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Stigma, Discrimination and Associated
Determinants Among People Living With Hiv/aids
Accessing Anti-retroviral Therapy in Ikeja, Lagos
State, Nigeria
Gambo Sidi Ali
Ahmadu Bello University
Abraham Oloture Ogwuche
University of Ilorin
Alexander Idu Entonu
University of Ilorin
Adekunle Kabir Durowade
Afe Babalola University
Research Article
Keywords: Stigma, Discrimination, People living with HIV/AIDs
Posted Date: January 2nd, 2025
DOI: https://doi.org/10.21203/rs.3.rs-5738939/v1
License: This work is licensed under a Creative Commons Attribution 4.0 International License.
Read Full License
Additional Declarations: No competing interests reported.
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Abstract
Discrimination and stigma towards those living with HIV/AIDS (PLWHAs) pose serious obstacles to their
ability to manage their disease and achieve overall wellbeing. These obstacles make it dicult to receive
mental health assistance, prolong social isolation, and impede access to healthcare resources. The
purpose of this study is to look into the types, prevalence, and factors that inuence stigma and
prejudice that PLWHAs in Ikeja, Lagos State, Nigeria, face when they seek antiretroviral therapy (ART).
The study also aims to comprehend the ways in which these experiences impact PLWHAs' mental health
and ability to receive healthcare.
Structured questionnaires were used in this cross-sectional study to gather data from 400 PLWHAs in
Ikeja who were undergoing ART. Aspects of stigma such as negative self-image, disclosure concerns,
personalized stigma, and public attitudes were all included in the questionnaire. The data were
summarized using descriptive statistics, and signicant predictors of discrimination and stigma were
found using logistic regression analysis. The study also looked at how stigma affects mental health and
healthcare access, with an emphasis on identifying important socio-demographic variables that
inuence these outcomes.
The results showed high prevalence of stigma against PLWHAs in Ikeja, in particular, 37.75% of
respondents reported they have encountered stigma associated to HIV while seeking healthcare
services, and 89.75% of respondents said they were aware of this stigma. Furthermore, 52% of
respondents agreed that stigma is exacerbated by the media and societal views, and 45.5% thought that
cultural and religious beliefs affected how PLWHAs were treated in their society. Gender, socioeconomic
class, and educational attainment were found to be signicant predictors of stigma.
In addition, 41.5% of respondents experienced unfavorable views from family or friends, and 48.75% of
respondents felt ashamed or condemned due to their HIV status. Similarly, 64.25% of PLWHAs said
stigma had a major negative impact on their social interactions and mental health, and 65% said stigma
made them decide not to disclose their HIV status. While more than a third, 39.75%, of the respondents
said that stigma made it dicult for them to get ART and other essential medical services, two-thirds,
67%, stated that the attitudes of healthcare providers inuenced their desire to ask for assistance.
The study found widespread stigma and prejudice against PLWHAs with a negative inuence on mental
health and access to healthcare. The study suggests strengthening anti-discrimination laws, holding
frequent training sessions for healthcare professionals, improving education and awareness campaigns,
and increasing support services for PLWHAs in order to solve these problems. Stakeholders can improve
the inclusive and supportive environment for people living with HIV/AIDS by putting these focused
actions into practice, which will eventually improve health outcomes and quality of life. These initiatives
are essential for reducing HIV/AIDS stigma and advancing a more equitable and compassionate society.
INTRODUCTION
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HIV/AIDS stands as a persistent and severe health condition with widespread implications for global
public health. 1,2 recognized by the World Health Organization (WHO) as a worldwide public health
emergency, HIV continues to pose signicant challenges, marking over three decades since its
emergence. This pandemic has inicted devastating consequences, claiming the lives of millions
globally and causing severe harm to countless others. The virus has affected over 75million people
since its onset .1 In the year 2022 alone, 39million individuals were living with HIV, and 1.3million
succumbed to AIDS-related causes worldwide. 1
The impact of HIV/AIDS remains particularly pronounced in the Sub-Saharan region which continues to
bear the brunt of the global HIV/AIDS burden, representing two-thirds of the total cases worldwide.3 HIV
which stands for human immunodeciency virus leads to the disease AIDS (acquired immuno-
deciency syndrome), if left untreated.4 Presently, there are 25million adults and children living with the
virus in this region, constituting nearly 70% of the global gure. The statistics reveal an alarming scenario
with approximately 1.9million new HIV infections and 1.2million AIDS-related deaths reported in Sub-
Saharan Africa 5. Nigeria, within this context, shoulders a signicant portion of the epidemic, hosting an
estimated 3.2million individuals living with HIV, positioning the country among those with the highest
HIV burden globally, second only to South Africa. In 2005, the international community embraced the
goal of universal access to HIV prevention, treatment, care and support by 2010.6,7 National HIV/AIDS
programs must fortify their health systems and remove any obstacles to treatment and preventive
initiatives in order to meet this objective. Nigeria has implemented several measures to stop the spread
of disease.8 People living with HIV/AIDS (PLWHAs) who have taken an HIV test and are on antiretroviral
therapy (ART) have increased signicantly as a result of international initiatives like the US Presidential
Emergency Plan for AIDS Relief (PEPFAR) program. 9 In addition, there are many more antenatal women
with HIV positivity who have received ART to prevent mother to child transmission of HIV.10 The
challenges many of these global and national programs face in a multi-diverse socio-cultural society like
Nigeria are the problems of stigma and discrimination(S&D).11–14 The issues of S&D described by
Jonathan Man 15 as the third phase of the HIV pandemic poses a serious threat to prevention and
treatment. Therefore, for Nigeria to achieve her national policy on HIV/AIDS, aimed at controlling the
spread of the infection and its impact, the issue of S&D needs to be addressed.8,16 Signicant research
and knowledge on HIV related S&D in many ethnic and cultural settings that constitute Nigeria, are
important tool in understanding this “hidden factors” that are impediments to effective prevention and
treatment. Incorporating these ndings into national prevention strategies will go a long way in reducing
the transmission of the virus in the population.17
In 2017, the demand for Anti-Retroviral Therapy (ART) in Nigeria was 1.9million, with over 52% of those
affected receiving treatment. The South-South region had the highest HIV prevalence at 3.1%, while
Lagos state recorded 1.4%. Global efforts to curb HIV have signicantly reduced infection rates,
especially in developed countries, by extending the lives of those infected. Though no cure exists, Highly
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Active Anti-Retroviral Therapy (HAART) has transformed HIV from a terminal illness to a manageable
chronic condition. 22–24
Over the past decade, Nigeria has witnessed notable advancements in curbing the HIV/AIDS
epidemic.25,26 The 2019 National AIDS and Reproductive Health Survey (NARHS) demonstrated a
substantial reduction in the national HIV prevalence, decreasing from a peak of 5.8% in 2001 to 3.1%.27
This accomplishment is largely attributed to impactful interventions such as Behavior Change Programs,
HIV care and support initiatives, Prevention of Mother to Child Transmission (PMTCT), and the
implementation of Highly Active Anti-Retroviral Therapy (HAART).19 HAART treatment primarily aims to
reduce the viral load to undetectable levels, fostering immune reconstitution and notable clinical
improvement. Additionally, HAART has proven effective in preventing opportunistic infections.28–30
Successful outcomes in the management of HIV/AIDS hinge signicantly on adherence to HAART, as
underscored by studies such as Shah (2007) and Giri et al. (2013).
