scholarly journals HIV stigma in the teaching hospitals in Sana’a, Yemen: a conflict and low-resource setting

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bothaina Ahmed Attal ◽  
Kowthar Mohammed Al-Rowaishan ◽  
Alaa Abdulbaset Akeel ◽  
Fawziah Kassim AlAmmar

Abstract Background HIV stigma undermines a person’s wellbeing and quality of life and hinders HIV control efforts. This study examined the extent and drivers of HIV stigma in the teaching hospitals in Sana’a City, Yemen. The country has low HIV prevalence (4000 (2000-11,000) per 100,000) and limited HIV control funds, worsened by a long conflict and an economic crisis. Methods We conducted a cross-sectional study of 320 Yemeni health professionals in all the four teaching hospitals in Sana’a City. Data were collected anonymously, using an adapted self-completed Arabic version of the Health Policy Project HIV Stigma tool. The questionnaire covered the respondents’ background, the stigmatising practices, and potential personal and professional drivers of stigma. Results The majority of the participants were: females (68%), 20–39 years old (85%), nurses (84%), and holding a nursing diploma (69%) or a bachelor’s degree (27%). None of the hospitals had institutional policies against HIV stigma, and 93% of the participants believed the current infection control measures were inadequate. Less than half of the participants provided care for people living with HIV (PLHIV) (45%), had received HIV training (33%), and were confident that their HIV knowledge was adequate (23%). The majority indicated a preference to test patients for HIV prior to surgical procedures (77%) and disclose positive HIV results to others (99%) without prior knowledge or consent. All the participants had exhibited a form of HIV-related stigmatization, such as avoiding physical contact with PLHIV (87%) or wearing gloves throughout the consultation (96.5%). These practices were significantly correlated with the fear of infection, high perceived risk of infection, and poor work environment (p < 0.05). Conclusion PLHIV face widespread stigmatizing behaviour in the teaching hospitals in Sana’a City, consistent with the higher level of stigma in low HIV prevalence countries and its links to the fear of infection, poor HIV knowledge, and limited funding for HIV control. Stigma reduction interventions are required at institutional and individual levels. In addition, anti-discrimination policies and structural adjustments are needed, in combination with training on HIV and universal precautions, and action to tackle negative attitudes towards PLHIV and key populations.

2009 ◽  
Vol 20 (5) ◽  
pp. 346-350 ◽  
Author(s):  
G Webber ◽  
N Edwards ◽  
I D Graham ◽  
C Amaratunga ◽  
I Gaboury ◽  
...  

Cambodia has one of the highest prevalence rates of HIV in Asia and is scaling up HIV testing. We conducted a cross-sectional survey with 358 health care providers in Phnom Penh, Cambodia to assess readiness for voluntary testing and counselling for HIV. We measured HIV knowledge and attitudes, and predictors of intentions to take a sexual history using the Theory of Planned Behaviour. Over 90% of health care providers correctly answered knowledge questions about HIV transmission, but their attitudes were often not positive towards people living with HIV. The Theory of Planned Behaviour constructs explained 56% of the variance in intention to take a sexual history: the control providers perceive they have over taking a sexual history was the strongest contributor (51%), while social pressure explained a further 3%. Attitudes about taking a sexual history did not contribute to intention. Interventions with Cambodian health care providers should focus on improving skills in sexual history-taking.


