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Yenesew MA, Yismaw G, Nigatu D, Alemu Y, Gasheneit A, Zeru T, Bezabih B, Abate G. HIV Stigma in Awi Zone, Northwest Ethiopia, and a Unique Community Association as a Potential Partner. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:982. [PMID: 39200593 PMCID: PMC11353804 DOI: 10.3390/ijerph21080982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Revised: 07/19/2024] [Accepted: 07/24/2024] [Indexed: 09/02/2024]
Abstract
Indigenous institutions play a vital role in fighting HIV stigma by leveraging their cultural knowledge, leadership, and community connections. Understanding HIV/AIDS attitudes, information gaps, and stigma among members of indigenous institutions is critical for devising culturally relevant and successful interventions and preventative strategies. This study was conducted with the objective of assessing the levels of knowledge about HIV/AIDS and the various HIV/AIDS discriminatory attitudes and practices among members of the Awi Equestrian Association, an indigenous association in Awi Zone, Northwest Ethiopia, that plays major roles in the social, cultural, political, and economic activities of the community. The study is a cross-sectional study conducted from June through July 2022. Eight hundred and forty-six people in the study area were interviewed using a pilot-tested questionnaire. Multiple linear regression analysis was used to identify factors associated with the score level of HIV-related stigma. Forty-five percent of study participants did not have adequate knowledge of HIV/AIDS, and 67.4% had moderate to high discriminatory attitudes towards people living with HIV. HIV-stigmatizing practices were high, with 36% admitting to speaking badly about people living with HIV and 23% wanting their relative with HIV to seek treatment in another zone. In our study, low level of knowledge about HIV/AIDS (p < 0.001), older age (p < 0.05), and male sex (p < 0.05) were factors associated with higher levels of stigmatizing practices. In conclusion, HIV-related stigma is common in Awi Zone. The Awi Equestrian Association has become a unique potential partner for HIV control in the area in an effort to achieve United Nation AIDS target of 95-95-95.
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Affiliation(s)
- Muluken Azage Yenesew
- School of Public Health, Bahir Dar University, Bahir Dar P.O. Box 79, Ethiopia; (M.A.Y.); (D.N.)
| | - Gizachew Yismaw
- Amhara Public Health Institute, Bahir Dar P.O. Box 3898, Ethiopia; (G.Y.); (T.Z.)
| | - Dabere Nigatu
- School of Public Health, Bahir Dar University, Bahir Dar P.O. Box 79, Ethiopia; (M.A.Y.); (D.N.)
| | - Yibeltal Alemu
- School of Public Health, Bahir Dar University, Bahir Dar P.O. Box 79, Ethiopia; (M.A.Y.); (D.N.)
| | - Addisu Gasheneit
- Awi Zone Health Office, Amhara Regional State Health Bureau, Bahir Dar P.O. Box 79, Ethiopia;
| | - Taye Zeru
- Amhara Public Health Institute, Bahir Dar P.O. Box 3898, Ethiopia; (G.Y.); (T.Z.)
| | - Belay Bezabih
- Amhara Public Health Institute, Bahir Dar P.O. Box 3898, Ethiopia; (G.Y.); (T.Z.)
