Experiences of Stigma and Discrimination among Adults Living with HIV in a Low HIV-Prevalence Context: A Qualitative Analysis

Zukoski, Ann P.; Thorburn, Sheryl

doi:10.1089/apc.2008.0168

Cited by 108 publications

(80 citation statements)

References 37 publications

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“…13,24,[37][38][39] Even if counseling and testing sites are close to a rural resident's home, rural residents may prefer to be tested in a different community to ensure anonymity, which can result in delayed testing. Rural providers have suggested that integrating HIV testing into other health services; rapid oral testing and community health education; outreach; and making HIV testing more convenient, accessible, and free are potential ways to decrease barriers.…”

Section: Discussionmentioning

confidence: 99%

Late HIV Diagnosis: Differences by Rural/Urban Residence, Florida, 2007–2011

Trepka

Fennie

Sheehan

et al. 2014

AIDS Patient Care and STDs

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The purpose of this retrospective cohort study was to identify individual-level demographic and communitylevel socioeconomic and health care resource factors associated with late diagnosis of HIV in rural and urban areas of Florida. Multilevel modeling was conducted with linked 2007-2011 Florida HIV surveillance, American Community Survey, Area Health Resource File, and state counseling and testing data. Late diagnosis (defined as AIDS diagnosis within 3 months of HIV diagnosis) was more common in rural than urban areas (35.8% vs. 27.4%) ( p < 0.0001). This difference persisted after controlling for age, sex, race/ethnicity, HIV transmission mode, country of birth, and diagnosis year (adjusted OR 1.39; 95% CI 1.17-1.66). In rural areas, older age and male sex were associated with late HIV diagnosis; zip code-level socioeconomic and county level health care resource variables were not associated with late diagnosis in rural areas. In urban areas only, Hispanic and non-Hispanic black race/ethnicity, foreign birth, and heterosexual mode of transmission were additionally associated with late HIV diagnosis. These findings suggest that, in rural areas, enhanced efforts are needed to target older individuals and men in screening programs and that studies of psychosocial and structural barriers to HIV testing in rural and urban areas be pursued.

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Section: Discussionmentioning

confidence: 99%

Late HIV Diagnosis: Differences by Rural/Urban Residence, Florida, 2007–2011

Trepka

Fennie

Sheehan

et al. 2014

AIDS Patient Care and STDs

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“…These findings are supported by findings in similar studies conducted in other African Countries which showed that people living with HIV experienced stigma and discrimination at all levels of the communities. [13][14][15][16][17] One quarter (25%) of the respondents had experienced stigmatization and discrimination (ie, unfair treatment) due to their positive HIV status. This finding is lower than findings from similar studies conducted in South Africa and Kenya, which found stigma and discrimination rates of 40% and 43%, respectively.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Stigma and Discrimination Experienced by People Living with HIV and AIDS Receiving Care/Treatment in University of Ilorin Teaching Hospital (UITH), Ilorin, Nigeria

Owolabi

Araoye

Osagbemi

et al. 2011

Journal of the International Association of Physicians in AIDS

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The research was designed to assess the stigma and discrimination faced by People living with HIV and AIDS (PLWHA) that are receiving treatment in UITH, Ilorin. The study was a descriptive cross-sectional survey conducted on three hundred (300) people living with HIV and AIDS receiving care at the antiretroviral therapy (ART) clinics within University of Ilorin Teaching Hospital (which was the only ART site in Kwara State as at then). A quantitative method through the use of interviewer administered questionnaire was used for data collection. This study was a cross-sectional descriptive study design. All the patients who came to the clinic and met the selection criteria were recruited until the desired sample size was reached. Data were analyzed by EPI-INFO 2005 software package. The mean age of the respondents was 39 years (SD ¼ 9.32), and their age ranged between 19 and 65 years. About two thirds (64.7%) of the respondents were females, 62.7% were married, and 62.9% were from monogamous family settings. Slightly less than half (47.3%) of the respondents were not informed before they were tested for HIV, majority (63.3%) were not counseled before the test, but only 11% did not receive posttest counseling. One quarter of the respondents had experienced stigmatization/discrimination. Various forms of stigmatization/discrimination experienced by the respondents include blame for being responsible for their HIV status, various name callings, telling them that they are no more useful to anybody, violation of confidentiality, social isolation, restriction of their participation in family/religious activities, rejection by their spouses/ families, dismissal from place of work, isolating them from other patients, and denying them care at health centers. It is therefore recommended that government at all levels should develop and implement programs to educate health care providers about HIV and AIDS, ethics, and treatment and care; educate the general population on HIV and AIDS, put in place policies that will reduce/ stop HIV-related stigma and discrimination at all levels of the society, educate PLWHA on their right to live and work without discrimination, and also ensure full community participation in HIV control programs.

