{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T17:14:28Z","timestamp":1784740468427,"version":"3.55.0"},"reference-count":42,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,4,15]],"date-time":"2025-04-15T00:00:00Z","timestamp":1744675200000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R21 TW012001"],"award-info":[{"award-number":["R21 TW012001"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing Open"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To understand HIV stigma and self\u2010efficacy of labour and delivery (L&amp;D) providers in caring for women living with HIV (WLHIV).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Cross\u2010sectional descriptive mixed methods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data were collected in six primary healthcare facilities in the Kilimanjaro region, Tanzania between February and November 2022. We conducted eight focus groups with L&amp;D providers (<jats:italic>n<\/jats:italic>\u2009=\u200936) and nurse\u2010midwifery students (<jats:italic>n<\/jats:italic>\u2009=\u200912). We conducted surveys with 60 L&amp;D providers assessing HIV stigma (fear of acquisition, extra precautions and attitudes) and self\u2010efficacy in caring for WLHIV. Qualitative findings were complemented by survey data to provide a comprehensive understanding of providers' attitudes and experiences.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Providers expressed fear of HIV acquisition when caring for WLHIV. Almost all providers noted that they used extra precautions with WLHIV; 97% used double gloves and 39% avoided touching WLHIV with bare hands, even when there were no bodily fluids. Most providers had positive attitudes towards WLHIV. Almost all rejected the idea that HIV was a punishment for bad behaviour, but 44% thought their patients might not be careful about infecting others. Qualitative data suggested providers worried that patients' reluctance to disclose their HIV status could raise the risk of occupational exposure. Provider self\u2010efficacy in normal birth was lower when caring for a woman with HIV compared with care for women who are HIV\u2010negative but did not differ significantly in other situations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study showed that providers had generally low\u2010stigmatising attitudes towards people living with HIV but feared occupational exposure, leading to avoidance of necessary patient contact. Training on clinical and interpersonal skills, coupled with evidence\u2010based care for women with HIV during childbirth, could benefit both providers and patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Reporting Method<\/jats:title><jats:p>The study is reported following the Good Reporting of a Mixed\u2010Methods Study (GRAMMS) checklist.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patient or Public Contribution<\/jats:title><jats:p>Patients and the public were not involved in this research.<\/jats:p><\/jats:sec>","DOI":"10.1002\/nop2.70226","type":"journal-article","created":{"date-parts":[[2025,4,15]],"date-time":"2025-04-15T12:22:08Z","timestamp":1744719728000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["<scp>HIV<\/scp> Stigma and Self\u2010Efficacy Caring for Women Living With <scp>HIV<\/scp>: A Mixed\u2010Methods Study of Labour and Delivery Providers\u2014Empirical Research Mixed Methods"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6583-9056","authenticated-orcid":false,"given":"Mariam L.","family":"Barabara","sequence":"first","affiliation":[{"name":"Kilimanjaro Christian Medical University College  Moshi Kilimanjaro Tanzania"},{"name":"Kilimanjaro Clinical Research Institute  Moshi Kilimanjaro Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9198-8610","authenticated-orcid":false,"given":"Susanna R.","family":"Cohen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Utah  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3627-6733","authenticated-orcid":false,"given":"Linda M.","family":"Minja","sequence":"additional","affiliation":[{"name":"Kilimanjaro Clinical Research Institute  Moshi Kilimanjaro Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8485-2021","authenticated-orcid":false,"given":"Virginie","family":"Marchand","sequence":"additional","affiliation":[{"name":"School of Medicine Duke University  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9331-0756","authenticated-orcid":false,"given":"Olivia","family":"Hanson","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences University of Utah  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7708-9360","authenticated-orcid":false,"given":"Gileard G.","family":"Masenga","sequence":"additional","affiliation":[{"name":"Kilimanjaro Christian Medical University College  Moshi Kilimanjaro Tanzania"},{"name":"Kilimanjaro Christian Medical Center Consultant Hospital  Moshi Kilimanjaro Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5550-1916","authenticated-orcid":false,"given":"Blandina T.","family":"Mmbaga","sequence":"additional","affiliation":[{"name":"Kilimanjaro Christian Medical University College  Moshi Kilimanjaro Tanzania"},{"name":"Kilimanjaro Clinical Research Institute  Moshi Kilimanjaro Tanzania"},{"name":"Kilimanjaro Christian Medical Center Consultant Hospital  Moshi Kilimanjaro Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1317-3536","authenticated-orcid":false,"given":"Melissa H.","family":"Watt","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences University of Utah  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,4,15]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/birt.12418"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.midw.2020.102667"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352\u20103018(19)30343\u20101"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.4278\/0890-1171-12.1.8"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2020.02.005"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"e_1_2_13_8_1","unstructured":"Broussard I. 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