scholarly journals HIV Stigma and Moral Judgement: Qualitative Exploration of the Experiences of HIV Stigma and Discrimination among Married Men Living with HIV in Yogyakarta

Author(s):  
Dionius B. Mahamboro ◽  
Nelsensius K. Fauk ◽  
Paul R. Ward ◽  
Maria S. Merry ◽  
Theodorus A. Siri ◽  
...  

It is well acknowledged that human immunodeficiency virus stigma (HIV stigma) challenges people living with HIV globally. There is a scarcity of information about determinants of HIV stigma and discrimination among married men in the Indonesian context. This study aimed to explore factors that contribute to stigma and discrimination against HIV-positive men married to women in Yogyakarta, Indonesia. Face-to-face in-depth interviews were conducted to collect data from participants using a snowball sampling technique. A framework analysis was used to guide the analysis of the data. HIV stigma framework was also applied in the conceptualisation and the discussion of the findings. The findings indicate that participants experienced external stigma within healthcare facilities, communities and families. This external stigma was expressed in various discriminatory attitudes and behaviours by healthcare professionals and community and family members. Similarly, participants experienced anticipated stigma as a result of HIV stigma and discrimination experienced by other people living with HIV. Individual moral judgement associating HIV status with amoral behaviours and participants’ negative self-judgement were determinants of perceived stigma. The current findings indicate the need for training programs about HIV stigma issues for healthcare professionals. There is also a need to disseminate HIV information and to improve HIV stigma knowledge among families and communities.

Author(s):  
Nelsensius Klau Fauk ◽  
Karen Hawke ◽  
Lillian Mwanri ◽  
Paul Russell Ward

HIV stigma and discrimination are a major challenge facing people living with HIV (PLHIV) globally. As part of a larger qualitative study with PLHIV in Yogyakarta and Belu, Indonesia, this paper describes the participants’ perceptions about drivers of HIV stigma and discrimination towards them within families, communities and healthcare settings, and highlights issues of HIV stigma as a social process. Participants were recruited using a snowball sampling technique. Data analysis was guided by the framework analysis for qualitative data, and conceptualization and discussion of the study findings were guided by the HIV stigma framework. The findings showed that participants experienced stigma and discrimination across settings, including in families and communities by family and community members, and in healthcare settings by healthcare professionals. The lack of knowledge about HIV, fear of contracting HIV, social and moral perceptions about HIV and PLHIV were perceived facilitators or drivers of stigma and discrimination towards PLHIV. HIV stigma and discrimination were also identified as a process linked to the whole groups of people within families or communities, which occurred within social context in Yogyakarta and Belu. The findings indicate the need for HIV education for family and community members, and healthcare providers to enhance their knowledge of HIV and improve acceptance of PLHIV within families, communities and healthcare settings.


2021 ◽  
Vol 8 ◽  
Author(s):  
Nelsensius Klau Fauk ◽  
Paul Russell Ward ◽  
Karen Hawke ◽  
Lillian Mwanri

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.


2016 ◽  
Vol 21 ◽  
pp. 187-195 ◽  
Author(s):  
Johanna B. Pretorius ◽  
Minrie Greeff ◽  
Fazel E. Freeks ◽  
Annamarie Kruger

Background: The diagnosis of HIV is life-changing that requires people not only to deal with the disease but also to cope with the stigma attached to HIV. People living with HIV (PLWH) as well as their close family members (CFM) are stigmatised; however, CFM also stigmatise PLWH. This interaction affects the relationship between PLWH and their CFM.Aim: To explore and describe the experiences of PLWH and CFM during and after a community-based HIV stigma reduction intervention in both an urban and rural setting in the North-West.Method: A qualitative description approach through in-depth interviews was used in both settings. Purposive sampling was used for the PLWH and snowball sampling for the CFM. Data was analysed using open coding.Results: Both urban and rural groups gained a richer understanding of HIV stigma and how to cope with it. The relationships were enriched by PLWH feeling more supported and CFM realising how they stigmatised PLWH and that they should be more supportive. Leadership was activated in PLWH and CFM through the stigma reduction project that they participated in.Conclusion: No significant differences were found between rural and urban communities, thus the intervention can be implemented with similar results in both settings. The intervention showed positive outcomes for both PLWH and CFM. Bringing PLWH and CFM together during an intervention in an equalised relationship proved to be useful as PLWH felt more supported and CFM showed much more compassion towards PLWH after the intervention.


