religiosity; HIV knowledge and stigmatizing attitudes; stigmatizing attitudes and perceived workplace stigma; and nurses’ religiosity and stigmatizing attitudes. Stepwise linear regression explained 35.5% of the variation in stigmatizing attitudes toward PLWH. Low educational backgrounds, perceived competence to care for PLWH, perceived workplace stigma, level of religiosity, religion as Muslim, and being in a Catholic (negative) and Islamic (positive) affiliated hospital were significant predictors of stigmatizing attitudes. HIV/AIDS education of nurses is necessary to improve the quality of health care and minimize stigmatization toward PLWH. The Ministry of Health and hospitals should have an anti-discrimination policy for HIV and AIDS care that clearly specifies the type of prevention, care services provided, standards for non-discriminating care, and support toward PLWH that should be provided.