The reported adherence rates to ART medication among people living with HIV (PLHIV) in Nigeria vary
from 44–98%.11,31,32 Factors shown to be associated with good adherence include text message as
reminders, patient selected treatment partners, use of pill box, age and gender. On the other hand,
psychiatric morbidity negatively had adverse impacts on adherence.11 Despite this efforts, HIV/AIDS
stigma continue to re-emerge as a formidable threat, particularly among many Nigerians who lack
awareness of the realities surrounding HIV and AIDS, leading to avoidance and stigmatization of
individuals affected by the virus due to misconceptions about its transmission. This misguided belief
suggests that one can contract the virus through association or close contact with an infected person.33
S&D as described by various sources, represent social barriers that signicantly impact the life
experiences of individuals. The stigma associated with HIV and AIDS tends to marginalize people within
their communities, adversely affecting the overall quality of life for PLHIV. Stigma is often synonymous
with social disgrace. Research indicates that individuals reporting high levels of stigma are more than
four times likely to experience limited access to healthcare. Moreover, HIV and AIDS-related stigma can
give rise to discrimination, such as restrictions on travel, healthcare facility usage, employment
opportunities, and social interactions for PLHIV.13,34, 60
Although there have been few studies as regard stigma and discrimination against individuals living with
HIV/AIDS,35–58 it remains prevalent, impacting their access to care and quality of life. This research aims
to comprehensively explore the knowledge, prevalence, types and determinants of stigma and
discrimination among people accessing Anti-retroviral Therapy (ART) in Ikeja, Lagos State, Nigeria.
This research aims to ll a gap in the literature by exploring the relationship between stigma,
discrimination, and factors affecting access to anti-retroviral therapy (ART) for people living with
HIV/AIDS (PLWHA) in Ikeja, Lagos State, Nigeria. The geographical scope is limited to Ikeja, a prominent
urban area, allowing for an in-depth exploration within a dened locale. It seeks to provide practical
insights for the local healthcare sector, identifying cultural, socioeconomic, and healthcare-related
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inuences that impact PLWHA's well-being. The ndings could guide policymakers and healthcare
professionals in developing inclusive interventions to reduce stigma and improve healthcare practices.
Additionally, the study aims to empower both PLWHA and the wider community by increasing public
understanding and contributing to global efforts against HIV-related discrimination.
METHODOLOGY
This study that was conducted in Lagos State in January 2024, focused on Ikeja, a major economic and
healthcare hub. Despite being the smallest state by landmass, Lagos had a population of 12.7 million in
2019, with Ikeja being home to over 470,200 people.35, 61 Overcrowding, rural-urban migration, and low-
income earners characterize the state. Ikeja’s diverse urban-suburban population and its healthcare
infrastructure, including several busy Anti-Retroviral Therapy (ART) clinics, provide an ideal backdrop to
examine stigma and discrimination among people living with HIV/AIDS (PLWHA). The study aims to
highlight the socio-economic and healthcare challenges affecting access to ART services in this region.
A cross‐sectional hospital‐based study conducted at the Antiretroviral Therapy Centre (ATC) was
employed.Among all adult clients on ART regimen, accessing treatment at any HAART clinic in Ikeja,
Lagos state.
Inclusion criteria
Adult HIV patients 18 years and above
Patients with conrmed HIV-positive status who had received Anti-Retroviral drugs for
at least 1 week prior to the study. This was to allow only established HAART clinic users in the study.
Individuals accessing Anti-retroviral Therapy (ART) services in any HAART clinic within Ikeja, Lagos
state.
Exclusion criteria
Pregnant women
Terminally ill/debilitated patients
Patients on admission
A sample size of 400 was selected using the scher formula. A simple random sampling technique was
used. Out of seven known ART centers, three hospitals were selected using simple random sampling.
The names of all seven centers were written on separate slips of paper, placed in a container, and three
slips were drawn randomly to select Lagos State University Teaching Hospital Ikeja, 661 Nigerian Air
Force Hospital Ikeja, and Primary Health Centre Ogba. For patient selection, a list of all PLWHAs
undergoing ART at these hospitals was obtained using a random number generator, 400 patients were
chosen from these lists to participate in the study, ensuring an unbiased and representative sample.
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Structured questionnaires was administered to individuals accessing ART in Ikeja to gather quantitative
data on their experiences of stigma, discrimination, and related factors. These instruments include
validated scales or items measuring stigma levels, discrimination experiences, and healthcare access
barriers. The socio‐demographic details of the participants was recorded using a pretested
questionnaire schedule. Social stigma related to HIV was assessed using the Berger HIV Stigma Scale.
During the process of patient interaction, queries/questions regarding HIV/AIDS/ART was claried and
solved. Any additional open‐ended responses of the subjects was noted, without further probing.
The Berger Stigma Scale measures HIV-related stigma across four domains: Personalized Stigma,
Disclosure Concerns, Negative Self Image, and Public Attitudes, totaling 40 items. Scores range from 40
to 160, with higher scores indicating greater stigma.62,63 The scale has strong reliability (coecients
0.90-0.96) and takes 15–25 minutes to complete. Knowledge of HIV was assessed through a separate
scoring system, with scores over 60% classied as good knowledge. Ethical clearance was obtained
from the Lagos state university teaching hospital Health Research and Ethics Committee with the Ref.No
LREC/06/10/2499, and informed consent was obtained from participants. Participants were informed of
their right to withdraw from the study at any time without penalty. Research assistants were trained to
ensure condentiality, and no personal identiers were included in the data to prevent stigma.