2020 ◽  
Vol 13 (4) ◽  
pp. 396-401
Author(s):  
Eva Kartika Hasibuan ◽  
Novita Aryani ◽  
Galvani Volta Simanjuntak

People living with HIV/AIDS (PLWHA), battling stigma, discrimination and coping strategies  in  Medan, IndonesiaBackground: People living with HIV/AIDS have a multiple problem, PLWHA has a decreased physical abilities effect immunodeficiency, but also having a psychological and social problems also increase their burden. The health provider should be a place for PLWHA to get the right information about HIV/AIDS, but they follow to stigmatize and discriminate against them.Purpose: To describe coping PLWHA face up to stigma and discrimination in health provider.Methods: A qualitative with a descriptive phenomenological approach with population of this research was people living with HIV/AIDS (PLWHA) in Medan, Indonesia. The number of samples was of 10 respondent  by purposive sampling technique. The criteria of the sample were PLWHA get treatment for ≥ 6 months and able to communication in Indonesia is well. Data collected with in-depth interviews and analysis by  Nvivo version 12.0 trial.Result: Finding that four themes, the first; get stigmatize and discriminate from health workers, second; have a psychological impact, third; continue treatment to the health provider and fourth; Hoping in health services well.Conclusion: People living with HIV/AIDS (PLWHA) in Medan Indonesia still having a positive coping to face stigma and discrimination in health provider and they keep continue to get treatment in health provider.. Keyword: People Living With HIV/AIDS (PLWHA); Battling; Stigma; Discrimination; Coping StrategiesPendahuluan: Pelayanan kesehatan yang seharusnya menjadi tempat orang dengan HIV/AIDS mendapatkan pengobatan dan informasi yang benar mengenai penyakitnya, justru ikut menstigma dan mendiskriminasikan mereka.Tujuan: Untuk menggambarkan stigma, koping dan harapan ODHA di pelayanan kesehatan.Metode: Penelitian kualitatif dengan pendekatan fenomenologi deskriptif dengan populasinya  orang dengan HIV/AIDS (ODHA) di Kota Medan. Jumlah partisipan sebanyak 10 orang yang diambil dengan teknik purposive sampling. Pengumpulan data dengan wawancara mendalam dan data dianalisis dengan menggunakan software N.Vivo versi 12 trial.Hasil: Di dapatkan  empat  tema yaitu 1) Pernah mendapatkan stigma dan diskriminasi dari petugas kesehatan, 2) Pernah mengalalami dampak secara psikologis, 3) Tetap melanjutkan pengobatan ke pelayanan kesehatan, 4) Harapan pada layanan kesehatan.Simpulan: Orang dengan HIV/AIDS ODHA di kota Medan masih memiliki koping yang positif  dalam menghadapi stigma dan diskriminasi sehingga ODHA tetap melanjutkan pengobatan di pelayanan kesehatan. 


2019 ◽  
Author(s):  
Fisaha Tesfay ◽  
Sara Javanparast ◽  
Lillian Mwanri ◽  
Anna Ziersch

Abstract Background In Ethiopia, stigmatizing attitudes towards people living with HIV have reduced over time. This is mainly due to improved HIV knowledge and the expansion of access to HIV care and support services. However, HIV stigma and discrimination remain a key challenge, and have negative impacts on access to and utilisation of HIV services including nutritional programs. A small number of studies have examined the experience of stigma related to nutritional programs provided to people living with HIV, but this is limited. This study explored HIV status disclosure and experience of stigma among people living with HIV enrolled in a nutritional program in HIV care setting in Ethiopia and impacts on program utilisation.Methods and participants As part of a larger study, qualitative in-depth interviews were conducted with 20 adults living with HIV, 15 caregivers of children living with HIV and 13 program staff in the nutritional program in three hospitals in the Tigray region of Northern Ethiopia. Framework analysis was employed to analyse the data and NVivo 11 was used to assist data analysis.Results The study found varying levels of positive HIV status disclosure, depending on who the target of disclosure was. Disclosing to family members was reported to be less problematic by most participants. Despite reported benefits of the nutritional in terms of improving their weight and overall health status, adults and caregivers of children living with HIV revealed experience of stigma and discrimination and fear of discovery of positive HIV status due to: a) nutritional support (Plumpynut/sup) to HIV by the community; b) increased frequency of visits to HIV services.Conclusion There is evidence that enrolment in the nutritional program is associated with increased concern about stigma and discrimination, which in turn negatively affected the utilisation of the nutritional program and HIV service more broadly. Nutritional programs in HIV care should include strategies which take these concerns into account by mainstreaming stigma prevention and mitigation activities. Further research should be done to identify innovative ways of social inclusion to mitigate stigma and improve utilisation.


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