The Open AIDS Journal

ISSN: 1874-6136 ― Volume 15, 2021

Attitudes Toward Caring for People Living with HIV/AIDS: A Cross-Sectional Study of Nursing Faculty in Six Countries

Juan. M. Leyva-Moral1, 2, 3, Karen A. Dominguez-Cancino3, 4, 5, Joan E. Edwards6, David Moriña-Soler7, Sandra K. Cesario6, Genesis M. Guevara-Vasquez3, 8, 9, Maria Feijoo-Cid2, Patrick A. Palmieri3, 8, 10, *
1 Grup de Recerca Infermera en Vulnerabilitat i Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
2 Department d'Infermeria, Universitat Autònoma de Barcelona, Barcelona, Spain
3 Evidence-Based Health Care South America: A Joanna Briggs Institute Affiliated Group, Lima, Perú
4 Escuela de Enfermería, Universidad Científica del Sur, Lima, Perú
5 Escuela de Salud Pública, Universidad de Chile, Santiago, Chile
6 Center for Global Nursing, Texas Woman’s University, Houston, United States
7 Departament de Matemàtiques, Universitat Autònoma de Barcelona, Barcelona, Spain
8 Vicerrectorado de Investigación, Universidad Norbert Wiener, Lima, Perú
9 Dirección de Investigación, Hospital Regional Lambayeque, Chiclayo, Perú
10 College of Graduate Health Studies, A. T. Still University, Kirksville, United States



Since the earliest study about nursing faculty and student attitudes about caring for people living with HIV/AIDS (PLHIV) in 1992, there have been less than 20 additional studies reported in the literature. Yet, PLHIV continues to report stigma and experience discrimination. Nursing faculty attitudes are part of the informal curriculum. Negativity about caring for PLHIV can adversely impact student perceptions as well as their care. Current research in this area is essentially non-existent.


To describe the attitudes of the university nursing faculty toward caring for PLHIV; and to identify the relationship between faculty attitudes and explanatory factors such as age, education, religion, nationality, teaching in a clinical setting, years of experience, and university attributes.


This was a multicenter cross-sectional study with nonrandomized electronic purposeful sampling. The Healthcare Provider HIV/AIDS Stigma Scale (HPASS) is a 30-item scale with three subscales: Prejudice, stereotype, and discrimination. The English and Spanish versions of the HPASS exhibit stable psychometric properties for cross-cultural research. The HPASS was delivered to university nursing faculty in six countries across three continents.


A sample of 368 nursing faculty completed the HPASS. The mean composite score was 2.41 (SD = 0.69), six-point scale with lower scores indicating more positive attitudes, with subscale scores: Stereotypes 2.55 (SD = 0.84), discrimination 2.28 (SD = 0.74), and prejudices 2.41 (SD = 0.63). Peruvian faculty had the highest scores while Canadian had the lowest. Significant correlations were observed between attitudes and the three subscales, and between the three subscales and the composite score.


Attitudes of the nursing faculty toward caring for PLHIV were slightly positive to slightly negative depending on the region and country. Knowledge deficiencies about HIV persist, incorrect beliefs are common, and attitudes appear to be influenced by culture. The correlation between subscales justifies continued research to implement targeted interventions. Education about HIV/AIDS can address knowledge deficits while structured interactions with PLHIV can facilitate experiential learning.

Keywords: Acquired Immunodeficiency Syndrome, HIV Infections, Faculty, Nursing, Social Stigma, Social Discrimination, Prejudice, Healthcare Provider HIV/AIDS Stigma Scale, HPASS.

Article Information

Identifiers and Pagination:

Year: 2020
Volume: 14
First Page: 90
Last Page: 99
Publisher Id: TOAIDJ-14-90
DOI: 10.2174/1874613602014010090

Article History:

Received Date: 16/4/2020
Revision Received Date: 22/7/2020
Acceptance Date: 28/7/2020
Electronic publication date: 20/10/2020
Collection year: 2020

© 2020 Leyva-Moral et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Vicerrectorado de Investigacion, Universidad Norbert Wiener, Avenida Arequipa 444, Torre 2, Piso 4, Lima, 15046, Perú; E-mails: or patrick.palmieri@uwiener.

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