Data was analyzed using STATA version 11.0, with statistical tests like Chi-squared, t-statistic, and
logistic regression. A p-value of <0.05 was considered signicant. Univariate analysis presented
frequencies, percentages, means, and standard deviations. Knowledge scores were graded, and
associations between stigma, discrimination, and ART accessibility were tested using Chi-square and
logistic regression, with signicance set at p < 0.05.
RESULT
A total of 409 questionnaires were given out and 400 returned indicating a 98% response rate. Univariate
analysis is expressed as frequency tables, mean and standard deviation while bivariate and multivariate
was presented in tables.
The rst section of the nding’s presentation covered the respondents' demographic and socioeconomic
details.
Table1Demographic characteristics of respondents.N= 400
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Variable Frequency Percentage (%)
Age(in years)
<20 6 1.5
20-29 105 26.3
30-39 110 27.5
40-49 107 26.7
≥ 50 72 18.0
Mean Age ± SD 39 ± 11
Gender
Female 201 50.3
Male 199 49.7
Marital status
Single 147 36.8
Married 195 48.8
Separated/Divorced 31 7.7
Widowed 27 6.7
Ethnicity
Yoruba 120 30.0
Hausa 43 10.7
Igbo 121 30.3
Others 116 29.0
Religion
Christianity 308 77.0
Islam 92 23.0
Education status
None 8 2.0
Primary 11 2.8
Secondary 87 21.7
Tertiary 294 73.5
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Occupation
Civil servant 136 34.0
Articer 20 5.0
Trader 168 42.0
Student 28 7.0
Others 48 12.0
Average monthly income (₦)
<50,000 113 28.3
50,000-100,000 71 17.7
100,001-500,000 119 29.7
>500,000 97 24.3
Average monthly income ± SD 301568.1 ± 318389.2
HIV status Disclosure
Undisclosed 215 53.7
Disclosed 185 46.3
Partner’s HIV status
Positive 171 42.8
Negative 110 27.5
Unknown 119 29.7
Duration on ART
< 5 211 52.7
≥ 5 189 47.3
Mean duration on ART ± SD(in years) 5.3 ± 5
Area of Residence
Within Ikeja 148 37.0
Outside Ikeja LGA 173 43.3
Outside Lagos State 79 19.7
From table 1, more than a quarter of respondents were in the 20-29years (26.3%), 30-39years (27.5%),
and 40-49years (26.7%) with a mean of 39 ± 11. Gender distribution shows a near-equal split with 50.3%
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female and 49.7% male. As regards the level of education, more than two thirds of participants (73.5%)
have completed university education, with 2.0% having no formal education. The average monthly
income of the participants varies; smaller proportion earn between ₦50,000 and ₦100,000 (17.7%), while
the bulk earn between ₦100,000 and ₦500,000 (29.7%). The monthly average income is roughly
₦301,568 ± ₦318,389.
Concerning HIV status disclosure, more than one third of participants (46.3%) have declared their status,
compared to over half (53.75%) who have not. For partners' HIV status more than one third (42.75%) of
the participants reported having an HIV-positive spouse. With a mean of 5.3 ± 5 years, the participants'
length of time on ART reveals more than half of participants (52.7%) have been on therapy for less than
ve years.
Awareness and Knowledge of Stigma and Discrimination
Table2Assessment of level of awareness and knowledge regarding stigma and discrimination. N=400
Variable Yes (%)
Are you aware of what stigma related to HIV/AIDS means? 359(89.7)
Have you received information regarding discrimination against PLWHAs? 232(58.0)
Do you know about support services available to address stigma and discrimination
faced by PLWHAs? 187(46.7)
Have you participated in educational programs related to HIV/AIDS stigma and
discrimination? 184(46.0)
Are you aware that reducing stigma could improve healthcare access for PLWHAs? 317(79.3)
Knowledge
Good 160(40.0)
Poor 240(60.0)
Table 2: Among the respondents, 89.7% were aware of what stigma related to HIV/AIDS means,
indicating high awareness levels. However, only 46.7% knew about support services available to address
stigma and discrimination faced by PLWHAs. Additionally, 58.0% had received information regarding
discrimination against PLWHAs, and 46.0% had participated in educational programs related to
HIV/AIDS stigma and discrimination. Furthermore, 79.3% were aware that reducing stigma could
improve healthcare access for PLWHAs. Despite high awareness, more than half (60.0%) of respondents
had poor knowledge overall.
Prevalence of Stigma and Discrimination
Table3Determination of level of prevalence of stigma and discrimination encountered by respondents.
N=400
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Variable Yes
Have you ever been treated differently by healthcare providers due to your HIV status? 155(38.7)
Have you encountered negative attitudes or behaviors from family or friends because of
your HIV status? 166(41.5)
Have you ever felt ashamed or judged because of your HIV status? 195(48.7)
Do you believe there is widespread discrimination against PLWHAs in Ikeja? 192(48.0)
Have you personally experienced verbal abuse or insults related to your HIV status? 127(31.7)
Prevalence
High 81(20.3)
Low 319(79.7)
From table 3 above, more than a third of participants (38.7%) reported being treated differently by
healthcare providers due to their HIV status. Negative attitudes or behaviors from family or friends were
encountered by 41.5% of participants, 48.7% felt ashamed or judged because of their HIV status, and
48.0% believed there is widespread discrimination against PLWHAs in Ikeja. Personal experiences of
verbal abuse or insults related to HIV status were reported by less than a third (31.7%) of respondents.
The prevalence of stigma and discrimination was generally low, with more than two third (79.7%) of
respondents classied as experiencing low prevalence. This classication was based on scoring and
grouping responses into low and high prevalence categories.
