Date Published: July 31, 2017
Author(s): Befekadu S. Wodajo, Gloria Thupayagale-Tshweneagae, Oluwaseyi A. Akpor.
Stigma and discrimination attached to human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) have been recognised as a major obstacle to HIV prevention, treatment, care and support throughout the world. Stigma and discrimination are more devastating when they occur in health care settings where it is least expected.
To explore the factors attributable to stigma and discrimination of people living with HIV in two Ethiopian rural hospitals on what they thought of health care professionals (HCPs) attending to them.
A qualitative exploratory approach was used. Data collection was by means of audio-taped interview and Tesch’s content analysis approach was used. The sample size for this study was determined by saturation of data and consisted of 16 participants who were people living with HIV admitted as inpatients to the two selected hospitals in Amhara region of Ethiopia.
Participants’ views were grouped into: fear of contact, delay of services, substandard services, denial of care, impoliteness of health care providers, breach of confidentiality and poor patient follow-up for persons infected with HIV.
The health care settings have been recognised as one of the contexts where HIV and AIDS-related stigmatisation and discrimination can occur. Hospital policies and institutional support should be tailored to embrace people living with HIV as the provision of institutional support is imperative in creating a good working environment and improving the commitment of HCPs so as to enable them to provide holistic care for people living with HIV and AIDS (PLWHA) without discrimination.
Stigma and discrimination (SAD) of people living with human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) has been a hindrance for prevention, treatment and care.1 HIV and AIDS-related stigmatisation and discrimination jeopardises the fight against the epidemic. Thus, it is imperative that health care policy makers and administrators give due emphasis to HIV and AIDS-related SAD reduction interventions in health care settings to address health care professionals’ (HCPs) negative attitudes and potential biases.2
Though many theories have been applied to health-related behavioural research and designing of behavioural interventions, some argue that there are a limited number of variables that need to be considered in understanding and predicting any given behaviour. They are (1) the Health Belief Model, (2) the Theory of Reasoned Action, (3) the Social Cognitive Theory and (4) The Integrated Theoretical Model. The integrated model has been adopted for this study as illustrated in Figure 1.
Findings from this study demonstrate that elimination of SAD is far from being realised as HCPs are also active participants in promoting SAD among PLWHA. Similarly, Neuman et al.9 affirm these findings that the quality of care is compromised for PLWHA because of stigma. More than three decades after the advent of HIV and AIDS, it still appears as if basic knowledge on transmission of HIV is elusive as participants in the study reported that it appeared HCPs feared casual contact. Previous researchers such as Saki et al.10 and Famoroti et al.11 attested to the fact that HCPs have basic knowledge of HIV transmission but implementation of that knowledge is not always applied.
This study provided evidence that HIV and AIDS-related SAD exits within the selected health care settings. Creation of HIV and AIDS-related institutional policies, strategies, guidelines and protocols is critical in reducing HIV and AIDS-related SAD in health care settings. It is necessary that all HCPs are exposed to timely orientations with regard to hospital policies, strategies, guidelines and protocols prior to assignment to their jobs. This will assist HCPs to deliver quality care and treatment based on the policies, strategies, guidelines and protocols. This will help to reduce discriminatory practices among the HCPs. However, the establishment of the policies, strategies, guidelines and protocols in the health care settings is meaningless unless it is implemented accordingly.14