Health Facility Staff: Fear of HIV Infection (Tier 1)

Export Indicator

Percent of health facility staff who worry about getting HIV when providing care or services to patients living with HIV
What it measures

It measures HIV infection worry among health facility staff when performing certain work-related activities -- both non-invasive procedures (with no risk of infection) and invasive procedures (with some risk of infection).


Fear of HIV infection in work-related activities is an individual-level driver of HIV stigma and discrimination in healthcare settings by leading to both differential and unnecessary use of protective measures that visibly mark patients living with HIV, thereby stigmatizing the patient as well as potentially disclosing the patient’s HIV status to other facility staff, as well as patients. Fear of HIV infection in the work setting continues to be prevalent among health facility staff so deepening knowledge of HIV transmission and prevention is necessary to offer high quality services in a non-stigmatizing environment.


Number of health facility staff who reported worry to any of the three statements


Number of all health facility staff who answered at least one of the three statements. If a respondent responds non-applicable or was missing to all three statements, they should be excluded from the denominator.


Numerator / Denominator

Method of measurement

Any form of facility-based surveys, e.g. Service Provision Assessment or Quality Assurance Surveys

This indicator is constructed from the responses to the following set of prompted questions:

  • How worried would you be of getting HIV if you did the following? Would you be very worried, worried, a little worried, not worried? If any of the following is not one of your job responsibilities please select “Not applicable”
  1. Touched the clothing of a patient living with HIV
  2. Dressed the wounds of a patient living with HIV
  3. Drew blood from a patient living with HIV
Measurement frequency


Every 3-5 years

Strengths and weaknesses

Measuring the fear of HIV transmission among health facility staff in work-related activities with patients living with HIV is an important driver of HIV stigma and discrimination. It can lead to discriminatory behaviors like physical isolation of PLHIV, refusal to care for PLHIV, visible marking of HIV status, and unnecessary use of precautions. Understanding the specific fears that health facility staff have around HIV transmission allows for a more effective response to address those fears facility-wide and can include trainings in universal precautions and increasing depth of understanding of how HIV is transmitted and not transmitted.

Because these three items are presented in increasing levels of procedure invasiveness where touching the clothing of a patient living with HIV is the least invasive procedure while drew blood from a patient living with HIV is the most invasive procedure and include at least one situation that most respondents will relate to, this indicator will capture fear of HIV transmission among the majority of respondents.

Further information

For further information on the methodology and survey instruments, visit

Jain, A., and L. Nyblade. 2012. “Scaling Up Policies, Interventions, and Measurement for Stigma-Free HIV Prevention, Care, and Treatment Services.” Working Paper #3. Washington, DC: Futures Group, Health Policy Project.

Nyblade, L., Stangl, A., Weiss, E., & Ashburn, K. (2009). Combating HIV stigma in health care settings: what works?. Journal of the International AIDS Society,12(1), 15.

Nyblade, L. Jain, A. et al. Journal of the International AIDS Society 2013, 16(Suppl 2):18718 |