Forms of Stigma and Discrimination
Table4shows the different forms of stigma and discrimination experienced by respondents. N=400
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Variable Yes (%)
Have you experienced stigma while accessing healthcare services for HIV/AIDS 151(37.7)
Have you encountered discrimination in educational or workplace settings due to 119(29.7)
Do you perceive media or societal attitudes contribute to stigma associated with
HIV/AIDS 208(52.0)
Do religious or cultural beliefs inuence the treatment of PLWHAs in your community 182(45.5)
Have you witnessed/experience instances where PLWHAs were excluded from
community 129(32.3)
Do you believe poverty or socioeconomic status inuences how PLWHAs are treated 224(56.0)
Have you experienced stigma or discrimination due to gender or sexual orientation 164(41.0)
Do healthcare provider attitudes affect stigma faced by PLWHAs 235(58.7)
Do you think education level or awareness impacts how people treat PLWHAs in Ikeja 278(69.5)
Are political or governmental policies contributing to discrimination against PLWHAs 209(52.3)
Do you perceive the community in Ikeja to hold negative attitudes towards PLWHAs 174(43.5)
Have you observed community-based programs aimed at reducing stigma against
PLWHAs 174(43.5)
Do you believe media representations of HIV/AIDS contribute to negative perception 224(56.0)
Do you think healthcare provider attitudes affect PLWHAs' willingness to seek help 268(67.0)
Do PLWHAs in Ikeja face challenges accessing ART and necessary healthcare service 159(39.7)
Have you or others encountered barriers/diculties accessing healthcare due to your
HIV status? 163(40.7)
Are PLWHAs in Ikeja comfortable disclosing their HIV status to others? 89(22.3)
Does fear of stigma or discrimination inuence the decision to disclose HIV status? 260(65.0)
Have you observed changes in your mental health or self-esteem because of your HIV
status? 219(54.7)
Do you believe stigma signicantly affects the mental well-being and social interactions
of PLHVAs? 257(64.3)
Do you think poverty amplies the stigma experienced by PLWHAs in Ikeja? 248(62.0)
Have you or others encountered barriers/diculties accessing healthcare due to
HIV/AIDS-related stigma? 163(40.7)
Does fear of stigma or discrimination inuence the decision to disclose HIV status? 260(65.0)
Have you observed changes in your mental health or self-esteem because of your HIV
status? 219(54.7)
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Do you believe stigma signicantly affects the mental well-being and social interactions
of PLWHAs? 257(64.3)
Do you think poverty amplies the stigma experienced by PLWHAs in Ikeja? 248(62.0)
Have you noticed differences in the treatment of PLWHAs based on socioeconomic
status? 196(49.0)
Can education and awareness programs substantially reduce stigma and discrimination
related to HIV/AIDS? 283(70.7)
Have educational campaigns in Ikeja shown any impact on reducing stigma against
PLWHAs? 232(58.0)
Have been gossiped about 96(24.0)
Verbally insulted/harassed or threatened 82(20.5)
Husband, spouse, or other household members have been discriminated against 75(18.7)
Sexual rejection 125(31.3)
Excluded from social gatherings 61(15.3)
Excluded from family activities 65(16.3)
Discriminated against by other PLWHAs 52(13.0)
Excluded from religious activities 42(10.5)
From table 4, two third (67.0%) of respondents believe that healthcare provider attitudes affect PLWHAs'
willingness to seek help, highlighting a crucial factor in stigma and discrimination, 69.5% think that
education and awareness impact how people treat PLWHAs in Ikeja. The perception that poverty or
socioeconomic status inuences the treatment of PLWHAs is shared by more than half (56.0%) of
respondents, while the fear of stigma or discrimination affecting the decision to disclose HIV status was
noted by 65.0% of participants. Furthermore, about two third (64.3%) of participants believe that stigma
signicantly impacts the mental well-being and social interactions of PLWHAs and 70.7% agree that
education and awareness programs can substantially reduce stigma and discrimination related to
HIV/AIDS.
Table 4.5Subscale of stigma distribution with Gender
Subscale Mean Score Male Female P (Independent t-test)
Personalized stigma 2.46 ± 2.04 2.29 ± 2.04 2.63 ± 2.02 0.0946
Disclosure concerns 1.43 ± 0.62 1.42 ± 0.60 1.44 ± 0.64 0.7391
Negative self-image 1.68 ± 1.02 1.61 ± 1.07 1.74 ± 0.96 0.1748
Public attitude 6.32 ± 4.43 6.48 ± 4.64 6.15 ± 4.42 0.4760
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The table demonstrated the mean scores for the various HIV/AIDS stigma subscales among participants
who were male and female, as well as the ndings of an independent t-test comparing these scores.
2.46 ± 2.04 was the mean score for personalized stigma. Although the mean score of females was
slightly higher (2.63 ± 2.02) than that of males (2.29 ± 2.04), there was no statistically signicant
difference between the two groups (p = 0.0946).
Participants' average score for disclosure concerns was 1.43 ± 0.62. Regarding these issues, there was
no discernible difference between the male and female participants (1.42 ± 0.60 and 1.44 ± 0.64,
respectively; p = 0.7391).
The mean score for having a poor self-image was 1.68 ± 1.02. The mean score of females was 1.74 ±
0.96, somewhat higher than that of males (1.61 ± 1.07), although this difference was not statistically
signicant (p = 0.1748). The mean score for public attitude was 6.32 ± 4.43. Regarding public attitude,
there was no statistically signicant difference between males (6.48 ± 4.64) and females (6.15 ± 4.42) (p
= 0.4760).
All things considered, these ndings imply that there were no appreciable gender disparities in the
participants' mean scores for personalized stigma, disclosure worries, negative self-image, or public
opinion.
Interpretation of Stigma Subscale Correlations
Table 4.6Correlation between the different subscales of stigma.
Stigma subscale Personalized
stigma Disclosure
concerns Negative self-
image Public
attitude
Personalized
stigma 1
Disclosure
concerns 0.0296 1
Negative self-
image 0.5838 0.1195 1
Public attitude 0.8012 0.0554 0.4698 1
The data reveals signicant relationships between stigma subscales in the study. There is a moderate
positive correlation between personalized stigma and negative self-image at 0.5838, indicating that
higher levels of personalized stigma are associated with more negative self-perceptions. A strong
positive correlation of 0.8012 exists between personalized stigma and public attitude, suggesting that
personal stigma is closely linked to perceptions of societal attitudes. Disclosure concerns show a weak
positive correlation with personalized stigma at 0.0296, and a weak positive correlation with negative
self-image at 0.1195. The strongest correlation is between personalized stigma and public attitude.
Meanwhile, public attitude and negative self-image have a moderate positive correlation of 0.4698, while
disclosure concerns and public attitude show a weak correlation of 0.0554.
