# Reducing stigmatizing attitudes and behaviors of nursing students in simulated clinical visits of patients living with HIV in Iran

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2024 · $190,668

## Abstract

Project Summary/Abstract
Iran has the highest burden of HIV in the Middle East. However, only 42% of Iranians living with HIV are
diagnosed and 28% on antiretroviral therapy. The largest gap in the continuum of HIV care is diagnosis. Due to
sociocultural and religious beliefs, HIV-associated stigma and drug use stigma are exceedingly high, and sex
outside of marriage, or sex of man with another man are considered to be “sinful” behaviors. These intersectional
stigmas (stigma towards drug use, sexism, and homophobia) in addition to HIV stigma are major barriers for
many people at risk for or living with HIV to engage in HIV testing or treatment. Our prior studies found that
health providers have limited clinical encounters with people living with HIV (PLWH) and have no HIV stigma
training. This lack of training can lead to stigmatizing attitudes and behaviors towards people at risk for HIV or
PLWH. The highest HIV stigmatizing behaviors was reported in nurses and physician assistants. These data,
coupled with the extreme marginalization of key populations at high risk for HIV in Iran, call for the development
of new ways to train nurses to reduce HIV-related stigma in clinical settings. We propose to develop, and field
test an HIV stigma online training including simulated patients living with HIV for nursing school students. In a
randomized controlled trial, we will assess the feasibility, acceptability, and preliminary efficacy of the online HIV
stigma training in reducing stigmatizing attitudes and behaviors of nursing students in simulated clinical visits of
patients living with HIV compared to an online HIV epidemiology training with no specific content on stigma.
Successful development of the HIV stigma training and simulated patients at risk for or living with HIV will set
the stage for developing a larger trial of nurses and other health providers which can lead to an effective and
scalable training program to reduce HIV-related stigma in clinical settings and improve engagement in HIV testing
and care services.

## Key facts

- **NIH application ID:** 10784672
- **Project number:** 5R01TW012408-02
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** Ali Mirzazadeh
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $190,668
- **Award type:** 5
- **Project period:** 2023-02-17 → 2025-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10784672

## Citation

> US National Institutes of Health, RePORTER application 10784672, Reducing stigmatizing attitudes and behaviors of nursing students in simulated clinical visits of patients living with HIV in Iran (5R01TW012408-02). Retrieved via AI Analytics 2026-06-12 from https://api.ai-analytics.org/grant/nih/10784672. Licensed CC0.

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