Author(s):  
Dharma N. Bhatta ◽  
Jennifer Hecht ◽  
Shelley N. Facente

Background: Stigma and discrimination are major challenges faced by people living with HIV (PLWH), and stigma continues to be prevalent among PLWH. We conducted a cross-sectional study of 584 men who have sex with men (MSM) living with HIV between July 2018 and December 2020, designed to better understand which demographic and behavioral characteristics of MSM living with HIV in San Francisco, California are associated with experience of stigma, so that programs and initiatives can be tailored appropriately to minimize HIV stigma’s impacts. Methods: This analysis was conducted with data from San Francisco AIDS Foundation (SFAF) encompassing services from multiple different locations in San Francisco. Data about the level of HIV-related stigma experienced were collected through a single question incorporated into programmatic data collection forms at SFAF as part of the client record stored in SFAF’s electronic health record. We performed linear regression to determine the associations between self-reported experiences of HIV stigma and other characteristics among MSM living with HIV. Results: HIV stigma was low overall among MSM living with HIV who are actively engaged in HIV care in San Francisco; however, it was significantly higher for the age groups of 13–29 years (adjusted risk difference (ARD): 0.251, 95% CI: 0.012, 0.489) and 30–49 years (ARD: 0.205, 95% CI: 0.042, 0.367) when compared to the age group of 50 years and older, as well as people who were homeless (ARD: 0.844, 95% CI: 0.120, 1.568), unstably housed (ARD: 0.326, 95% CI: 0.109, 0.543) and/or having mental health concerns (ARD: 0.309, 95% CI: 0.075, 0.544), controlling for race, injection history, and viral load. Conclusions: These findings highlight an opportunity to develop culturally, socially, and racially appropriate interventions to reduce HIV stigma among MSM living with HIV, particularly for younger men and those struggling with housing stability and/or mental health.


Curationis ◽  
2018 ◽  
Vol 41 (1) ◽  
Author(s):  
Indiran Govender ◽  
Kathryn Nel ◽  
Nhlanhla Banyini

Background: Sport has the capability to unite a country. To achieve winning teams, athletes have to rely on each other and often have close physical contact. Disclosure of a positive human immunodeficiency virus (HIV) status may be problematic for athletes in contact sports as they may suffer discrimination and stigmatisation which may impact their relationship behaviours. This may impact frontline nursing and medical staff dealing with on-field ‘blood’ injuries.Objectives: The purpose of this study was to determine if individuals who participate in football and rugby are aware of the risk of HIV infection in contact sports and their perceptions and reported behaviour towards HIV-positive athletes.Method: A cross-sectional survey design with a qualitative element. Quantitative data were analysed using descriptive statistics, while thematic content analysis was used to analyse qualitative data.Non-proportional quota sampling was used for male rugby (n = 23) and football (30) players registered at the University of Limpopo (Turfloop campus).Results: The results supported previous research in that there are gaps in HIV knowledge. For instance, not knowing that anal sex may cause HIV infection and believing that saliva can transmit HIV and that blood transfusions are unsafe.Conclusion: Problematic findings were that a portion of the sample believed that having sex with a virgin could cure HIV and the majority of the sample believed that being ‘bewitched’ could cause HIV and acquired immunodeficiency syndrome (AIDS).


Author(s):  
Shihabul Islam ◽  
Shah Ehsan Habib

Background: Rohingyas living in refugee camps of Bangladesh have been identified as a high-risk group for HIV transmission. This study aimed to assess gender differences in risk perception towards HIV/AIDS among Rohingyas in Cox’s Bazar. Methods: A cross-sectional design was adopted to assess the level of risk perception towards HIV/AIDS. This analysis utilizes data from a survey of 130 Rohingya people through face-to-face interviews utilizing a 28-item HIV-Knowledge Questionnaire. A systematic sampling technique was used to accomplish data collection survey. Analyzing was done by SPSS 25. Results: Only 41.8% of males and 58.2% of females had a good knowledge score (8 out of 11 items) regarding the transmission of HIV. Knowledge is significantly associated with female gender (χ2 = 8.927, p < 0.005). Gender differences were also significantly associated with the perceived risk of contracting HIV/AIDS in the future (p < 0.001). When rank averages were investigated, perceived risk of contracting HIV/AIDS score of the female participants (mean rank = 76.71) appeared to be higher compared to the score of male participants (mean rank = 54.29). Conclusion: Female Rohingyas perceive a higher risk of contracting HIV/AIDS than male Rohingyas. Programs should address harmful gender norms, HIV testing and education emphasizing the risks involved in transactional sex within the camps.


Author(s):  
James Prah ◽  
Anna Hayfron-Benjamin ◽  
Mohammed Abdulai ◽  
Obed Lasim ◽  
Yvonne Nartey ◽  
...  

