Abstract: When HIV-AIDS emerged in the United States, many people were clueless as to what the disease was, how individuals transmitted it, and why it was so deadly. Once established that it was transmitted via bodily fluids, HIV, blood, and sexual fluids, patients were stigmatized when receiving medical care-a situation leading to many individuals going from HIV to AIDS more rapidly because they avoided medical care. This study explored factors associated with the stigmatization of people with HIV. Nonparametric correlations were used to determine how knowledge of HIV and knowing someone and having cared for someone with HIV correlated with the willingness of graduate nursing students to care for people living with HIV-AIDS (PLWHA). The data showed that students, irrespective of personally knowing or having a patient with HIV, were willing to care for PLWHA. This finding demonstrated that the factors explored contributed but were not key to stigmatization.

The aim of this study was to identify the attitudes of nursing students in Alabama toward people living with the Human Immunodeficiency Virus (HIV) or Acquired Immunodeficiency Syndrome (AIDS), and then further explore how specific attitudes impact students' willingness to care for people living with HIV/AIDS (PLWH). In addition, influence on attitudes based on differences in socio-demographic characteristics were investigated. Exploration into students' perceptions regarding how close others would view them if they were to care for PLWH, and students' perceptions of how their communities, religion, and nursing education have influenced their attitudes were also performed. A sequential mixed methods study examined the attitudes of senior level students (n=36) from one Baccalaureate of Science in Nursing (BSN) and three Associate Degree in Nursing (ADN) programs. Students completed the HIV/AIDS Provider Stigma Inventory (HAPSI) using Awareness and Acceptance scales to identify sigma related tendencies, and a socio-demographic questionnaire via online survey. Findings were further explored using individual semi-structured telephone interviews with students (n=9) who completed the online survey. Descriptive statistics and themes suggest that nursing students in Alabama carry generally positive attitudes and a willingness to care for PLWH, and the attitudes of close others have no influence on their own attitudes or willingness to care for this population. However, underlying stigmas were found to be associated with lifestyle factors associated with HIV transmission. There were significant differences found between White and non-White nursing students on both Acceptance and overall HAPSI scale scores, indicating more stigmatizing tendencies toward PLWH among white students. There were differences in Awareness scores between male and female nursing students, with males scoring higher indicating more stigma related tendencies. Themes revealed through interviews suggest that nursing students have concerns about lacking HIV knowledge and experience in caring for PLWH. However, students revealed that education within their respective nursing programs had increased some HIV knowledge. Both nursing education and religious faith had influence on students' compassionate attitudes toward caring for PLWH, despite underlying stigma. Theory of Reasoned Action provided a frame work for understanding attitudes and willingness to care, and how these attitudes are influenced by students' behavioral beliefs and normative beliefs. Findings revealed in this study may assist nurse educators in developing curriculum which focuses on both psychosocial and physical aspects of caring for PLWH.