The role of people living with HIV as patient instructors - reducing stigma and improving interest around HIV care among medical students
Abstract
People living with HIV/AIDS (PHAs) are increasingly recognized as experts in HIV and their own health. We developed a simulated clinical encounter (SCE) in which medical students provided HIV pre- and post-test counselling and point-of-care HIV testing for PHAs as patient instructors (PHA-PIs) under clinical preceptor supervision. The study assessed the acceptability of this teaching tool with a focus on assessing impact on HIV-related stigma among medical students. University of Toronto pre-clerkship medical students participated in a series of SCEs facilitated by 16 PHA-PIs and 22 clinical preceptors. Pre- and post-SCE students completed the validated Health Care Provider HIV/AIDS Stigma Scale (HPASS). HPASS measures overall stigma, as well as three domains within HIV stigma: stereotyping, discrimination, and prejudice. Higher scores represented higher levels of stigma. An additional questionnaire measured comfort in providing HIV-related care. Mean scores and results of paired t-tests are presented. Post-SCE, students (n = 62) demonstrated decreased overall stigma (68.74 vs. 61.81, p < .001) as well as decreased stigma within each domain. Post-SCE, students (n = 67) reported increased comfort in providing HIV-related care (10.24 vs. 18.06, p < .001). Involving PHA-PIs reduced HIV-related stigma among medical students and increased comfort in providing HIV-related care.
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People living with HIV participated as teachers during a simulated clinical encounter in which students provided counselling.
“People living with HIV participated as teachers during a simulated clinical encounter in which students provided counselling.60”
From Role of active patient involvement in undergraduate medical education: a systematic review (2020) · cites this paper as [60]
Some patient teachers worked under the supervision of a clinical preceptor.
“Some patient teachers worked under the supervision of a clinical preceptor.60”
From Role of active patient involvement in undergraduate medical education: a systematic review (2020) · cites this paper as [60]
In the intervention study by Jaworksy et al, medical students provided HIV test counselling to patient instructors.
“In the intervention study by Jaworksy et al, medical students provided HIV test counselling to patient instructors.60”
From Role of active patient involvement in undergraduate medical education: a systematic review (2020) · cites this paper as [60]
Students reported increased comfort in providing HIV-related care (10.24 vs 18.06).
“Students reported increased comfort in providing HIV-related care (10.24 vs 18.06).”
From Role of active patient involvement in undergraduate medical education: a systematic review (2020) · cites this paper as [60]
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- Authors
- Jaworsky, D., Gardner, S., Thorne, J. G., Sharma, M., McNaughton, N., Paddock, S., Chew, D., Lees, R., Makuwaza, T., Wagner, A., Rachlis, A., & CHIME Research Group
- Affiliations
- University of Toronto (CA)
- Toronto People With AIDS Foundation (CA)
- Nine Circles Community Health Centre (CA)
- Toronto Metropolitan University (CA)
- Sunnybrook Health Science Centre (CA)
- Corresponding author
- Jaworsky, Denise
- ORCID
- Venue
- AIDS Care
- Publisher
- Informa UK Limited
- Published
- 2016-08-31
- Volume
- 29
- Issue
- 4
- Pages
- 524-531
- ISSN
- 0954-0121 (ISSN-L)
- 1360-0451
- OpenAlex
- W2511483270
- Cited by
- 34
- References
- 37
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 4 · 2023: 3 · 2022: 4 · 2021: 1 · 2020: 6 · 2019: 5 · 2018: 6
- FWCI
- 3.39
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- AIDS Care (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Institute of Infection and Immunity (CBR-104070)
- Topics
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
- Health Sciences › Medicine › Physiology › Simulation-Based Education in Healthcare
- Keywords
- people living with HIV, HIV stigma, medical students, simulated clinical encounters, point-of-care HIV testing, health professions education, stigma reduction, discrimination
- MeSH terms
- Adolescent, Adult, Counseling, Education, Medical, Undergraduate, Female, Humans, Male, Prejudice, Surveys and Questionnaires, Stereotyping, Students, Medical, HIV Infections, Patient Simulation, Point-of-Care Systems, Young Adult, Social Stigma
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