| | - Getahun Abate
- Division of Infectious Diseases, Saint Louis University, Saint Louis, MO 63104, USA
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Adekoya P, Lannap FD, Ajonye FA, Amadiegwu S, Okereke I, Elochukwu C, Aruku CA, Oluwaseyi A, Kumolu G, Ejeh M, Olutola AO, Magaji D. Experiences of Stigmatization and Discrimination in Accessing Health Care Services Among People Living with HIV (PLHIV) in Akwa Ibom State, Nigeria. HIV AIDS (Auckl) 2024; 16:45-58. [PMID: 38406768 PMCID: PMC10891273 DOI: 10.2147/hiv.s447551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 02/01/2024] [Indexed: 02/27/2024] Open
Abstract
Background Recent advances in care and treatment have turned HIV into a "chronic but manageable condition". Despite this, some people living with HIV (PLHIV) continue to suffer from stigma and discrimination in accessing health care services. This study examined the experience of stigma and discrimination and access to health care services among PLHIV in Akwa Ibom State. Methods The Center for Clinical Care and Clinical Research (CCCRN), implementing a USAID-funded Integrated Child Health and Social Services Award (ICHSSA 1) project, conducted a community-based cross-sectional survey in 12 randomly selected local government areas in Akwa Ibom State, Nigeria. A structured quantitative questionnaire was used for data collection. In total, 425 randomly selected PLHIV were interviewed after providing informed consent. Descriptive statistics and bivariate analyses were conducted using the data analytical application Stata 14. Results The study revealed that 215 PLHIV (50.4%) had been denied access to health care services, including dental care, because of their HIV status in Akwa Ibom State. Respondents reported being afraid of: gossip (78%), being verbally abused (17%), or being physically harassed or assaulted because of their positive status (13%). Self-stigmatization was also evident; respondents reported being ashamed because of their positive HIV status (29%), exhibiting self-guilt (16%), having low self-esteem (38%), and experiencing self-isolation (36%). Women, rural residents, PLHIV with no education, unemployed, single, young people aged between 19 and 29 years, and older adults were more likely to experience HIV-related stigmatization. Conclusion Data from the study revealed that the percentage of PLHIV who experience health-related stigmatization because of their HIV status is high in Akwa Ibom State. This finding calls for the prioritization of interventions to reduce stigma, enhance self-esteem, and promote empathy and compassion for PLHIV. It also highlights the need for HIV education for family and community members and health care providers, to enhance the knowledge of HIV and improve acceptance of PLHIV within families, communities, and health care settings.
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Affiliation(s)
- Peters Adekoya
- Centre for Clinical Care and Clinical Research, Abuja, Nigeria
| | - Faith D Lannap
- Centre for Clinical Care and Clinical Research, Abuja, Nigeria
| | | | | | | | | | | | | | - Grace Kumolu
- Centre for Clinical Care and Clinical Research, Abuja, Nigeria
| | - Michael Ejeh
- Centre for Clinical Care and Clinical Research, Abuja, Nigeria
| | | | - Doreen Magaji
- United States Agency for International Development, Abuja, Nigeria
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Hannon-Walker I, McLuskey J. How does intersectionality impact the quality of healthcare services for Black women living with HIV? BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2024; 33:S20-S25. [PMID: 38194323 DOI: 10.12968/bjon.2024.33.1.s20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
Women with HIV are affected more than men by intersecting discriminations. For Black women, additional discrimination can have a detrimental effect on their HIV care. An extended literature review of primary research studies was undertaken to explore the issues and the impact of intersectionality on Black women with HIV. Electronic databases were searched for studies published since antiretroviral treatment became recognised to be effective, and eight studies met detailed inclusion and exclusion criteria. Critical appraisal led to the identification of three themes: discrimination; stigmatisation; and racism. The findings suggest that while Black women with HIV reported barriers to health care because of intersectionality, older women who felt confident in their self-identity were more able to cope with issues around this. Knowledge of the factors affecting these women will enable health professionals to deliver person-centred care.
