HIV/AIDS-Related Stigma and Discrimination: A Study of Health Care Providers in Bangladesh

Centre for Migration and Refugee Studies (CMRS), The American University in Cairo, Cairo, Egypt, .
Journal of the International Association of Physicians in AIDS Care (JIAPAC) 03/2011; 10(2):97-104. DOI: 10.1177/1545109710381926
Source: PubMed


People living with HIV/AIDS (PLWHA) are stigmatized and looked at negatively by people at large. Stigma, discrimination, and prejudice extend its reach to people associated with HIV-positive people such as health providers, hospital staff, as well as family member and friends. Studies demonstrate that, in low-income countries, especially in South Asia and sub-Saharan Africa, health providers' views toward the HIV-positive individuals is not very much different from the general population. The study has been qualitative in nature and conducted among health providers such as physicians and nurses attached to different hospitals. The study was conducted from March 2005 to May 2007. The study shows that 80% of the nurses and 90% of the physicians' behavior with the HIV-positive individuals were discriminatory. They talk to their patients standing far from them. The interview revealed that the spouses of the physicians and nurses in charge of the HIV-positive individuals put pressure to stop serving the patient or even quit the job. The notion that HIV is only transmitted through sexual activities is prevalent among them. Interestingly, although the physicians know well about the routes of transmission, they do not believe it by heart. Therefore, their fear of being infected makes them discriminate against the HIV-positive individuals. HIV-related stigma remains a barrier to effectively fighting this pandemic. Fear of discrimination often prevents people from seeking treatment publicly. There are evidences that they were evicted from home by their families and rejected by their friends and colleagues. The stigma attached to HIV/AIDS can extend into the next generation, placing an emotional burden on them.

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Available from: AKM Ahsan Ullah, Sep 27, 2014
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    • "In this way, HIV is considered highly polluting and threatens not only public health, but the extant social order. The findings from this study support the strong sense of sexual " morality " in Bangladeshi society in which premarital and extramarital sexual relations are strictly prohibited, with real consequences for individuals and families (Ullah, 2011). The data reveal that the experiences of stigma and discrimination of HIV-positive parents are heavily influenced by the socio-cultural meanings of HIV that are constructed through interactions with families, extended families, and community members. "
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    ABSTRACT: With much of the focus on the “risk” groups, families have often been less studied in HIV research. Further, because of a focus on the aetiology and epidemiology of HIV, the social impacts associated with HIV on families and neighbours are sometimes overlooked. This study examined parental experiences of stigma and discrimination while living with HIV within a family context in Bangladesh. A qualitative research design using a grounded theory approach was used for this research. Data was collected through in-depth interviews with 19 HIV-positive parents, recruited with the support of two self-help groups of HIV-positive people, in two settings namely Khulna and Dhaka in Bangladesh. The findings indicate that HIV-positive parents held the view that they continue to experience significant stigma and their narratives clearly show how this affected them and their children. A range of informal practices were enacted in everyday contexts by extended family and community members to identify, demarcate and limit the social interaction of HIV-positive parents. Parents highlighted a number of factors including negative thoughts and behaviours, rejection, isolation and derogatory remarks as manifestations of stigma and discrimination, impacting upon them and their children because of their association with HIV. 
    Full-text · Article · Aug 2015 · AIDS Care
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    • "Similarly, Ullah (2011) found that 80% of the nurses and 90% of the physicians' behavior toward HIV-positive individuals were discriminatory. Interestingly, Ullah (2011) also found that when talking to the patients, the health personnel stood far from them. As opined by Letamo (2005), usually health care personnel who have negative feelings toward persons with HIV may discriminate against them either overtly or covertly. "
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    ABSTRACT: Drawing on Earnshaw and Chaudoir's HIV stigma framework, this study explored the experiences of persons living with HIV and AIDS regarding stigmatization and discrimination in accessing health services. Using a qualitative research methodology, 42 participants were purposively recruited during support group meetings of persons living with HIV and AIDS (PLWHA) at Amasaman in Accra, Ghana. Four focus group discussions (n = 22) and 10 in-depth interviews were conducted. Discussions and interviews were audio-taped, transcribed, and categorized based on the objectives of the study. The findings indicated that PLWHAs had knowledge of stigma that was experienced through enacted, anticipated, and internalized stigma mechanisms. Evidence showed that PLWHA did not experience stigma and discrimination when they accessed services at the Korle-Bu Teaching Hospital, the largest hospital in Ghana. However, the situation was different when they accessed services at other public health facilities. Based on the findings, implications are discussed for policy, social work, and public health practices.
    Full-text · Article · Mar 2015 · Social Work in Health Care
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    • "The issue has grown in importance in the light of literature showing that 80% of the nurses' and 90% of the physicians' behavior with the HIV-positive individuals were discriminatory (Ullah 2011). HIV-infected patients are experiencing refusal of healthcare services and stigmatizing attitudes (i.e., attitudes of blame or judgment) from healthcare providers, nurses in particular. "
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    ABSTRACT: Background: In a setting where HIV/AIDS is highly endemic, nurses may respond to patients with increase fear of being at risk of acquiring HIV infection, decrease willingness to care, or both. The resulting stigmatization creates social barriers and discrimination between nurses and patients with HIV/AIDS. Objectives: This study aimed to increase nurses’ knowledge on HIV/AIDS and reduce HIV/AIDS-related stigma and discrimination in healthcare through HIV/AIDS educational intervention. Methods: This quasi-experimental study was carried out in all nursing departments of Shaqra General Hospital from February to April 2014. Nurses (n = 58), meeting the eligibility criteria, were included in the sample and were non-randomly assigned in one-group pre-test and post-test using purposive sampling technique. Results: The results of the pre- and post-intervention phases were compared using paired-sample t-test. Significant increase in nurses’ knowledge was demonstrated following HIV/AIDS educational intervention (p = 0.000). HIV/AIDS educational intervention was significantly associated with less stigmatization for ‘attitudes towards imposed measures’ (p = 0.002). In pre-intervention phase, the greatest stigmatizing attitude was observed in statement concerning the need for screening all inpatients for HIV/AIDS. The assessment at pre- and post-intervention for ‘comfortableness dealing with HIV/AIDS patients’ did not differ significantly, indicating least stigmatizing attitude. However, a statistical significant difference (p = 0.044) on nurses’ overall attitude towards patients with HIV/AIDS was detected between pre- and post-intervention assessment. Pooled mean revealed no observed discriminatory act among nurses at pre- and post- intervention assessment. Conclusion: The utilization of HIV/AIDS educational intervention improved nurses’ theoretical knowledge about HIV/AIDS. Although nurses’ knowledge on HIV/AIDS was improved significantly, their attitudes of blame or judgment as well as their comfortableness deal- ing with HIV/AIDS patients have not changed. The effectiveness of HIV/AIDS educational intervention in reducing HIV/AIDS-related discrimination as well as its impact on nurses’ attitudes towards patients with HIV/AIDS warrants further investigation.
    Full-text · Article · Oct 2014
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