HIV is no longer a terminal diagnosis. With the right medication, HIV-positive people can lead full and healthy lives.
But, although that has changed since the disease was first identified, stigma persists. For instance, not everyone knows that a person living with an undetectable viral load is unable to pass HIV on to someone else. Undetectable = untransmittable.
Surprisingly, much of this stigma and discrimination persists in the medical profession, leading to ongoing issues for patients.
Now, however, a team at RCSI has developed RISE (Redefining Institutional Stigma Education), a new online module to help educate healthcare workers about HIV, stigma and best practices in caring for patients with HIV.
The module was developed with funding through RCSI’s Student Engagement and Partnership (StEP) fund, which supports students and academics to collaborate on research.
Additional support came through the Gilead Fellowship Fund, which supports innovation and best practice for people living with HIV, viral hepatitis, invasive fungal disease and cancer.
Solid evidence
Before developing this teaching aid, however, the RISE team needed solid evidence and data around the problem of HIV stigma in healthcare settings.
The team consisted of Dr Eoghan de Barra (an infectious diseases consultant at Beaumont Hospital and senior lecturer at RCSI), Dr Amir K. Bachari (medical student at the time), Michael O’Dea (person living with HIV and advocate), and Ellen Conlon (research assistant).
Through the needs assessment and conversations with those living with HIV, the team found that some surgeons have refused to operate on people with HIV. Meanwhile, some respondents have witnessed healthcare staff who were reluctant to take blood samples. More than 75% of healthcare professionals have seen their colleagues discriminate against people with infectious diseases.
The RISE module addresses this stigma in two ways. First, it places those impacted by HIV at the centre of learning through testimonials and the sharing of lived experiences.
Secondly, it applies theoretical knowledge to real-world situations, providing healthcare professionals with useful tools and skills to address HIV stigma in their practice.
The team all felt that given the taboo nature of HIV in society, those impacted by it – often among the most marginalised in society – must be empowered by this research.
With this in mind, the module was designed to put a face to HIV stigma by centering those impacted by it, allowing them to tell their own stories.
By the end of the module, learners will have an understanding of basic HIV medicine, the history of HIV, the theory behind stigma, intersectionality in HIV stigma, and how to apply this knowledge to create a stigma-free practice.
Healthcare workers are busy, a factor that guided how the RISE team structured the module. The online nature of the module, however, allowed greater flexibility and barrier-free access for participants. The course is 2.5 hours long, with a diverse split that includes lectures, testimonials, quizzes, and application scenario videos.
Providing a template
Early feedback from participants indicates that they enjoyed the interactive nature of the module, with videos, theory and quizzes all included in the teaching and learning methodology.
RISE was initially piloted among first-year graduate entry medicine students, with the hope of it becoming a mandatory part of the curriculum the following year. It is now a Royal College of Physicians of Ireland-accredited module, while physicians who complete it will receive three continuous professional development (CPD) credits.
The creators of RISE may just have provided a template that could apply to stigma around other infectious diseases.
Beyond RCSI, the team is now working with other colleges, universities and governing bodies to integrate RISE into their curricula – and help to end needless and harmful stigma.
Healthcare workers and students who are interested in accessing the module can find out more here or via the project’s Instagram page, @riseproject_ie.
RCSI is committed to achieving a better and more sustainable future through the UN Sustainable Development Goals.