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Affiliation(s)
| | - John McLuskey
- Associate Professor, School of Health Sciences, University of Nottingham
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Hidayat J, Chen MY, Maulina R, Nurbaya S. Factors Associated With HIV-Related Stigma Among Indonesian Healthcare Workers: A Cross-Sectional Online Survey. J Nurs Res 2023; 31:e295. [PMID: 37668415 DOI: 10.1097/jnr.0000000000000573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND Despite worldwide advances in HIV care and growing scientific knowledge about HIV, stigma and prejudice continue to hinder people living with HIV/AIDS (PLWHA) from seeking treatment and care. HIV-related stigma among healthcare workers in Indonesia has been investigated and measured in only a few empirical studies. PURPOSE This study was developed to identify factors related to holding stigmatizing attitudes toward PLWHA among professional healthcare providers in Indonesia. METHODS A cross-sectional survey approach using convenience and snowball sampling techniques was used. Data were collected in February and March 2022. All of the participants were healthcare workers in Indonesia who had completed an online survey that collected demographic data and measured HIV-related stigma, fear of HIV transmission, and HIV-related knowledge. Bivariate analysis and multiple linear regression were used to investigate the association between the independent and dependent variables. RESULTS The study enrolled 252 participants, including eight physicians (3.2%), 200 nurses (79.4%), and 44 midwives (17.5%). Over two thirds of the participants (65.1%) had no formal HIV training. Stigmatizing attitudes were associated with lower levels of HIV knowledge ( B = -0.480, p < .01), fear of becoming infected with the HIV virus ( B = 0.354, p < .05), and type of HIV care setting ( B = -2.913, p < .05). Of the three participant categories, physicians had the highest levels of both HIV knowledge and PLWHA-related stigma. CONCLUSIONS The findings indicate many healthcare workers in Indonesia receive limited formal training on HIV, have low levels of HIV knowledge, and fear HIV transmission. Therefore, providing comprehensive and up-to-date education about HIV for health workers and proper personal protective equipment should be incorporated into programs aimed at reducing stigmatizing attitudes against patients with HIV among healthcare workers in Indonesia.
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Affiliation(s)
- Jufri Hidayat
- MSN, RN, Doctoral Student, School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Miao-Yen Chen
- PhD, RN, Associate Professor, School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Rufidah Maulina
- MS, Lecturer, Midwifery Department, Universitas Sebelas Maret, Surakarta, Indonesia
| | - Sitti Nurbaya
- MS, Lecturer, Faculty of Nursing, Stikes Nani Hasanuddin Makassar, Indonesia
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Pattillo M, Stieglitz S, Angoumis K, Gottlieb N. Racism against racialized migrants in healthcare in Europe: a scoping review. Int J Equity Health 2023; 22:201. [PMID: 37770879 PMCID: PMC10540333 DOI: 10.1186/s12939-023-02014-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 09/14/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND Racism is frequently mentioned as a social determinant of migrants' health and a barrier to health services. However, in the European context, racism and its impact on racialized migrants' access to healthcare is remarkably under-researched. This scoping review makes a first step toward filling this void by mapping the existing literature on racial and ethnic discrimination against racialized migrants in healthcare in Europe, identifying evidence gaps, and offering recommendations for future research on this topic. METHODS Following PRISMA guidelines, four databases were searched for empirical studies published in English between 1992 and 2022. Studies were included if they report findings on manifestations, experiences and/or impacts of racial or ethnic discrimination against racialized migrants in a healthcare setting in a European country. They were summarized by study characteristics (geographical scope, study design, research question and measures) and research findings were synthesized. RESULTS Out of 2365 initial hits, 1724 records were included in the title/abstract-screening, 87 records in the full text-screening, and 38 records in the data extraction. For many country and healthcare contexts, evidence on racism in healthcare is lacking. Most studies apply an explorative qualitative research design; comparability and generalizability of research results are low. Our analysis furthermore shows a near-exclusive research focus on racism on the interpersonal level as compared to institutional and structural levels. Our synthesis of study results identifies three interrelated ways in which racism manifests in and impacts migrants' healthcare: 1) general anti-migration bias, 2) health- and healthcare-related prejudice, and 3) differential medical treatment. CONCLUSIONS Our review underscores how racism reinforces inequities in healthcare access and quality for racialized migrants. It also highlights the need for more research on racism in Europe across a greater scope of country contexts, healthcare settings and migrant/racialized categories in order to understand specific forms of racism and capture race as a context-contingent social construct. It is critical that future research includes the consideration of individual-level racism as embedded in racism on institutional and structural levels. Methods and insights from other disciplines may help to critically examine concepts in light of underlying historical, sociopolitical and socioeconomic processes and structures, and to improve methods for researching racialization and racism in healthcare.
