Date Published: December 10, 2015
Publisher: Public Library of Science
Author(s): Maznah Dahlui, Nazar Azahar, Awang Bulgiba, Rafdzah Zaki, Oche Mansur Oche, Felix Oluyemi Adekunjo, Karuthan Chinna, Anil Kumar.
HIV/AIDS remain a major public health concern in Nigeria. People living with HIV/AIDS (PLWHA) face not only personal medical problems but also social problems associated with the disease such as stigma and discriminatory attitudes. This study provides an insight into HIV/AIDS related stigma and discrimination against PLWHA in Nigeria.
The data for this study was extracted from the 2013 Nigeria Demographic and Health Survey conducted by the National Population Commission. All men and women aged 15–49 years, permanent residents and visitors of the households were eligible for the interview. Several questionnaires were used in the survey, some covering questions on HIV/AIDS.
A total of 56 307 men and women aged 15–49 years participated in this national survey. About half of the population in Nigeria have HIV stigma. Younger persons, men, those without formal education and those within poor wealth index are more likely to have stigma towards PLWHA. In addition, married people are more likely to have stigma on PLWHA and are more likely to blame PLWHA for bringing the disease to the community. Also about half of the population discriminates against PLWHA. However, those with higher levels of education and those from higher wealth index seem to be more compassionate towards PLWHA. About 70% in the population are willing to care for relative with AIDS, even more so among those with higher level of education.
There is a high level of HIV stigma and discrimination against PLWHA in the Nigerian population. Education seems to play a major role in the society with respect to HIV stigma and discrimination against PLWHA. Educating the population with factual information on HIV/AIDS is needed to reduce stigma and discrimination towards PLWHA in the community.
Human Immunodeficiency Virus (HIV) infection and Acquired Immune Deficiency Syndrome (AIDS) remain a major public health problem in Nigeria which is only second behind South Africa in terms of the number of people with HIV/AIDS . Despite of numerous efforts on prevention and treatment of HIV/AIDS, this infection is still an epidemic and affects healthy people as well. One of the most significant challenges for the success in controlling HIV/AIDS infection is stigma and discrimination. Existences of prejudice and discrimination against people with specific diseases have been well established [2–4]. Stigma and discrimination tend to isolate PLWHA from the community and give negative impact on their quality of life [5–7]. Even though the prognosis of PLWHA could be improved with anti-retroviral treatment, they still have to face condemnation and isolation from colleagues, family and community because people around them are conscious about their HIV status . On the other hand, when PLWHA are shown compassion by the community, they are likely to take protective precautions in their sexual behavior  and be more open about their HIV status . This problem of stigmatization and discrimination among PLWHA is particularly more widespread in sub-Saharan Africa including Nigeria, due to the weak health system coupled with poor legal and ethical framework .
The data for this study were taken from the 2013 Nigeria Demographic and Health Survey (2013 NDHS), conducted by the National Population Commission. In this survey, women and men aged 15–49 years of age, permanent residents or visitors of the households were included. A stratified three-stage cluster design was used in this study. Prior to the commencement of the study, a complete listing of the household was obtained. Training on how to use the Global Positioning System (GPS) receiver was delivered to the enumerators .
A total of 56 307 men and women aged 15–49 years had participated in the study. Majority of the participants were aged 21–30 years (34.6%), had secondary education (40.5%), were able to read (62.1%), in the richer wealth index (22.2%), resided in rural areas (59.7%), resided in North West region (24.5%), Christians (51.4%) and were married (61.6%). The socio-demographic characteristics by gender are shown in Table 1.
Negative perceptions towards PLWHA are some of the common manifestations of AIDS stigma which leads to discrimination and prejudice attitudes. Consistent with previous studies [4,17,25,28], our findings showed that there is a high level of stigma and discrimination towards PLWHA in the Nigeria population. Stigma and discrimination could have significant adverse effects on the daily lives of PLWHA. This issue tends to create a hidden epidemic of the disease based on fear, misinformation, socially-shared ignorance and denial [4,29]. In a study conducted by Alubo et al. (2002) , aimed at determining the levels of perception, knowledge and attitude towards PLWHA in the North-central Nigeria, it was found that the level of acceptance was low and the level of rejection was high towards PLWHA by the community members. Findings from the 2002 National HIV and AIDS Household Survey revealed that 80.8% of participants refused to sleep together in the same room with someone who has HIV infection and 94.5% of respondents would not even have conversation with HIV-infected person . Stigma and discriminatory attitudes towards HIV/AIDS lead to secrecy and denial among PLWHA which form catalysts for HIV transmission .
This study observed high discriminatory attitudes and practices towards PLWHA; however about 70% of the population are willing to care for relatives with HIV/AIDS. In order to combat HIV/AIDS epidemic in Nigeria, issues pertaining to stigma and discrimination need to be addressed. Health promotion campaigns should incorporate a shift from fear to care for PLWHA as this is important for effective preventive measures. As stigma and discrimination continues to be a hidden factor that acts as impediment for the effective prevention program, policy makers need to strengthen the HIV/AIDS intervention and health education program in local communities in Nigeria. Educating the population with respect to improve their understanding on HIV/AIDS transmission and control are crucial to reduce this menace in Nigeria. Education and knowledge are believed to be the vanguard for the disease prevention. Behavioral change strategies should be delivered among the population in order to impede the spread of the disease.