<p>Sick and solo: a qualitative study on the life experiences of people living with HIV in Somalia</p>

Abstract

BackgroundHIV stigma and the resultant fear of being identified as HIV-positive can compromise the effectiveness of HIV programs by undermining early diagnosis and antiretroviral treatment initiation and adherence of people living with HIV (PLHIV). In the wake of the longstanding conflict in the country, little is known about the life experiences of PLHIV in Somalia.MethodsA qualitative study using unstructured interviews was conducted in Somalia from September to December 2017. A convenience sampling approach was used to recruit 13 participants, including 10 persons who live with HIV and three senior officials who work for the HIV program at the Ministry of Health. Data were analyzed using a thematic analysis.ResultsOur findings show that PLHIV are alienated and prefer to isolate themselves due to widespread stigma subjected to them by their family members, society, employers, and health providers, which continue to undermine the scale-up of testing and treatment of PLHIV in Somalia. Consequently, they are reluctant to seek voluntary diagnosis and treatment of HIV. They often come to know about their status when their partners are found HIV positive, they are tested for other clinical purposes, or when an individual’s health deteriorates, and all other means fail to work in improving his/her situation. The study also pointed out a shortage of facilities that provide HIV diagnosis, counseling and treatment in Somalia.ConclusionAddressing stigma and discrimination subjected to PLHIV are critical to a successful HIV response in Somalia. To successfully address stigma, HIV programs need evidence on effective interventions at individual, community, and societal levels in order to strategically incorporate stigma and discrimination reduction into national HIV programs.

Prevalence of and factors associated with depression among adult patients living with HIV/AIDs undergoing ART unit in Banadir hospital, Mogadishu Somalia

“…Stigma in people living with HIV is a predisposing factor for Depression globally since it is widespread in Somalia with self-isolation that restricts life opportunities, and they struggle to remain employed due to discrimination and poor social acceptance [28,29]. Stigma increases fatigue, decreases the feeling of worthlessness, increases the feeling of shame, fear of HIV disclosure, isolation, and despair.…”

“…Furthermore, a similar study has not been implemented before in Somalia, while around 43% of new African HIV cases are in East and Southern African countries, including Somalia [7]. In addition, healthcare coverage among HIV patients in Somalia is deficient, with few ART centers in the country [28]. People living with HIV/AIDs experience a generalized HIV stigma with self-isolation that restricts life opportunities, including good income and education, which may cause severe depression.…”

“…People living with HIV/AIDs experience a generalized HIV stigma with self-isolation that restricts life opportunities, including good income and education, which may cause severe depression. They struggle to remain employed and hesitate to seek treatment due to HIV-related discrimination, poor social support, and stigma [28,29]. Moreover, depression is misdiagnosed because of an absence of routine screening.…”

Does the Narrative About the Use of Evidence in Priority Setting Vary Across Health Programs Within the Health Sector: A Case Study of 6 Programs in a Low-Income National Healthcare System

“…Furthermore, respondents from programs such as HIV and Vaccines-seemed more appreciative for qualitative information-which might be a reflection of their experiences with the various types of evidence. [59][60][61] Qualitative evidence, which accesses personal experiences play a big role in the acceptability of interventions as were the case of HIV control, and new vaccines.…”

The role of community pharmacists in increasing access and use of self-care interventions for sexual and reproductive health in the Eastern Mediterranean Region: examples from Egypt, Jordan, Lebanon and Somalia

“…People do not voluntarily seek HIV diagnosis and treatment because of HIV stigma, discrimination and the resultant fear of being identified as HIV-positive. HIV stigma and social rejection limit the disclosure of one’s HIV status to families and communities; this situation is worse in vulnerable internally displaced and rural areas of the country [ 46 ]. Many campaigns have been conducted in both the public and private health sectors.…”