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“…These range from subtle to blatant and include awkward social interactions, increased physical distance, avoidance, unnecessary referrals to other health care providers, neglect, the discouragement of treatment regimens, contempt, testing without consent, blaming, excessive protective measures, the labeling of charts, beds, and/or rooms, breaches of confidentiality, refusal to treat, isolation in wards, and verbal abuse. 15,[23][24][25][26][27] Such discriminatory acts have been found to occur in hospitals, doctor's offices, dental practices, ambulances, and pharmacies. 15,[24][25][26] In fact, in a study previously conducted in the Netherlands, 26.2% of surveyed PLWH had experienced stigma in hospitals, 28.8% at their dentist's office, and 19.2% in their contact with a general practitioner.…”

mentioning

confidence: 99%

“…15,[23][24][25][26][27] Such discriminatory acts have been found to occur in hospitals, doctor's offices, dental practices, ambulances, and pharmacies. 15,[24][25][26] In fact, in a study previously conducted in the Netherlands, 26.2% of surveyed PLWH had experienced stigma in hospitals, 28.8% at their dentist's office, and 19.2% in their contact with a general practitioner. 28 In another study surveying PLWH in 14 European countries, 17% reported having experienced HIV-related discrimination from health professionals including non-HIV specialists (46%), dentists (39%), general practitioners (22%), and gynecologists (16%).…”

mentioning

confidence: 99%

Patient and Provider Perspectives on HIV and HIV-Related Stigma in Dutch Health Care Settings

Stutterheim

Sicking²,

Brands³

et al. 2014

AIDS Patient Care and STDs

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Ensuring that people living with HIV (PLWH) feel accepted in health care settings is imperative. This mixed methods study explored the perspectives of PLWH and health professionals on their interactions. A total of 262 predominantly gay men of Dutch origin participated in a survey study of possible negative interactions with health professionals, and semi-structured interviews were subsequently conducted with 22 PLWH and 14 health professionals. Again, most PLWH were gay men of Dutch origin. All health professionals were Dutch. PLWH reported negative experiences with health professionals including awkward interactions, irrelevant questions, rude treatment, blame, pity, excessive or differential precautions, care refusal, unnecessary referrals, delayed treatment, poor support, and confidentiality breaches. They also reported positive experiences including equal treatment, being valued as a partner in one's health, social support provision, and confidentiality assurances. Health professionals reported having little experience with PLWH and only basic knowledge of HIV. They contended that PLWH are treated equally and that HIV is no longer stigmatized, but also reported fear of occupational infection, resulting in differential precautions. Additionally, they conveyed labeling PLWH's files to warn others, and curiosity regarding how patients acquired HIV. The findings suggest that there is a gap in perception between PLWH and health professionals regarding the extent to which negative interactions occur, and that these interactions should be improved. Implications for stigma reduction and care optimization are discussed.

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Experiences of Stigma and Discrimination among Adults Living with HIV in a Low HIV-Prevalence Context: A Qualitative Analysis

Cited by 108 publications

References 37 publications

Late HIV Diagnosis: Differences by Rural/Urban Residence, Florida, 2007–2011

Late HIV Diagnosis: Differences by Rural/Urban Residence, Florida, 2007–2011

Assessment of Stigma and Discrimination Experienced by People Living with HIV and AIDS Receiving Care/Treatment in University of Ilorin Teaching Hospital (UITH), Ilorin, Nigeria

Patient and Provider Perspectives on HIV and HIV-Related Stigma in Dutch Health Care Settings

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