Health Facility Staff: Unnecessary Precautions and Measures (Tier 2)

Avoiding physical contact or using double gloves with a patient living with HIV is an important manifestation of stigma to capture. It provides information about the unnecessary behaviors health facility staff uses to “protect” themselves, often without knowing that their actions are stigmatizing and can disclose a patient’s HIV status inadvertently to those around them.

This indicator may be subject to response bias as medical/clinical staff is likely to know what is considered appropriate and inappropriate behavior and be hesitant to report it happening.

Note there may still be some places where double gloves are considered standard or best practice. However, if this is the case then double gloves should be used universally for everyone, not just for patients living with HIV.

In addition to measuring fear of HIV infection in routine activities that health facility staff engages in with patients (Indicator 1.2), which is a driver of stigmatizing behavior in health facilities, it is also important to measure the actual behaviors that result from this fear -- the use of unnecessary measures and precautions. For example, additional analysis of the data collected in the field-tests were conducted to explore whether there was a relationship between staff worry about workplace HIV infection and use of unnecessary precautions. Findings showed that staff that worried about HIV infection were more likely to report the use of unnecessary precautions and measures with patients living with HIV.