HIV/AIDS Stigma

The objective of this study was to field test tools designed to measure stigma and discrimination against patient with HIV/AIDS in the Kenyan context, focusing on facilities and providers of health services. [adapted from summary]

The Kenya Treatment Access Movement has mobilized healthcare workers from across the country to facilitate formation of a national network for HIV-positive healthcare workers. The network’s mission is to act as an advocate for all healthcare workers living with or affected by HIV, helping to reduce stigma and discrimination, increase their visibility, and expand access to treatment, care, and support services. [from author]

The purpose of this review paper is to provide information and guidance to those in the health care setting about why it is important to combat HIV-related stigma and how to successfully address its causes and consequences within health facilities. [from abstract]

This document discusses the outcomes of a qualitative study to describe the knowledge and practices of private clinic and laboratory service providers regarding HIV and HIV counseling and testing.

The study also identifies the characteristics of the stigma that private service providers place on female sex workers, men who have sex with men, people living with HIV/AIDS and describes the experiences of these groups regarding private counseling and testing services. [adapted from executive summary]

The HIV status of surgeons is a contentious matter in the context of the informed consent obtained from patients. This article presents the results of a survey of the views of practicing surgeons in South Africa regarding aspects of HIV and its impact on surgeons. [adapted from introduction]

This study examined the attitude of health care workers to nurses, doctors and patients infected with HIV. [from abstract]

The toolkit is a collection of participatory educational exercises for educating health care providers on the issues of stigma and gender-based violence. It was developed for and with health care providers in Andhra Pradesh, India. The goal is to facilitate open discussion on HIV stigma and gender violence, and on what health workers can do to promote a change in attitude and practice. [from publisher]

The purposes of this study were to quantify stigma among Rwandan healthcare providers toward patients with HIV/AIDS; to assess healthcare provider fears and perceived risks for HIV while providing services to patients with HIV/AIDS; to quantify practices in hospitals and health centers and among health providers that discriminate against HIV-positive patients; and to evaluate the relationship between provider stigma, provider fears, and perceived risks with discrimination against HIV-positive patients in health facilities and among healthcare providers. [from summary]

HPI conducted a survey in Ukraine to test indicators and questions regarding HIV/AIDS-related stigma and discrimination at the facility/provider level. This research examined HIV/AIDS-related stigma and discrimination by providers of general medical services in three regions in Ukraine. [from summary]

This paper provides a review of the reported barriers that prevent doctors from managing HIV infected patients. The four most commonly reported barriers were: fear of contagion, fear of losing patients, unwillingness to care, and inadequate knowledge /training about treating HIV patients. [from abstract]

This paper reports on AIDS-related stigma baseline findings from a study to evaluate the impact of a stigma-reduction intervention in three large hospitals in New Delhi, India. The study highlights issues particular to the health care sector in limited-resource settings. [from abstract]

The purpose of this study was to assess physicians’ knowledge, attitude and global comfort in caring for patients with AIDS (PWA), to determine the sociodemographic variables that could influence physicians and to identify any relationship between their knowledge, attitude and comfort. The study reinforced the need for an ongoing education focused on experiential learning and professional socialization in order to influence physicians’ attitude and enhance their feeling of comfort when caring for PWA. [adapted from abstract]

Although adequate knowledge about HIV infection and effective antitransmission measures, such as taking universal precautions in the handling of blood and other body fluids, are important factors in minimizing the risk of HIV transmission in the healthcare setting, little has been reported on the knowledge of nurses with regard to HIV infection and their attitude toward patients with AIDS in Iran. The aim of the present study was to assess these matters. [author’s description]

This study conducted structured interviews with 204 health care providers in three public hospitals in Dar es Salaam, Tanzania, to evaluate the prevalence of stigma and discrimination among providers toward people living with HIV/AIDS (PLWHAs) and the factors associated with stigmatizing attitudes. Information on HIV/AIDS-related knowledge, perceived risk of infection, willingness to care, and availability of protective gear was also obtained. [from executive summary]

This toolkit was written for and by HIV trainers in Africa. It has been designed to help trainers plan and organise educational sessions with community leaders or organised groups to raise awareness and promote practical action to challenge HIV stigma and discrimination. [author’s description]

We examined how individual and institutional factors in health care settings affected discrimination toward persons with HIV/AIDS. A representative sample of 1101 Chinese service providers was recruited in 2005, including doctors, nurses, and laboratory technicians. [from abstract]

There is currently a scarcity of research on the nature of HIV/AIDS stigma within the Thai health context. This is problematic given the negative role of stigma in hindering the provision of patient care and treatment. This study used a mixed-method approach to investigate the interrelationships between the stigma of HIV/AIDS and the stigmas relating to its various modes of disease transmission including injection drug use. [from abstract]

This series of 13 short video scenarios (each between 30 seconds and five minutes long) were produced to trigger discussion about common situations in Caribbean health care settings where HIV and AIDS stigma and discrimination may occur and can be prevented. The videos were produced to be used during HIV and AIDS training for health workers at all levels, including physicians, nurses, lab technicians, janitors and receptionists. A companion Facilitator Guide, provides detailed instructions for effective use of each trigger scenario, including suggested discussion questions and activities.