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Affiliation(s)
- Mia Pattillo
- Weill Cornell Medicine, 1300 York Avenue, New York, NY, 10021, USA
| | - Sigsten Stieglitz
- Bielefeld School of Public Health, Universitätsstrasse 25, 33615, Bielefeld, Germany
| | - Konstantinos Angoumis
- Bielefeld School of Public Health, Universitätsstrasse 25, 33615, Bielefeld, Germany
| | - Nora Gottlieb
- Bielefeld School of Public Health, Universitätsstrasse 25, 33615, Bielefeld, Germany.
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Singh SK, Shri N. Sociodemographic correlates of discrimination against PLHIV in High HIV prevalence states of India, NFHS 2016-21. Sci Rep 2023; 13:15083. [PMID: 37699942 PMCID: PMC10497618 DOI: 10.1038/s41598-023-42162-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 09/06/2023] [Indexed: 09/14/2023] Open
Abstract
This study investigates the socio-demographic correlates of HIV discrimination among individuals aged 15-49 years. This study also aims to assess the change in discriminatory attitudes towards PLHIV in high HIV prevalence states from 2016 to 2021 using data from the national Demographic Health Survey (4th and 5th). To identify factors associated with discriminatory attitudes, a multivariable logistic regression analysis was performed. Further, predicted probabilities and average marginal effects were computed, and the difference in discriminatory attitudes across both rounds was examined using a non-linear Fairlie decomposition. Mass media exposure, improved wealth index, and comprehensive knowledge significantly reduced the discriminatory attitudes towards PLHIV. Fairlie decomposition indicated that comprehensive knowledge, knowledge of mother-to-child transmission, and mass media exposure was significant contributor to the differences observed in the discriminatory attitude towards PLHIV across survey rounds. This study emphasizes the importance of spreading accurate information about HIV transmission modes and reinforces existing programmes and policies aimed at reducing stigma and discrimination against PLHIV. These programmes' efficiency and effectiveness can be ensured by linking them with community-level programmes and activities organized by Self Help Groups (SHGs), which have resulted in a paradigm shift in empowering women in India.
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Affiliation(s)
- Shri Kant Singh
- Department of Survey Research and Data Analytics, International Institute for Population Sciences, Mumbai, Maharashtra, 400088, India
| | - Neha Shri
- Department of Survey Research and Data Analytics, International Institute for Population Sciences, Mumbai, Maharashtra, 400088, India.
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Experiences of Migrants Living with HIV from HIV-Endemic Sub-Saharan African Countries: A Systematic Review of Qualitative Research Studies. J Immigr Minor Health 2023; 25:219-231. [PMID: 35262813 DOI: 10.1007/s10903-022-01340-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2022] [Indexed: 01/07/2023]
Abstract
The aim of this qualitative systematic review was to explore the experiences of migrants living with HIV from HIV endemic sub-Saharan African countries who migrated to high-income countries. In this systematic review of qualitative research studies, we focused on the experiences of migrants living with HIV and the intersections between living with HIV, migration, settlement, culture, race relations, access to health services and HIV care, treatment, and support during migration and settlement in a new host country. We searched 12 electronic databases from database inception for English-language publications. A thematic analysis of qualitative studies [n = 10] was conducted. Complexities exist across the migration and settlement trajectories of migrants living with HIV, which influenced people's level of engagement in the HIV care cascade as well as social determinants of health and social wellbeing.