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Section E: Factors contributing to Experience of Stigma and Discrimination
Table 4.7Association of socio-demographic parameters of study participant and stigmatization
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Variable Stigmatization χ² P value
High (%) Low (%) Total (100%)
Age
<20 2(33.3) 4(66.7) 6
20-29 34(32.4) 71(67.6) 105
30-39 47(42.7) 63(57.3) 110 3.33 0.504
40-49 35(32.7) 72(67.3) 107
>=50 25(34.7) 47(65.3) 72
Average monthly income (#)
<50,000 105(92.9) 8(7.1) 113
50,000-100,000 38(53.5) 33(46.5) 71 290.74 <0.001
100,001-500,000 0(0.0) 119(100.0) 119
> 500,000 0(0.0) 97(100.0) 97
Gender
Male 77(38.7) 122(61.3) 199 1.49 0.222
Female 66(32.8) 135(67.2) 201
Marital Status
Single 55(37.4) 92(62.6) 147
Married 70(35.9) 125(64.1) 195
Separated/Divorced 10(32.3) 21(67.7) 31 0.78 0.853
Widowed 8(29.6) 19(70.4) 27
Partner’s HIV status
Positive 74(43.3) 97(56.7) 171
Negative 30(27.3) 80(72.7) 110 8.12 0.017
Unknown 39(32.8) 80(67.2) 119
Ethnicity
Yoruba 45(37.5) 75(62.5) 120
Hausa 14(32.6) 29(67.4) 43 0.97 0.808
Igbo 40(33.1) 81(66.9) 121
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Others 44(37.9) 72(62.1) 116
Religion
Christianity 106(34.4) 202(65.6) 308 1.04 0.308
Islam 37(40.2) 55(59.8) 92
Educational status
None 3(37.5) 5(62.5) 8
Primary 4(36.4) 7(63.6) 11 6.57 0.087
Secondary 21(24.1) 66(75.9) 87
Tertiary 115(39.1) 179(60.9) 294
HIV status disclosure
Undisclosed 76(35.4) 139(64.6) 215
Disclosed 67(36.2) 118(63.8) 185 0.03 0.857
Occupation
Civil servant 57(41.9) 79(58.1) 136
Articer 5(25.0) 15(75.0) 20
Trader 54(32.1) 114(67.9) 168 4.21 0.379
Student 10(35.7) 18(64.3) 28
Others 17(35.4) 31(64.6) 48
Area of Residence
Within Ikeja LGA 51(34.5) 97(65.5) 148
Outside Ikeja LGA 58(33.5) 115(66.5) 173 2.31 0.316
Outside Lagos State 34(43.0) 45(57.0) 79
Duration on ART (in years)
<5 75(35.6) 136(64.4) 211 0.01 0.928
≥5 68(36.0) 121(64.0) 189
The partner's HIV status was found to be a signicant variable in the stigmatization analysis. With p =
0.017 and χ² = 8.12, there was clear statistical signicance. This implies that a person's ability to avoid
stigmatization is signicantly inuenced by the HIV status of their partners.
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Additionally, there was an association between respondents' average monthly income and
stigmatization (χ² = 290.74, p <0.001, indicating that socioeconomic position is a key factor inuencing
stigmatization.
However, a number of factors had no statistically signicant association with stigmatization. The χ² =
3.33 and the p=0.504 for age did not indicate an association.
The following factors did not signicantly differ (p > 0.050): gender, marital status, ethnicity, religion,
educational status, disclosure of HIV status, occupation, place of residence, and duration on ART.
Table 4.8Association of socio-demographic parameters of study participants and Discrimination
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Variable Discrimination χ² P value
High (%) Low (%) Total (100%)
Age
<20 0(0.0) 6(100.0) 6
20-29 9(8.6) 96(91.4) 105
30-39 12(10.9) 98(89.1) 110 1.50 0.826
40-49 12(11.2) 95(88.8) 107
≥50 9(12.5) 63(87.5) 72
Average monthly income(#)
<50,000 20(17.7) 93(82.3) 113
50,000-100,000 16(22.5) 55(77.5) 71 33.06 <0.001
100,001-500,000 0(0.0) 119(100.0) 119
> 500,000 6(6.2) 91(93.8) 97
Gender
Male 18(9.0) 181(91.0) 199 0.89 0.345
Female 24(11.9) 177(88.1) 201
Marital Status
Single 12(8.2) 135(91.8) 147
Married 23(11.8) 172(88.2) 195 2.52 0.471
Separated/Divorced 5(16.1) 26(83.9) 31
Widowed 2(7.4) 25(92.6) 27
Partner’s HIV status
Positive 31(18.1) 140(81.9) 171
Negative 4(3.6) 106(96.4) 110 18.80 <0.001
Unknown 7(5.9) 112(94.1) 119
Ethnicity
Yoruba 17(14.2) 103(85.8) 120
Hausa 4(9.3) 39(90.7) 43 3.79 0.285
Igbo 8(6.6) 113(93.4) 121
Page 19/40
Others 13(11.2) 103(88.8) 116
Religion
Christianity 28(9.1) 280(90.9) 308 2.83 0.093
Islam 14(15.2) 78(84.8) 92
Educational status
None 2(25.0) 6(75.0) 8
Primary 0(0.0) 11(100.0) 11
Secondary 9(10.3) 78(89.7) 87 3.08 0.379
Tertiary 31(10.5) 263(89.5) 294
Table 4. 8 continued
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Variable Discrimination χ² P value
High (%) Low (%) Total (100%)
Status disclosure
Undisclosed 16(7.4) 199(92.6) 215
Disclosed 26(14.1) 159(85.9) 185 4.63 0.031
Occupation
Civil servant 18(13.2) 118(86.8) 136
Articer 6(30.0) 14(70.0) 20
Trader 13(7.7) 155(92.3) 168 13.82 0.008
Student 0(0.0) 28(100.0) 28
Others 5(10.4) 43(89.6) 48
Area of Residence
Within Ikeja LGA 21(14.2) 127(85.8) 148
Outside Ikeja LGA 11(6.4) 162(93.6) 173 5.69 0.058
Outside Lagos State 10(12.7) 69(87.3) 79
Duration on ART
<5 23(10.9) 188(89.1) 211 0.08 0.782
≥5 19(10.0) 170(90.0) 189
The average monthly income has an association with discrimination among the factors analyzed. With p
<0.001 and χ² = 33.06 there was clear statistical signicance. This implies that people's experiences of
discrimination are signicantly inuenced by their nancial levels.
The presence of HIV in a partner was also signicantly associated with discrimination (χ² = 18.80, p
<0.001). This suggested that a person's ability to avoid discrimination is signicantly inuenced by their
partner's HIV status. Another variable that showed statistical signicance in relation to discrimination
was status disclosure (χ² = 4.63, p = 0.031). This suggests that a person's chance of facing
discrimination is greatly impacted by whether they disclose their HIV status.
It was also found that discrimination was associated with occupation (χ² = 13.8243, p = 0.008) indicating
that occupational status has an effect on experiences of discrimination.
However, several factors (including age, marital status, religion, ethnicity, educational attainment, place
Page 21/40
of residence, and duration on ART) did not show statistically signicant differences from one another
when it came to discrimination (p value > 0.05).
