Towards zero discrimination: a survey on HIV-related stigma and discrimination among healthcare providers in a medical center in Southern Taiwan.

Background HIV-related stigma and discrimination among healthcare providers deter people living with or at high risk of HIV (PLHIV and key populations) from seeking and adhering to care. Understanding its determinants is essential for targeted interventions. Methods We administered the validated Measuring HIV Stigma and Discrimination Among Workers in Health Facilities Questionnaire to staff of an HIV-designated teaching hospital in Taiwan. Descriptive statistics were followed by multivariable logistic regression models adjusting for gender, age, years in service, infectious diseases ward experience, the number of PLHIV cared for in the past 12months and personal training program. Model diagnostics included variance inflation factors and Hosmer-Lemeshow tests. A post-stratification weighting sensitivity analysis was performed to correct the 84% female sample toward the hospital's 70% female workforce. Results Of 550 respondents, 42% had cared for PLHIV in the previous year, and 8.4% worked in the infectious diseases ward. Unnecessary precautions were reported by 90.1%, worry about occupational HIV acquisition by 83.3%, negative attitudes toward PLHIV by 70.2%, professional refusal toward key populations by 38.0% and observed discriminatory behaviors by 34.7%. In adjusted analyses, HIV-related training was associated with lower fear of infection (aOR 0.35), reduced observed stigma (aOR 0.50) and higher willingness to serve key populations (aOR 2.36). Infectious diseases ward experience also reduced fear (aOR 0.38). Age showed a marginal protective effect on fear, whereas gender and prior contact with PLHIV were not significant. Weighted estimates were consistent, supporting robustness of findings. Conclusions HIV-related stigma remains pervasive among healthcare providers, with lack of HIV-specific training and limited clinical exposure being risk factors. Tailored education, ongoing surveillance and further interventions are urgently needed within healthcare facilities to promote a friendly medical environment for equitable care for PLHIV.