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Fauk NK, Gesesew HA, Seran AL, Raymond C, Tahir R, Ward PR. Barriers to Accessing HIV Care Services in Host Low and Middle Income Countries: Views and Experiences of Indonesian Male Ex-Migrant Workers Living with HIV. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14377. [PMID: 36361253 PMCID: PMC9654942 DOI: 10.3390/ijerph192114377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 10/31/2022] [Accepted: 11/01/2022] [Indexed: 06/16/2023]
Abstract
Migrant populations are one of the vulnerable groups to HIV transmission and its consequences. They are also reported to experience delayed entry or linkage into HIV services and have poorer HIV-related health outcomes. This study aimed to understand barriers to accessing HIV care services in host countries among Indonesian, male, former (returned) migrant workers living with HIV. The study was carried out from December 2020 to February 2021. It utilised a qualitative design employing in-depth interviews to collect data from twenty-two returned migrant workers from Eastern Indonesia, recruited using the snowball sampling technique. A qualitative data analysis framework was used to guide a step-by-step analysis of the findings. Findings demonstrated that limited host-country language proficiency, lack of knowledge regarding healthcare systems in host countries and having 'undocumented' worker status were barriers to accessing HIV care services. Data also revealed the unavailability of HIV care services nearby migrants' work locations, long-distance travel to healthcare facilities, and challenges in accessing public transportation as barriers that impeded their access to the services. Other factors limiting the participants' access to HIV services were identified as the transient and mobile nature of migrant work requiring frequent relocation and disrupting work-life stability. Additionally, in lieu of formal HIV services, many participants self-medicated by using over-the-counter herbal or 'traditional' medicines, often because of peer or social group influence regarding the selection of informal treatment options. Recommendations arising from this study demonstrate the need to improve pre-departure information for migrant workers regarding the healthcare system and access procedures in potential host countries. Data from this study also indicate that social services should be available to assist potential migrants to access legal channels for migrant work overseas, to ensure that Indonesian migrants can safely access healthcare services in the countries for which they are providing migrant labour. Future studies to understand barriers to accessing HIV care services among various migrant groups living with HIV are warranted to build evidence for potential social policy change.
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Affiliation(s)
- Nelsensius Klau Fauk
- Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide 5000, Australia
- Institute of Resource Governance and Social Change, Kupang 85227, Indonesia
| | - Hailay Abrha Gesesew
- Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide 5000, Australia
- College of Health Sciences, Mekelle University, Mekelle 1871, Ethiopia
| | - Alfonsa Liquory Seran
- Atapupu Public Health Centre, Health Department of Belu District, Atambua 85752, Indonesia
| | - Christopher Raymond
- Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide 5000, Australia
| | - Roheena Tahir
- College of Medicine and Public Health, Flinders University, Adelaide 5042, Australia
| | - Paul Russell Ward
- Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide 5000, Australia
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Ghasemi E, Rajabi F, Negarandeh R, Vedadhir A, Majdzadeh R. HIV, migration, gender, and drug addiction: A qualitative study of intersectional stigma towards Afghan immigrants in Iran. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e1917-e1925. [PMID: 34725886 DOI: 10.1111/hsc.13622] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 10/09/2021] [Accepted: 10/12/2021] [Indexed: 06/13/2023]
Abstract
HIV-related stigma has been identified as a major barrier to the diagnosis, prevention, and treatment of HIV among immigrants. The intersection of HIV with other forms of stigma can lead to greater inequality in health outcomes and access to health services. This study aimed to improve the understanding of HIV stigma towards Afghan immigrants in Iran through an intersectional perspective. The data were collected using 25 semi-structured interviews with the following three groups: Afghan immigrants who were diagnosed with or at risk of HIV infection due to injection drug addiction or having multiple sexual partners (n = 8), HIV service providers (n = 8), and policymakers/managers/experts (n = 9). Thematic analysis was used for data analysis. The participants described different manifestations of stigma (internalized, anticipated, perceived, experienced stigma, and discrimination) associated with HIV and interlocked with other aspects of stigma, including migration, gender, and drug addiction. According to the results, the intersection of different layers of stigma should be taken into account while designing and implementing HIV prevention and treatment programmes. It was also recommended to conduct the necessary interventions such as comprehensive HIV education, social support, as well as peer and outreach services to reduce stigma and discrimination based on the immigrants' needs as well as cultural and social values.