Table 4.9Association of socio‐demographic parameters of study subjects with Stigmatization (Logistic
Regression analysis) N=400
Page 22/40
Variable Stigmatization
OR [95% Conf. Interval] P>z
Age (years)
<20 Reference
20-29 50.41(1.66185 - 1529.633) 0.024
30-39 44.82(1.607253 - 1249.628) 0.025
40-49 7.56(0.335789 - 170.0604) 0.203
>50 5.92(0.256746 - 136.8447) 0.267
Gender
Female Reference
Male 1.22(0.451968 - 3.295689) 0.694
Marital Status
Single Reference
Married 2.30(0.494824 - 10.70581) 0.288
Divorced 2.14(0.313285 - 14.66395) 0.437
Widowed 1.68(0.088629 - 31.76929) 0.730
Ethnicity
Yoruba Reference
Hausa 0.10(0.016882 - 0.619667) 0.013
Igbo 1.57(0.356462 - 6.931393) 0.550
Others 1.11(0.310046 - 3.975394) 0.872
Religion
Christianity Reference
Islam 2.34(0.56546 - 9.66315) 0.241
Educational Status
None Reference
Primary 0.06(0.000758 - 4.869785) 0.21
Secondary 0.28(0.007398 - 10.97426) 0.500
Tertiary 0.38(0.010955 - 12.88153) 0.587
Page 23/40
Occupation
Civil servant Reference
Articer 0.83(0.024666 - 28.21668) 0.920
Trader 0.72(0.08047 - 6.462311) 0.770
Student 0.42(0.123071 - 1.40783) 0.159
Place of residence
Within Ikeja Reference
Outside Ikeja LGA 1.39(0.478736 - 4.049149) 0.543
Outside Lagos State 4.75(1.085868 - 20.8087) 0.039
HIV status disclosure
Undisclosed Reference
Disclosed 4.37(1.406066 - 13.56713) 0.011
Table 4. 9 continued
Variable Stigmatization
OR [95% Conf. Interval] P>z
Partner’s Status
Positive Reference
Negative 0.61(0.18053 - 2.091202) 0.436
Unknown 0.70(0.138353 - 3.495726) 0.659
Years you have been on ART
< 5 Reference
≥ 5 0.88(0.276574 - 2.793859) 0.827
Average monthly Income(₦)
< 50,000 Reference
50,000-100,000 0.03(0.007962 - 0.110472) <0.001
100,001-500,000
> 500,000
Page 24/40
Table 4.9 highlights several statistically signicant variables associated with stigmatization. Individuals
aged 20-29 years have a signicantly higher likelihood of experiencing stigmatization with an odds ratio
(OR) of 50.41 (95% CI: 1.66 - 1529.63, P=0.024), and those aged 30-39 years have an OR of 44.82 (95%
CI: 1.61 - 1249.63, P=0.025). Ethnicity also plays a role, as Hausa individuals are less likely to experience
stigmatization with an OR of 0.10 (95% CI: 0.02 - 0.62, P=0.013). Those living outside Lagos State have
an increased likelihood of stigmatization, with an OR of 4.75 (95% CI: 1.09 - 20.81, P=0.039). Disclosure
of HIV status signicantly affects stigmatization, with disclosed individuals having an OR of 4.37 (95%
CI: 1.41 - 13.57, P=0.011). Additionally, individuals with an average monthly income of ₦50,000-
₦100,000 are signicantly less likely to experience stigmatization, with an OR of 0.03 (95% CI: 0.008 -
0.11, P<0.001).
Table 4.10Association of socio‐demographic parameters of study subjects with Discrimination
(Logistic Regression analysis) n=400
Page 25/40
Variable Discrimination
OR [95% CI] P>z
Age
>20 Reference
20-29 1.78(0.290562 - 10.88299) 0.533
30-39 0.70(0.178499 - 2.752831) 0.611
40-49 0.80(0.249451 - 2.565658) 0.707
>50
Gender
Female Reference
Male 0.33(0.136237 - 0.789087) 0.013
Marital status
single Reference
Married 1.57(0.417577 - 5.88339) 0.505
Divorced 5.34(0.944528 - 30.16217) 0.058
Widowed 0.76(0.084505 - 6.916386) 0.811
Ethnicity
Yoruba Reference
Hausa 0.21(0.040554 - 1.105638) 0.066
Igbo 0.39(0.120352 - 1.278844) 0.121
Others 0.59(0.213736 - 1.615236) 0.303
Religion
Christianity Reference
Islam 1.59(0.596543 - 4.232781) 0.354
Level of Educational
None Reference
Primary
Secondary 0.13(0.013472 - 1.167885) 0.068
Tertiary 0.12(0.012748 - 1.041251) 0.054
Page 26/40
Occupation
Civil servant Reference
Articer 11.28(2.180583 - 58.30819) 0.004
Trader
Student 0.50(0.201388 - 1.217385) 0.126
Others
Area of residence
Within Ikeja Reference
Outside Ikeja 0.35(0.132875 - 0.904878) 0.030
Outside Lagos 0.76(0.265375 - 2.194287) 0.616
Status disclosure
Undisclosed Reference
Disclosed 1.81(0.750922 - 4.386543) 0.186
Table 4.10 continued
Page 27/40
Variable Discrimination
OR [95% CI] P>z
Partner’s status
Positive Reference
Negative 0.11(0.029828 - 0.441713) 0.002
Unknown 0.72(0.203469 - 2.543071) 0.609
Duration on ART
<5 years Reference
>=5 Years 1.57(0.55778 - 4.428542) 0.392
Average monthly Income(₦)
< 50,000 Reference
50,000-100,000 1.28(0.516153 - 3.151279) 0.598
100,001-500,000
> 500,000 0.13(0.032582 - 0.487093) 0.003
Table 4.10 highlights several statistically signicant variables associated with discrimination. Males are
less likely to experience discrimination with an odds ratio (OR) of 0.33 (95% CI: 0.14 - 0.79, P=0.013).
Occupation as an articer signicantly increases the likelihood of discrimination, with an OR of 11.28
(95% CI: 2.18 - 58.31, P=0.004). Residing outside Ikeja is associated with a decreased likelihood of
discrimination, with an OR of 0.35 (95% CI: 0.13 - 0.90, P=0.030). Having a partner with a negative HIV
status signicantly reduces the odds of discrimination, with an OR of 0.11 (95% CI: 0.03 - 0.44, P=0.002).
Finally, an average monthly income of over 500,000 also signicantly lowers the likelihood of
experiencing discrimination, with an OR of 0.13 (95% CI: 0.03 - 0.49, P=0.003).
