Experiences and Impact of Stigma and Discrimination among People on Antiretroviral Therapy in Dar es Salaam: A Qualitative Perspective

Abstract

Background. The impact of stigma on adherence to antiretroviral therapy (ART) has been less studied in Tanzania. Recent studies indicate that people on ART still experience stigma. Qualitative information on the subject matter is especially insufficient. Objective. This paper reports on the dimensions of stigma and discrimination and their impact on adherence to ART as experienced by people living with HIV (PLHIV). Design. A phenomenological approach was used to gather information on the lived experiences of stigma and discrimination. The sample size was determined according to the saturation principle. Results. Respondents experienced different forms of HIV-related stigma such as verbal, social, and perceived stigma. Various forms of discrimination were experienced, including relational discrimination, mistreatment by health care workers, blame and rejection by spouses, and workplace discrimination. HIV-related stigma and discrimination compromised ART adherence by reinforcing concealment of HIV status and undermining social suppport. Conclusion. After nearly a decade of increasing the provision of ART in Tanzania, PLHIV still experience stigma and discrimination; these experiences still appear to have a negative impact on treatment adherence. Efforts to reduce stigma and discrimination remain relevant in the ART period and should be given more impetus in order to maximize positive treatment outcomes.

Intimate partner violence and challenges facing women living with HIV/AIDS in accessing antiretroviral treatment at Singida Regional Hospital, central Tanzania

“…This implies that a lack of financial independence, which is compounded by the experience of IPV, hinders women's access to ARV treatment. Similar studies done in Dar-es Salaam (11) and Botswana (12) found that women LWHA fail to attend CTC due to a lack of fare for transport. Thus, they run short of ARVs, which is associated with poor adherence to ARV treatment, which results in treatment failure due to a lack of fare to attend CTC.…”

“…According to the National AIDS Control Program Care and Treatment report, it is estimated that 21–30% of PLHIV in Tanzania have registered at care and treatment clinics (CTCs), and that 63–83% of those eligible for treatment are receiving ARV medication. The availability of ARV treatment has a significant impact on prolonging the lives of HIV-infected people (11, 12). Little is known about the challenges facing women LWHA as victims of IPV in Tanzania.…”

Adherencia al tratamiento anti-retroviral para el VIH/SIDA en mujeres: una mirada socio-cultural

“…En la relación específica con la adherencia a TARV en mujeres, un primer elemento que impacta y que ha sido mencionado en otras investigaciones, es el estigma que aún rodea a la infección por VIH 24,32 , el que actúa sobre el imaginario personal de las mujeres en relación al VIH, la discriminación vivida y percibida, y la propia discriminación hacia el imaginario de perfil de personas afectadas por el VIH. Como muestran los resultados, el estigma está asociado no sólo a padecer de esta infección, sino a ser una mujer que vive con ella, lo que es motivo de doble discriminación.…”

“…23 . Otros estudios han mostrado que la adherencia a la TARV en mujeres estaría relacionada con temor a la discriminación 24 , a la divulgación de su diagnóstico…”

Effect of participation in a randomised controlled trial of an integrated palliative care intervention on HIV-associated stigma

“…The persistence of HIV associated stigma, is a threat to progress in the control of HIV internationally (Stangl & Grossman, 2013), a barrier to testing (Dapaah & Senah, 2016), prevention of mother-to-child transmission (Turan & Nyblade, 2013), and, once diagnosis is confirmed, stigma remains a barrier to PLWH accessing adequate healthcare (Bogart et al, 2013;Dasgupta, Sullivan, Dasgupta, Saha, & Salazar, 2013). It is also associated with non-adherence to antiretroviral therapy (ART), increasing the risk of viral resistance (Mhode & Nyamhanga, 2016;Sweeney & Vanable, 2016).…”