Background: Stigma against people living with HIV (PLHIV) among health workers remains a barrier to the provision of needed care to HIV patients worldwide. We sought to investigate predictors of HIV stigma among health workers in Cape Coast, Ghana. Methods: This was a cross sectional study conducted in three hospitals from November 2016 to February 2017. The study made use of a pre-existing self-administered questionnaire. Multiple regression analysis and Pearson’s coefficient tests were performed to determine the relationship between the dependent variable, stigmatized attitudes of health workers and some independent variables, and to determine which of the independent variables predict stigma amongst health care workers. Results: A total of 331 health workers of different categories participated. Respondents’ personal opinions on HIV, fears/worries of getting infected and category of staff {F(3,327)= 23.934 p<0.00 }, R2 = 0.180) significantly predicted their stigmatizing behaviour. Compared to other health workers, nurses had higher scores for stigmatizing behaviour. Conclusions: the study found evidence of discriminatory and stigmatizing behaviour towards PLHIV by health workers. Stigma reduction programmes aimed at health workers should be strengthened at all health facilities that provide care to PLHIV.


2020 ◽  
Author(s):  
Jochen Drewes ◽  
Phil C. Langer ◽  
Jennifer Ebert ◽  
Dieter Kleiber ◽  
Burkhard Gusy

Abstract HIV-related stigmatization and adversarial growth are known to influence health outcomes in people living with HIV. But not much is known how these psychosocial factors are related to each other and how they interact to influence health outcomes. We tested whether the effect of experienced and internalized stigma on mental health and self-rated health is mediated by adversarial growth, and whether each of these factors is uniquely associated with health outcomes. In our sample of 839 people aging with HIV in Germany based on a cross-sectional study design we did not find an indirect effect of experienced HIV stigma on health outcomes and a very small indirect effect of internalized HIV stigma. All variables were significant predictors of health outcomes in multiple regression analyses.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anju Sinha ◽  
Reynold Washington ◽  
Rajeev Sethumadhavan ◽  
Rajaram Subramanian Potty ◽  
Shajy Isac ◽  
...  

Abstract Background India lacks epidemiological information on the disease burden of pediatric HIV. The National AIDS Control Program (NACP) estimates the numbers of HIV-positive children as a proportion of adult persons living with HIV. A third of HIV-positive children die before their first birthday and a half before they reach their second birthday. The early detection of HIV is crucial for the prevention of morbidities, growth delays, and death among HIV-positive children. Methods The study aimed to estimate the disease burden of pediatric HIV among children in ‘A’ category district of a high HIV prevalence state. An ‘A’ category district is defined by the presence of > 1% HIV prevalence among the general population, as estimated by HIV Sentinel Surveillance. The study used an innovative three-pronged strategy combining cross-sectional and longitudinal methods. The overall burden of pediatric HIV was calculated as a product of cases detected multiplied by a net inflation factor, for each of three strategies. Results The existing pool of HIV infection in the district is estimated to be 3266 (95% CI: 2621–4197) HIV positive children < 15 years of age, in a mid-year (2013) projected child population of about 1.4 million, thus giving an HIV prevalence of 0.23% (CI: 0.19–0.30) among children (0–14 years of age). The proportion of children among all people living with HIV in the district works out to 10.4% (CI: 8.6–13.5%). Conclusions The study estimate of 0.23% HIV prevalence among children (0–14 years of age) is higher than the NACP estimates (0.02) and is 2.5 higher than the Karnataka state estimate (0.09)22. Similarly, the proportion of children among all persons living with HIV in Belgaum district is 10.4% in this study, as against 6.54% for India. The study methodology is replicable for other settings and other diseases.


Author(s):  
Azreen Abdullah ◽  
Adibah Hanim Ismail ◽  
Ching Siew Mooi

Introduction:HIV stigma refers to negative beliefs, feelings and attitudes towards people living with HIV (PLWH), groups associated with PLWH and other key populations at higher risk of HIV infection, such as people who inject drugs, sex workers, men who have sex with men and transgender people. Despite the advancement made in the knowledge and treatment of HIV, PLWH continues to be stigmatized.Objective: To determine the level of HIV stigma and its predictors among people living with HIV/AIDS in a tertiary hospital in Malaysia.Methods: A cross sectional study was conducted among HIV/AIDS patients aged 18 and above at infectious disease clinic in Hospital Sungai Buloh, Gombak, Malaysia. HIV stigma was assessed using Berger’s HIV stigma scale, which is available in Bahasa Malaysia and English.A self-administered questionnaire was used to determine their demographic and clinical characteristics. Multiple linear regression analysis was used to identify the predictors.Results: 526 subjects participated in this study. The mean age of the study population was 33.5± 8.4 years. The majority of the participants were male (90.9%) and contracted HIV through sexual activities (87.8%). The mean score of HIV stigma was 104.7 ± 19.5. Based on multiple linear regression analysis, patients who were unemployed (B = -8.00, 95% confidence interval (CI) = -12.12,-3.88, p = < 0.001) and being on antiretroviral treatment (B = 4.95, 95% (CI) = 0.30, 9.60, p = < 0.037) had higher level of HIV stigma.Conclusions: The level of HIV stigma was high (mean score =104.7 ± 19.5). HIV/AIDS patients who are unemployed and on antiretroviral agents were at risks of having higher level of HIV stigma. Future study is needed urgently to implement intervention that can minimize the stigmatization among patients with HIV/AIDS.International Journal of Human and Health Sciences Vol. 04 No. 01 January’20 Page : 26-35