DISCUSSION
This study assessed the level of knowledge and HIV-related stigma and discrimination faced by people
living with HIV/AIDS in Ikeja local government, Lagos state. The report reveals that majority (89.75%) of
participants are aware of the stigma associated with HIV/AIDS, 60% possess only a limited
understanding of the issue. This aligns with previous studies showing that although awareness is high,
detailed comprehension of stigma and active involvement in educational programs remain low. The high
rate of stigma and discrimination against people living with HIV/AIDS (PLWHAs) in Ikeja highlights the
complex interactions between institutional operations, cultural norms, and societal views. 61, 62, 64, 65
Page 28/40
A signicant portion of participants reported experiencing stigma in healthcare settings, which reects
ongoing challenges faced by PLWHAs in accessing healthcare services.66, 67These ndings are
consistent with prior research, indicating that negative attitudes from healthcare providers discourage
PLWHAs from seeking medical attention, worsening their healthcare outcomes. 57,68–70 Discrimination is
also widespread in the workplace and educational institutions71, which echoes research demonstrating
how HIV stigma inltrates multiple areas of life, affecting the opportunities and well-being of
PLWHAs.73,74
Media portrayals were also cited as contributors to HIV stigma, reinforcing negative stereotypes and
societal prejudices. This underscores the role of public perception in perpetuating stigma. Religious and
cultural beliefs were identied by many respondents as signicant factors inuencing attitudes toward
PLWHAs. These cultural stigmas pose serious barriers to acceptance and support, further isolating
PLWHAs from social and community activities. This social isolation is a recurring theme in HIV stigma
studies, as it exacerbates the emotional and psychological toll on affected individuals. 74–78
Economic factors were also identied as contributors to stigma. Many participants believed that poverty
worsens the stigma associated with HIV, a viewpoint supported by research indicating that PLWHAs with
lower socioeconomic status are more vulnerable to discrimination. The report highlights the potential of
educational initiatives to reduce stigma, with respondents recognizing that increased awareness and
understanding can foster more accepting attitudes and behaviors toward PLWHAs. This reinforces
previous ndings showing that educational efforts can challenge stereotypes and improve public
perceptions.74-79
The study’s ndings align with broader research on HIV-related stigma and discrimination, emphasizing
the importance of continuous efforts in community support, legislative reform, and education to address
these issues. The regularity of stigma and discrimination reported by participants reects the broader
dynamics of HIV-related stigma. Family, friends, and healthcare providers were common sources of
stigma, which can lead to feelings of guilt, rejection, and condemnation among PLWHAs. These
experiences have a signicant impact on their quality of life and mental health, underscoring the critical
need to address stigma in HIV/AIDS care. 80,81
Interestingly, the study found a lower prevalence of overt discrimination and verbal abuse, which
contrasts with some literature suggesting these forms of discrimination are more widespread. This
discrepancy may stem from cultural differences in how stigma is perceived and expressed, as well as
potential improvements in Ikeja’s efforts to reduce stigma. However, the mixed views on stigma indicate
the complexity of HIV-related discrimination, highlighting the need for ongoing research and locally
tailored solutions.83
The report provides valuable insights into the different dimensions of stigma faced by PLWHAs, as
shown by the stigma subscales in Tables4.5 and4.6. These subscales—Personalized Stigma, Disclosure
Concerns, Negative Self-Image, and Public Attitude—offer a comprehensive understanding of the stigma
Page 29/40
phenomenon and its impact on PLWHAs in Ikeja.This subscale measures internalized stigma, also
known as self-stigma, which is the experience of feeling guilty, ashamed, or having a bad self-image due
to one's HIV status. Studies on self-stigma in HIV-positive communities in Abeokuta, Nigeria; Tamil Nadu,
India, conrms the idea that women may internalize negative societal attitudes more thoroughly than
men, as seen by the somewhat higher ratings among females 36,59,85.
Perceptions of how the general public perceives and handles individuals living with HIV/AIDS are
measured by this subscale. A strong conviction that the public has negative attitudes towards people
living with HIV, which are a result of social prejudice and misinformation, is indicated by high scores on
this subscale. Numerous studies support these conclusions, showing that stigma from the public still
poses a serious obstacle to the quality of life for those living with HIV 56,86,87.
The ndings from the subscale analysis are logical and align with current research on HIV stigma.
Personalized Stigma, Disclosure Concerns, Negative Self-Image, and Public Attitude are all critical
dimensions that impact the lives of individuals with HIV. These dimensions help to pinpoint areas where
interventions can be most effective, such as public education to reduce societal stigma and supportive
services to help individuals cope with internalized stigma. The gender differences observed, though not
always statistically signicant, highlight the need for gender-sensitive approaches in addressing HIV-
related stigma. These insights are invaluable for developing comprehensive strategies to combat stigma
and improve the well-being of people living with HIV/AIDS 88,89. The data showed that, in comparison to
people under 20, those in the 20–29 and 30-39 age groups are substantially more likely to encounter
stigma. This result is in line with the theory that widespread assumptions and misconceptions regarding
the lifestyles of younger PLWHA contribute to their increased social stigma. Youth are sometimes
unfairly condemned for imagined acts that may have contributed to their HIV status in many nations,
including Nigeria. Cultural norms that stigmatize drug use and premarital sexual activity, both of which
are frequently (and often incorrectly) linked to HIV transmission, may be the root cause of this age-
related stigma 90.
Additionally, younger PLWHA may lack the social support systems that older individuals might have,
exacerbating their vulnerability to stigma. The absence of strong family or community support can leave
younger individuals feeling isolated and more susceptible to negative societal attitudes. This pattern
aligns with previous research indicating that younger people with HIV face more pronounced stigma,
making targeted interventions for this age group crucial.
Gender emerged as a key inuence in discrimination but not in Stigma. It was discovered that the
likelihood of discrimination was far lower for men than for women. This demonstrates the relationship
between gender-based discrimination and HIV-related stigma. HIV-positive women frequently bear a dual
burden: they are discriminated against because of their gender identity and stigmatized for having the
virus 91,92.
Page 30/40
Women may experience more severe societal repercussions and are frequently held responsible for HIV
transmission within their families in many countries, including Nigeria. This social guilt can show up as a
variety of discriminatory experiences, such as being neglected in medical settings or being shunned by
the community. This research emphasizes how gender-sensitive strategies are necessary to combat HIV-
related prejudice and make sure that women's particular needs are met.
