ORIGINAL PAPER Improving Hospital-Based Quality of Care by Reducing HIV-Related Stigma: Evaluation Results from Vietnam Julie Pulerwitz • Khuat Thi Hai Oanh • Dayo Akinwolemiwa • Kim Ashburn • Laura Nyblade Published online: 11 November 2014 Ó Springer Science+Business Media New York 2014 Abstract Operations Research conducted at four hospitals in Vietnam sought to reduce HIV-related stigma and dis- crimination among hospital workers. The quasi-experimen- tal study compared effects of focusing on ‘fear-based’ stigma (stemming from lack of knowledge) versus both fear- based and social stigma (stemming from moral judgments). Interventions included staff training (ranging from physi- cians to ward cleaners), hospital policy development, and supplies provision. At baseline (n = 795), reported stigma was substantial (e.g., about half of hospital workers indi- cated fear of casually touching PLHIV, and felt HIV was a punishment for bad behavior). By endline, stigma measures had improved significantly for both intervention groups (e.g., proportion reporting signs on beds indicating HIV status decreased from 51 to 24 % in Arm 1, and 31 to 7 % in Arm 2), with the combined intervention group showing greater effects. This study highlights successful strategies to reduce stigma, and thus, improve quality of care for PLHIV. Keywords HIV-related stigma Á Discrimination Á Values Á Healthcare workers Á Vietnam Resumen Esta investigacio ´n de ‘‘operaciones’’ tuvo como objetivo reducir estigma y discriminacio ´n asociados con VIH en el personal en cuatro hospitales en Vietnam. El estudio casi-experimental comparo ´ el impacto defocalizar la intervencio ´ n en el estigma causado por miedo (basado en falta de conocimiento) con el estigma causado por miedo y factores sociales (motivado por valoraciones morales). Las intervencionesincluyeron capacitacio ´n del personal (desde me ´dicos a personal de limpieza), desarrollo de polı ´tica- shospitalarias, y provisio ´n de equipamiento. En la lı ´nea de base (n = 795), se encontro ´ que el estigma erasignificativo (ejemplos, aproximadamente la mitad del personal del hospital expreso ´ miedo de tocarcasualmente a personas que viven con VIH, y dijeron que el VIH es un castigo por mala conducta). Alfinal de la intervencio ´n, las medidas de estigma mejoraron significativamente en ambos grupos deintervencio ´n (por ejemplo, proporcion de personas que reporta letreros en las camas indicando que elestatus del VIH se redujo del 51 al 24 por ciento en Grupo 1, y del 31 al siete por ciento en el Grupo 2), con el agregado que el grupo sujeto a la intervencio ´n mixta experimento ´ mayores cambios. Este estudiomuestra estrategias exitosas para re- ducir estigma y, por lo tanto, mejorar la calidad del cuidado de laspersonas viviendo con VIH. Introduction Vietnam has experienced an important HIV epidemic over the past 25 years (since the first reported case in 1990) [1]. The 2012 United Nations General Assembly Special Present Address: J. Pulerwitz (&) Population Council, 4301 Connecticut Ave, NW, Suite 280, Washington, DC 20008, USA e-mail: jpulerwitz@popcouncil.org J. Pulerwitz PATH/Horizons, Washington, DC, USA K. T. H. Oanh ISDS (Institute for Social and Development Studies), Hanoi, Vietnam D. Akinwolemiwa Washington, DC, USA K. Ashburn Á L. Nyblade International Center for Research on Women, Washington, DC, USA 123 AIDS Behav (2015) 19:246–256 DOI 10.1007/s10461-014-0935-4