Stigma and discrimination associated with HIV/AIDS in health care settings: a comparative study in two hospitals of different categories in Douala-Cameroon

Abstract

The response to the human immunodeficiency virus epidemic faces many challenges with stigma and discrimination being two of them. The aim of this study is to determine the extent of effects of stigmatization and discrimination against people living with HIV-AIDS, and the influence of the type of hospital structure, in the manifestations of stigma and discrimination. A prospective cross sectional study was conducted among a total of 400 patients, using a pre-tested questionnaire. An observation form was also filled to evaluate attitudes and behaviour of health care providers towards patients. Chi-Square test and Fisher test were used to test association between two variables, then multi logistic regression tests were done to check predictive factors of discrimination. The level of significance was chosen at p<0.05. Among the participants, 104 (26%) patients reported having been victims of discrimination. Laquintinie hospital of Douala has a risk factor for blames and maltreatment (p = 0.0060) and (p= 0.0091) respectively. Also 152 (76.1%) patients of Laquintinie vs 103 (51.5%) of Nylon have been victims of stigmatization. The stigmatizing elements were: the name of the treatment center (p<0.0001) and the unconfidential manner of handling medical files (p=0.0527). Among the 400 patients, fifty nine (14.8%) avoided going to the hospital because of past experience of stigma and discrimination. Patients encounter several difficulties and those related to stigma and discrimination experienced in a hospital milieu can particularly constitute obstacles to better health seeking and therapeutic adherence. The human immunodeficiency virus infection response strategy should address stigma and discrimination by reviewing the management of treatment centers, elaborating relevant public health policies and training of healthcare practitioner.

Seroprevalence, attitudes and practices of the Baka Pygmies of eastern Cameroon towards HIV and AIDS

“…This result is similar to that of Onoya et al in South Africa [17] and confirms the fact that having more sexual partners is a risk factor for HIV/AIDS in general [18].…”

Stigmatization and the Predictors of Reported Discrimination among HIV Positive Patients Receiving Care in Hospitals in Imo State, Nigeria

“…This level of discrimination in the present study was similarly observed in studies done in Cameroon [17] and Madagascar [18] where 26% and 36% of the patients reported having been victims of discrimination respectively. The level of education and the socioeconomic status of the respondents, may also have contributed to their level of knowledge of stigmatization and hence, could have influenced what was regarded as discrimination by the respondents.…”

“…Also, with respect to occupation, even though it is not unusual in our environment for a mandatory HIV test before employment, it is quite unusual for employees in the public sector to be mandated to do a HIV test, and this, coupled with the unlikelihood of HIV status disclosure, may be an explanation why the respondents who are employed as civil servants with undisclosed HIV status were less likely to have reported discrimination. Furthermore, though the present study observed a similar lack of association between gender and discrimination with a previous study in Cameroon [17], the relationship between age and discrimination was not consistently observed.…”

“…As observed in the present study, close to two thirds of the respondents' highest level of education attained, was a secondary education with a majority of the respondents either unemployed or engaged as traders or artisans earning monthly incomes of less than 20,000 Naira ($55). Though, in the present study, it was observed that the level of education and monthly income was not significantly associated with the respondents' experience of discrimination and also, with respect to the level of education, this lack of association was similarly observed in a previous African study [17]. On the contrary, some other studies [19,20] reported that, low levels of education among respondents, appear to be protective against perceived stigma among people living with HIV.…”

Factors associated with HIV-related stigma toward people living with HIV among nurses in Liangshan Yi Autonomous Prefecture, China: a cross-sectional study

“…Stigma related to the human immunodeficiency virus (HIV) is prevalent and has been identified to be a major barrier for HIV prevention and treatment [1]. Researchers suggest that HIV-related stigma is also still a barrier for people living with HIV (PLWH) to disclose their HIV status and to seek and adhere to treatments; consequently, this barrier has an adverse impact on their health [2][3][4]. HIVrelated stigma exists in nursing care worldwide and has large impact on the health outcomes of PLWH [5][6][7][8][9].…”