Anecdotal evidence suggests that health-care professionals in Nigeria may discriminate against and stigmatise people living with HIV/AIDS(PLWA). In a study in the August issue of PLoS Medicine, Reis and colleagues set out to characterise the nature and extent of discriminatory practices and attitudes in the health sector, and indicate possible contributing factors and intervention strategies. The study was specifically designed to answer three research questions: are there discriminatory practices in the health sector that affect the health and well-being of PLWA in Nigeria; how receptive are health workers and institutions to treating PLWA; and what underlying factors may contribute to any discriminatory practices? [author’s description]

The checklist is intended as a self-assessment tool for managers to use in gauging how well their facility (hospital, clinic, or department) reaches, serves, and treats HIV-positive patients. This gives managers an opportunity to identify institutional strengths and weaknesses, consider ways to address the weaknesses, and later to assess progress toward PLHA-friendliness. The Checklist is designed in a simple format that can be readily adapted for each unique context. [from introduction]

Hospital managers who used a checklist to assess their facilities’ policies and practices took action to improve staff safety and reduce AIDS-related stigma. Findings suggest that the actions taken, including education, training, policy formulation, and involvement of AIDS NGOs, contributed to improved knowledge, attitudes, and practices among health workers. UNAIDS has recognized the intervention as a best practice, and NACO has endorsed the intervention’s tools and approaches. [author’s description]

Stigma and discrimination are widely recognized as factors that fuel the HIV/AIDS epidemic. Uganda’s success in combating HIV/AIDS has been attributed to a number of factors, including political, religious and societal engagement and openness – actors that combat stigma and assist prevention efforts. Our study aimed to explore perceptions of Uganda-based key decision-makers about the past, present and optimal future roles of FBOs in HIV/AIDS work, including actions to promote or dissuade stigma and discrimination. [from abstract]

The study sought to assess the knowledge of health-care providers about HIV/AIDS, determine the potential for discrimination in the provision of services based on patients’ HIV sero-status and review the factors that may contribute to such attitude. [from abstract]

The manual is designed to help the ILO’s partners understand the issues and apply the ILO Code of Practice on HIV/AIDS and the world of work. The Code is at the core of the ILO’s Programme on HIV/AIDS, providing guidance to governments, employers and workers, as well as other stakeholders, on national action plans and workplace policies and programmes to combat HIV/AIDS.

The objective of this code is to provide a set of guidelines to address the HIV/AIDS epidemic in the world of work and within the framework of the promotion of decent work. The guidelines cover the following key areas of action: prevention of HIV/AIDS; management and mitigation of the impact of HIV/AIDS on the world of work; care and support of workers infected and affected by HIV/AIDS; elimination of stigma and discrimination on the basis of real or perceived HIV status. [from preface]

Using a representative sample of 478 doctors, nurses, and lab technicians working with people living with HIV/AIDS (PLWHA), a cross-sectional study was conducted to assess the impact of the AIDS epidemic on medical care systems and service providers in China. The study findings suggest that improved institutional support for AIDS care at the facility level and HIV-related stigma reduction intervention are crucial to maintain a high quality performance by the workforce in the health care system. [from publisher’s description]

HIV/AIDS provider stigma has been understudied in the context of prevention, testing, and treatment. This article documents the results of a survey of persons associated with HIV/AIDS education, health care, and social service delivery in the Eastern Caribbean.

The integration of HIV-prevention activities into care has received little attention within or outside formal healthcare settings. The contribution of community home-based care services in facilitating disclosure of HIV status and reducing stigma have also not been described. This study examines the community impact of an integrated community home-based care (ICHC) programme on HIV-prevention efforts and disclosure of status. Quantitative data was collected from 363 people living with HIV (PLHIV) and 1 028 members of their micro-communities. [from abstract]

AIDS-related stigma and discrimination is a pervasive problem worldwide. People living with HIV/AIDS (PLHA) in India, as elsewhere, face stigma and discrimination in a variety of contexts, including the household, community, workplace, and health care setting. Research in India has shown that stigma and discrimination against HIV-positive people and those perceived to be infected are common in hospitals and act as barriers to seeking and receiving critical treatment and care services (UNAIDS 2001). Recognizing the need to move beyond documentation of the problem, three New Delhi hospitals; SHARAN, an Indian NGO; and the Horizons Program, with support from the National AIDS Control Organisation (NACO), carried out an operations research project to develop and test responses to hospital-based stigma and discrimination against people living with HIV/AIDS.

The handbook is a resource collection of information sheets and participatory activities for NGOs working on HIV/AIDS who want to work towards a greater involvement of people living with HIV (GIPA) in their work. It aims at sensitising NGOs, building individual skills and organisational capacities so that NGO management, staff and volunteers can discuss and plan together in a participatory way how to meaningfully involve people living with HIV in their organisation. [from introduction]