Stigma against people living with Human Immunodeficiency Virus: A quasi-experimental evaluation of active stigma reduction workshops among medical students in Tunisia

Abstract

INTRODUCTION: Stigma against people living with Human Immunodeficiency Virus (PLHIV), particularly from healthcare providers, continues to be a significant barrier discouraging individuals from seeking necessary care. However, HIV stigma, particularly among healthcare workers, is still underexplored, with limited focus on medical students. This study assesses the impact of active stigma reduction workshops on stigma towards PLHIV among a sample of medical students in Tunisia and identifies its related factors. METHOD: We performed a quasi-experimental study among all fifth-year students during the academic years 2024 and 2025 in the Faculty of Medicine of Monastir (Tunisia). We evaluated HIV stigma before and after each workshop via self-administrated and anonymous questionnaire. We used the validated versions of the brief HIV knowledge questionnaire and the Health Care Provider HIV/AIDS Stigma Scale. RESULTS: A total of 216 medical students completely answered the questionnaire. Overall, most participants demonstrated a good level of HIV-related knowledge (88.4%). Good HIV knowledge, higher parental education and involvement in community or associative activities were significantly associated with lower stigma levels. Interestingly, using multivariate analyses, poor parental educational level and being stigmatized were independently associated with higher prejudice scores. This student-centered learning approach was revealed to be effective in significantly improving HIV-related knowledge and reducing HIV stigma among medical students. CONCLUSION: Our findings emphasize the value of integrating active learning methods into the medical curriculum to prepare future healthcare providers to deliver stigma-free care in order to promote ethical and inclusive behavior toward PLHIV.