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Affiliation(s)
- Elham Ghasemi
- Community-Based Participatory Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Rajabi
- Community-Based Participatory Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Center for Academic and Health Policy, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Negarandeh
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - AbouAli Vedadhir
- Department of Anthropology, Faculty of Social Sciences, University of Tehran, Tehran, Iran
- Population Health Sciences, University of Bristol, Bristol, UK
- Center of Excellence in Health Sociology (CEHS), University of Tabriz, Tabriz, Iran
| | - Reza Majdzadeh
- Community-Based Participatory Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran
- School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Bahar Z, Cal A, Beser A, Cavusoglu F, Deveci A, Badur S, Bahar IH. A study on the adaptation of the HIV/AIDS-related Stigma Scale into Turkish. Perspect Psychiatr Care 2022; 58:509-517. [PMID: 34878644 DOI: 10.1111/ppc.12984] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 11/18/2021] [Accepted: 11/19/2021] [Indexed: 12/01/2022] Open
Abstract
PURPOSE This study aims to test the validity and reliability of the Turkish version of the HIV/AIDS-related Stigma Scale. DESIGN AND METHODS The study has a methodological design. The sample included a total of 428 participants. of the participants, 198 were HIV/AIDS patients, 230 were HIV-negative individuals. The data were analyzed using the Exploratory and Confirmatory Factor Analysis. FINDINGS The Turkish version of the HIV/AIDS-related Stigma Scale was found to be valid and reliable for the Turkish society. Cronbach's α was 0.93 for the community perspectives subscale and 0.89 for the patient perspectives subscale, and all the model fit indices were acceptable. PRACTICE IMPLICATIONS The level of stigmatization revealed by the scale helps gain an insight into the community and patient perspectives on HIV/AIDS.
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Affiliation(s)
- Zuhal Bahar
- Department of Nursing, Istanbul Aydin University, School of Health Sciences, Istanbul, Turkey
| | - Ayse Cal
- Department of Nursing, Ankara Medipol University School of Health Sciences, Ankara, Turkey
| | - Ayse Beser
- Department of Public Health Nursing, Koc University, Faculty of Nursing, Istanbul, Turkey
| | - Figen Cavusoglu
- Department of Public Health Nursing, Ondokuz Mayis University, Faculty of Health Sciences, Samsun, Turkey
| | - Aydin Deveci
- Department of Infectious Diseases and Clinical Microbiology, Ondokuz Mayis University, Faculty of Medicine, Samsun, Turkey
| | - Selim Badur
- Vaccines Scientific Affairs and Public Health, GSK, Istanbul, Turkey
| | - Ismail Hakki Bahar
- Department of Nursing, Faculty of Health Sciences, Cyprus Science University, Kyrenia North, Cyprus
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Teshale AB, Tesema GA. Discriminatory attitude towards people living with HIV/AIDS and its associated factors among adult population in 15 sub-Saharan African nations. PLoS One 2022; 17:e0261978. [PMID: 35120129 PMCID: PMC8815885 DOI: 10.1371/journal.pone.0261978] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 11/29/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Discrimination of people living with HIV/AIDS is one of the reported obstacles to the achievement of universal access to HIV/AIDS prevention, treatment, care, and support programs. Many international agencies have made combating HIV/AIDS stigma and discrimination a top priority. However, previous evidence in different parts of Africa revealed that the magnitude of HIV/AIDS-related discriminatory attitude is significantly high. OBJECTIVE To assess discriminatory attitude towards people living with HIV/AIDS and its associated factors among the adult population in 15 sub-Saharan African nations. METHODS We have used the 15 Demographic and Health Survey data that were conducted in sub-Saharan Africa (SSA) from 2015 to 2019/20. Each country's data was appended and a total weighted sample of 318,186 (unweighted sample = 315,448) adults who had ever heard of AIDS was used for the final analysis. The two discriminatory attitude questions were used to get the outcome variable and those who answered "Yes" or "don't know" for both questions were counted as if they had no discriminatory attitude towards people living with HIV/AIDS. To assess the factors associated with discriminatory