Stigma and discrimination against people living with HIV by healthcare providers, Southwest Ethiopia

Stigma and discrimination are major challenges facing People Living with HIV/AIDS (PLWHA) globally due to their HIV status. As part of a larger qualitative study in Yogyakarta and Belu, Indonesia, using in-depth interviews with 92 PLWHA (52 women, 40 men) and 20 healthcare providers, this paper describes perspectives and personal experiences of the 20 healthcare providers, relating to HIV stigma and discrimination toward PLWHA in both study settings. The healthcare providers were recruited from healthcare facilities providing HIV-related healthcare services, using a snowball sampling technique. A qualitative framework analysis was used to guide data analysis. Health stigma and discrimination framework guided the conceptualisation and discussion of the findings. The findings presented the views and perspectives of healthcare providers that HIV stigma and discrimination toward PLWHA still occurred within families, communities and healthcare settings. These were reflected in negative labelling, separation of personal belongings, avoidance, denial of treatment and rejection of PLWHA by healthcare providers, family and community members. Some healthcare providers reported that they had personally stigmatised and discriminated against PLWHA. A lack of knowledge about HIV, fear of contracting HIV, personal values, religious thoughts and sociocultural values and norms, were reported as drivers or facilitators behind this HIV-related stigma and discrimination. The findings indicate the importance of continued HIV/AIDS education for families, community members and healthcare providers, to raise awareness and to ensure that healthy and professional support systems are in place for PLWHA. The findings indicate the need to enhance improvement within the healthcare or HIV care system to adequately address the needs of PLWHA, which may facilitate their early initiation of HIV treatment and better treatment adherence and retention to increase Cluster of Differentiation 4 (CD4) count and suppress viral load. Future studies are also needed to explore the role that government and non-government institutions can play in improving health service delivery for people newly diagnosed with HIV and those living with HIV/AIDS.

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Refused and referred-persistent stigma and discrimination against people living with HIV/AIDS in Bihar: a qualitative study from India

BMJ Open ◽

10.1136/bmjopen-2019-033790 ◽

2019 ◽

Vol 9 (11) ◽

pp. e033790 ◽

Cited By ~ 1

Author(s):

Mohit Nair ◽

Pragya Kumar ◽

Sanjay Pandey ◽

Amit Harshana ◽

Shahwar Kazmi ◽

...

Keyword(s):

Qualitative Study ◽

Hiv Transmission ◽

Healthcare Providers ◽

People Living With Hiv ◽

Hiv Status ◽

Community Members ◽

Universal Precautions ◽

Stigma And Discrimination ◽

Living With Hiv ◽

Hiv Aids

ObjectivesThis study aimed to explore barriers to accessing care, if any, among people living with HIV/AIDS (PLHA) in two districts of Bihar. We also aimed to assess attitudes towards PLHA among healthcare providers and community members.DesignThis qualitative study used an exploratory study design through thematic analysis of semistructured, in-depth interviews.SettingTwo districts were purposively selected for the study, namely the capital Patna and a peripheral district located approximately 100 km from Patna, in order to glean insights from a diverse sample of respondents.ParticipantsOur team purposively selected 71 participants, including 35 PLHA, 10 community members and 26 healthcare providers.ResultsThe overarching theme that evolved from these data through thematic coding identified that enacted stigma and discrimination interfere with each step in the HIV care continuum for PLHA in Bihar, India, especially outside urban areas. The five themes that contributed to these results include: perception of HIV as a dirty illness at the community level; non-consensual disclosure of HIV status; reliance on identifying PLHA to guide procedures and resistance to universal precautions; refusal to treat identified PLHA and referrals to other health centres for treatment; and inadequate knowledge and fear among health providers with respect to HIV transmission.ConclusionsThe continued presence of discriminatory and stigmatising attitudes towards PLHA negatively impacts both disclosure of HIV status as well as access to care and treatment. We recognise a pressing need to improve the knowledge of HIV transmission, and implement universal precautions across all health facilities in the state, not just to reduce stigma and discrimination but also to ensure proper infection control. In order to improve treatment adherence and encourage optimal utilisation of services, it is imperative that the health system invest more in stigma reduction in Bihar and move beyond more ineffective, punitive approaches.

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HIV/AIDS STIGMA AND DISCRIMINATION AMONG THE GENERAL PUBLIC IN SELECTED RURAL COMMUNITY, KANCHEEPRAM DISTRICT, INDIA.

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2016.v9i6.13872 ◽

2016 ◽

Vol 9 (6) ◽

pp. 132

Author(s):

Hema Malini

Keyword(s):

General Public ◽

Rating Scale ◽

People Living With Hiv ◽

Descriptive Research ◽

Stigma And Discrimination ◽

Treatment Services ◽

Aids Stigma ◽

Point Rating Scale ◽

Living With Hiv ◽

Hiv Aids

Community-level stigma and discrimination towards people living with HIV is found all over the world, with people forced to leave their home, change their daily activities such as shopping, socializing or schooling, face rejection and verbal and physical abuse. The objective of the study was to assess the HIV/AIDS stigma among the general public. Quantitative approach and descriptive research design was adopted for the present study. The study was conducted in Vallancherry a selected rural village of Kattankulathur . The sample size for the present study was 300. Three point rating scale was used to assess the HIV/STIGMA and discrimination.The present study findings revealed that among 300 samples none of them reported severe stigma ,50 (16.7%) participants reported moderate stigma and 250 (83.3%) participants reported low stigma. Stigma blocks access to HIV testing and treatment services, making onwards transmission more likely. The removal of barriers to these services is key to end the global HIV epidemic.Key Words : HIV, AIDS, Stigma, Discrimination, Rejection

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The Impact of Stigma and Discrimination on Adherence to Medication amongst People Living with HIV in Tiv Land, North Central Nigeria

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2019/v30i130165 ◽

2019 ◽

pp. 1-9

Author(s):

Godwin Aondohemba Timiun ◽

Timothy J. Scrase

Keyword(s):

People Living With Hiv ◽

Structured Interviews ◽

Hiv Patients ◽

Stigma And Discrimination ◽

Treatment Services ◽

Adherence To Medication ◽

Multi Stage ◽

Living With Hiv ◽

And Control ◽

The Impact

In spite the identification of stigma as a factor impeding public utilisation of HIV counselling, testing, and treatment services in Nigeria, gaps still exist in knowledge on the impact of stigma, and discrimination on adherence to medication amongst people living with HIV (PLWH). This study adopted mixed methods to examine the impact of stigma and discrimination on adherence to medication amongst PLWH in Nigeria. A sample of 1,621 respondents was collected using multi-stage and purposive sampling methods. Structured interviews using questionnaires and in-depth interviews (using a guide) were utilised for data collection. SPSS (version 21) was used for quantitative data analysis while the qualitative data was analysed thematically. There are 46.3% men and 53.7% women respondents. Generally, their income is low, 70.7% are earning less than N25, 000 (approximately $125 USD) per month. Some of the HIV patients are stigmatised. In reaction, they avoid public places, travel long distances away from their immediate community to collect drugs and to avoid been noticed around the centers. They sometimes miss taking drugs regularly as prescribed, suffer depression and die. Stigma and discrimination impede adherence to medication amongst PLHW in Nigeria. More efforts should be made to create awareness to reduce stigma and discrimination of HIV patients, while augmenting their income to meet up with the challenges of adherence to medication. The overall benefits would be enhanced mechanism of HIV prevention, treatment and control in the study area.

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