2019 ◽  
Author(s):  
Yao Yin ◽  
Angela Chia-Chen Chen ◽  
Shaoping Wan ◽  
Hong Chen

Abstract Background The Liangshan Yi Autonomous Prefecture has one of the most serious human immunodeficiency virus (HIV) epidemics in China. Evidence shows HIV-related stigma toward people living with HIV (PLWH) among nurses impedes HIV prevention and treatment. However, only limited research about HIV-related stigma toward PLWH from the perspective of nurses in Liangshan has been conducted. This cross-sectional study aimed to assess HIV-related stigma toward PLWH among nurses and determine factors associated with it in Liangshan, China. Methods Using a stratified, random cluster sampling method, registered nurses (N=1,248; primary hospitals=102, secondary hospitals=592, tertiary hospitals=554) were recruited 10 hospitals in Liangshan. All participants completed an anonymous online survey measuring sociodemographic characteristics, HIV-related stigma and HIV knowledge. We used multiple stepwise regression analysis to examine factors associated with HIV-related stigma toward PLWH among these nurses. Results The mean score of HIV-related stigma among nurses was 50.7 (SD = 8.3; range 25-78). Nurses who were more experienced, had higher levels of education, and were working in tertiary hospitals reported higher level of HIV-related stigma. Those who had better HIV knowledge, reported a willingness to receive HIV-related training, were working in areas that had a high prevalence of HIV, had prior experience working in acquired immune deficiency syndrome (AIDS) specialized hospitals, and worked in hospitals that had policies to protect PLWH showed a lower level of HIV-related stigma toward PLWH. Conclusions Findings suggested that providing culturally congruent education and training about HIV and care, and having hospitals that promoted policies protecting PLWH, may reduce HIV-related stigma toward PLWH among nurses in China.


Author(s):  
Antonia L. Wadley ◽  
Tamar Pincus ◽  
Michael Evangeli

Background: Stigma related to the human immunodeficiency virus (HIV) remains common and has been associated with severity of HIV-related symptoms. Associations between HIV stigma and HIV-related pain, one of the most common symptoms in HIV, have however not been investigated. Data from low back pain populations suggest that stigma is associated with worse pain intensity and so we hypothesised that the same would be the case in HIV.Aim: The goal of this study was to assess the association between HIV stigma and pain intensity in people living with HIV (PLWH) with chronic pain whilst controlling for depression, a well-established correlate of pain.Setting: The study took place at an HIV clinic in Johannesburg, South Africa.Methods: Mediation analysis was used to assess the effect of depression on the relationship between stigma and pain intensity in a cross-sectional cohort of 50 PLWH and chronic pain (pain most days of the week for > 3 months). All participants were assessed using the HIV/AIDS Stigma Instrument – PLWA, an 11-point numerical pain rating scale and the Beck Depression Inventory II.Results: In all, 88% (44/50) of participants reported experiencing some form of HIV stigma (HIV stigma scale score ≥ 1). Worst pain intensity and depressive symptoms individually correlated with total stigma score (Spearman’s r = 0.33, p = 0.02 for both). The mediation analysis highlighted that mediation of the relationship by depression was equivocal (b = -0.002, bootstrapped confidence interval -0.02 to 0.00).Conclusion: Whilst these preliminary data are marginal, they do suggest that associations between HIV stigma and HIV-related pain warrant further investigation. Future study should also include potential mechanisms, which may include mediation through depression.


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