Looking at different forms of stigmatization across gender distribution females living with HIV/AIDS in
Ikeja experience slightly higher personalized stigma (mean score: 2.63) compared to males (2.29),
though the difference is not statistically signicant (P = 0.0946). This might be due to societal
expectations placing more pressure on women. Disclosure concerns were nearly identical for both
genders, suggesting a shared fear of stigma (P = 0.7391). Negative self-image scores were also similar,
indicating internalized stigma affects both sexes equally (P = 0.1748). Public attitude scores were high
across the board, reecting widespread societal stigma (P = 0.4760). These rational conclusions are
consistent with recent research showing that stigma associated to HIV affects men and women in a
similar way, highlighting the widespread nature of stigma irrespective of gender 93,94.
While marital status was not signicantly associated with stigma or discrimination in this study, divorced
individuals had higher, though not statistically signicant, odds of experiencing both. This points to an
intricate relationship in which other variables, such as social support and nancial stability, interact with
married status to predict stigma and discrimination rather than stigma or discrimination alone 95–97.
PLWHA who are divorced or alone may face more stigma and discrimination as a result of losing their
spouse's support, which can be an important defense against negative societal perceptions.
Furthermore, societal standards that stigmatize divorce or singlehood may make it harder for PLWHA to
overcome these obstacles.
Religion and ethnicity were signicant factors in stigma experiences. Those who identied as Hausa
were much less likely than Yoruba people to face stigma. This might be explained by the different
cultural perspectives that various ethnic groups have on HIV/AIDS. Communities that have more robust
support networks within the community and less judgmental views towards disease, for instance, may
create more conducive circumstances where stigma is less common.
Religion, although not signicantly associated with stigma or discrimination in this study, still showed
trends where individuals practicing Islam had higher odds of stigma. This nding suggests that religious
beliefs and community practices might inuence how HIV/AIDS is perceived and how individuals are
treated. Previous studies have shown mixed results regarding the role of religion, indicating that it can
either mitigate or exacerbate stigma depending on the religious context and its teachings about illness
and morality 76,77,98.
Higher educational attainment was signicantly associated with lower odds of experiencing
discrimination. This suggests that education can serve as a protective factor, possibly because educated
individuals are better equipped to understand HIV/AIDS, advocate for their rights, and navigate
Page 31/40
healthcare systems. Education might also foster more progressive attitudes towards HIV, reducing the
likelihood of discriminatory behavior from others.
This is consistent with the larger body of literature that emphasizes the value of education in
empowering people and lowering stigma and discrimination associated with health issues. Additionally,
those with higher levels of education might have easier access to social networks and resources that
help lessen the negative effects of discrimination 34,99.
Experiences of prejudice were strongly inuenced by occupation, with artisans experiencing much
greater odds than civil servants. This draws attention to the occupational vulnerabilities that some
occupations have, especially those that are less stable and have a lower social status, which might make
people more vulnerable to discrimination.
Workplaces with pervasive prejudice toward HIV/AIDS or without policies protecting PLWHA can provide
as fertile grounds for discrimination. This research highlights the signicance of workplace interventions
and regulations that safeguard the dignity and rights of PLWHA, guaranteeing equitable support for all
occupational groups 71,76,100.
Both stigma and discrimination were inuenced by geographic location. Outside of Ikeja, people were
more likely to face stigma than outside of Lagos State, where prejudice was less likely to occur. This
regional discrepancy may result from differing HIV/AIDS knowledge, resources, and support networks in
various areas.
It's possible that urban regions like Ikeja have stronger support networks and healthcare infrastructures,
which lessen discrimination. On the other hand, stigma associated with HIV/AIDS may be higher in rural
or less urbanized areas due to stronger traditional beliefs and limited access to factual information
101,102.
Disclosure of HIV status was substantially linked to increased risk of stigma. This research emphasizes
the two-edged sword of disclosure: although it is necessary to obtain assistance and medical care, it can
also subject people to stigma from society. People frequently avoid declaring their status out of fear of
stigma, which can make it more dicult for them to get the support and treatment they need 56,103. This
conclusion supports the necessity for safe disclosure contexts that shield people from stigma. Previous
research has shown that disclosure can have detrimental societal implications.
The likelihood of facing stigma and discrimination was much decreased if one's partner's HIV status was
unknown or negative. This implies that the social dynamics and support networks accessible to PLWHA
can be impacted by the partner's status. Partners who do not know their status or who are HIV-negative
may offer stronger support, lessening the negative effects of discrimination and stigma in society. The
suffering of having been infected by a positive spouse may, despite the appearance of normalcy,
intensify discrimination and stigma amongst Sero concordant couples 104,105.
Page 32/40
There was a strong association found between higher income and a decreased likelihood of
discrimination and stigma. This emphasizes how stable economies provide protection against stigma
and discrimination, since those with higher wages may have better access to healthcare, social services,
and educational opportunities.
In line with the larger body of research on the protective benets of socioeconomic position, economic
empowerment can give PLWHA the means to stand up for their rights, get better healthcare, and create
supportive social networks 106,107
CONCLUSION
The study concludes that stigma and prejudice against PLWHAs are still pervasive in Ikeja and have an
impact on their general well-being, social inclusion, and access to healthcare. The diculties that
PLWHAs confront are mostly caused by socioeconomic issues, stigmas associated with culture and
religion, and unfavorable attitudes from healthcare professionals. Even though stigma-related problems
are becoming more widely recognized, there is still a signicant need for improved education and
focused treatments to deal with these problems. The results are consistent with previous research,
which emphasizes the necessity for a multifaceted strategy to counteract stigma and discrimination
connected to HIV.
Abbreviations
AIDS Acquired immune deciency syndrome
ART Anti-Retroviral Therapy
ATC Antiretroviral Therapy Centre
HAART Highly Active Anti-Retroviral Therapy
HIV Human immunodeciency virus
NARHS National AIDS and Reproductive Health Survey
PEPFAR US President’s Emergency Plan for AIDS Relief
PLHIV People Living with HIV
PLWHA People Living With HIV/AIDS
PMTCT Prevention of Mother to Child Transmission
Declarations
Page 33/40
Ethical Approval and Consent to participate: ethical approval was obtained from the health research and
ethics committee Lagos state university teaching hospital (LASUTH)
Consent for publication: All authors agreed to publish this article
Competing interests: The authors declare that they have no competing interests
Funding: No funding was received for this study
Authors' contributions: GSA conceptualised the study; all authors were involved in the literature review;
AOO analysed the data from the eld; All authors wrote the nal and rst drafts. All authors read and
approved the nal manuscript.
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