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Original Article HIV-related Perceptions, Knowledge, Professional Ethics, Institutional Support, and HIV/AIDS-Related Stigma in Health Services: An Empirical Evaluation Using PLS-SEM
Vivi Triana1orcid , Nursyirwan Effendi2orcid , Brian Sriprahastuti3, Cimi Ilmiawati8corresp_iconorcid , Dodi Devianto4orcid , Afrizal Afrizal5orcid , Adang Bachtiar6orcid , Rima Semiarty1orcid , Raveinal Raveinal7orcid

DOI: https://doi.org/10.3961/jpmph.23.503 [Accepted]
Published online: July 15, 2024
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1Doctoral Program of Public Health, Faculty of Medicine, Universitas Andalas, Padang, West Sumatra, Indonesia
2Department of Anthropology, Faculty of Social and Political Sciences, Universitas Andalas, Padang, West Sumatra, Indonesia
3Public Policy Analyst, Executive Office of the President of the Republic of Indonesia, Jakarta, Indonesia
4Department of Mathematics and Data Science, Faculty of Mathematics and Natural Sciences, Universitas Andalas, Padang, West Sumatra, Indonesia
5Department of Sociology, Faculty of Social and Political Sciences, Universitas Andalas, Padang, West Sumatra, Indonesia
6Department of Public Health, Faculty of Public Health, Universitas Indonesia, Jakarta, Indonesia
7Subdivision of Allergy & Immunology, Department of Internal Medicine, Faculty of Medicine, Universitas Andalas/Dr. M. Djamil General Hospital, Padang, Indonesia
8Department of Pharmacology, Undergraduate Programme of Medicine, Faculty of Medicine, Universitas Andalas, Padang, West Sumatra, Indonesia
Corresponding author:  Cimi Ilmiawati,
Email: ilmiawati@med.unand.ac.id; dr.ilmiawati@gmail.com
Received: 7 November 2023   • Revised: 19 May 2024   • Accepted: 26 June 2024

Objectives
The aim of this study was to investigate the significance of associations between knowledge, professional ethics, institutional support, perceptions regarding HIV/AIDS, and HIV/AIDS-related stigma among health workers in West Sumatra, Indonesia.
Methods
We conducted a cross-sectional study involving health workers at public hospitals and health centers in West Sumatra in June 2022. The Health Care Provider HIV/AIDS Stigma Scale (HPASS) was employed to assess the stigma associated with HIV/AIDS. To estimate and evaluate the model\'s ability to explain the proposed constructs, we utilized the standardized partial least squares structural equation model (PLS-SEM).
Results
In total, 283 individuals participated in this study (average age, 39 years). The majority were female (91.2%), nearly half were nurses (49.5%), and 59.4% had been working for more than 10 years. The study revealed that HIV/AIDS-related stigma persisted among health workers. The PLS-SEM results indicated that all latent variables had variance inflation factors below 5, confirming that they could be retained in the model. Knowledge and professional ethics significantly contributed to HIV-related stigma, with an effect size (f²) of 0.15 or greater. In contrast, perceived and institutional support had a smaller impact on HIV-related stigma, with an effect size (f²) of at least 0.02. The R2 value for health worker stigma was 0.408, suggesting that knowledge, professional ethics, institutional support, and perceived support collectively explain 40.8% of the variance in stigma.
Conclusions
Improving health workers’ understanding of HIV, fostering professional ethics, and strengthening institutional support are essential for reducing HIV-related stigma in this population.

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