There is a lack of high-quality evidence on reducing HIV-related stigma in healthcare, and a need for randomised controlled trials using validated instruments that can measure stigma and discrimination (18).  Nyblade et al note that interventions to address HIV-related stigma in nursing and midwifery practice need to focus on individual, environmental and policy levels (19).   

Nevertheless, there are numerous documented strategies that can help change prejudicial attitudes and promote ethical care of PLHIV:  

• Role modelling and demonstrating kindness, core actions to support care that upholds human rights (20)  
• Educating other healthcare workers and the community about HIV, including training popular opinion leaders (18) 
• Providing education about standard precautions; educational interventions to address HIV-related fear, dispel myths and clarify misunderstandings about transmission risks (21, 22) 
• Leading discussions about ethical issues and providing an open forum for questions and clarification of concerns.  
• Moral consciousness-raising among colleagues about the effects of stigma and discrimination (23) 
• Using HIV-positive speakers in healthcare worker education (24-26). 

Nurses and midwives need to be very mindful of the impact and effects of self-stigma or internalised stigma.  Notably, internalised stigma acts as a barrier to medication adherence and clinic attendance and may have other detrimental effects on the HIV care continuum (27). It is therefore also important to measure stigma to enable us to enact measures to address it, to achieve quality of life and not only treatment goals (28).