attitude towards people living with HIV/AIDS, we have fitted a multilevel binary logistic regression model. Bivariable analysis was done to select eligible variables for the multivariable analysis. Finally, variables with p<0.05, in the multivariable analysis, were considered as significant predictors of discriminatory attitude towards people living with HIV/AIDS. RESULTS The prevalence of discriminatory attitude towards HIV/AIDS in the 15 sub-Saharan African nations was 47.08% (95% CI: 47.08, 47.42), which ranges from 17.64% (95% CI: 17.22, 18.07) in Malawi to 79.75% (95% CI: 79.02, 80.45) in Guinea. In the multivariable analysis, both individual level and community level variables were significantly associated with discriminatory attitude towards people living with HIV/AIDS. Being younger age, no formal education, never married, low socioeconomic status, male-headed household, non-contraceptive use, no mass media exposure, and incorrect comprehensive knowledge towards HIV/AIDS were among the individual-level factors that were associated with higher odds of discriminatory attitude towards people living with HIV/AIDS. While being from urban residence and the western SSA region were among the community-level factors that were significantly associated with higher odds discriminatory attitude towards people living with HIV/AIDS. CONCLUSION The prevalence of discriminatory attitude towards people living with HIV/AIDS in 15 sub-Saharan African nations was high. Both individual and community-level factors were associated with discriminatory attitude towards people living with HIV/AIDS. Therefore, special attention should be given to those who are poor, uneducated, and younger adults. In addition, it is better to strengthen the accessibilities of different media for adult populations to create an appropriate attitude towards people with HIV/AIDS.
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Affiliation(s)
- Achamyeleh Birhanu Teshale
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Getayeneh Antehunegn Tesema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Ponce-Blandón JA, Romero-Castillo R, Jiménez-Picón N, Palomo-Lara JC, Castro-Méndez A, Pabón-Carrasco M. Lived Experiences of African Migrants Crossing the Strait of Gibraltar to Europe: A Cross-Cultural Approach to Healthcare from a Qualitative Methodology. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9379. [PMID: 34501968 PMCID: PMC8431138 DOI: 10.3390/ijerph18179379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 08/31/2021] [Accepted: 09/02/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND The migratory flow from the African continent to Europe is intense and the European countries should apply a humanitarian, health and social response to this emerging problem. Migrants coming from Africa to Europe are a very vulnerable population. Healthcare professionals should be prepared for answering their needs from a transcultural approach, which requires a better understanding of this phenomenon. Thus, the aim of this study was to improve nursing and healthcare professionals' awareness and better understanding of migrant life experiences during the migration journey. An exploratory descriptive qualitative research was conducted. In-depth interviews were conducted involving four key informants and content analysis were performed with the transcriptions. RESULTS Three themes merged: life situations in their countries of origin; motivations that led them to undertake the migratory journey; and experiences they lived during the migratory journey. The results described the dramatic experience and motivations for crossing the strait of Gibraltar from Africa to Europe, including feelings, fears, hopes and lived experiences. The determination of immigrants to fight for a better life opportunity and the physical damage and psychological consequences they suffer were revealed. CONCLUSIONS This study would help healthcare professionals to better understand this complex reality and deliver culturally adapted care. Knowledge of the starting reality of these populations can help health professionals to incorporate a cross-cultural approach that improves the relational, ethical and affective competences to provide quality care to the migrant population, as well as the development of health measures to fight against inequalities suffered by these population groups.
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Affiliation(s)
- José Antonio Ponce-Blandón
- Red Cross Nursing University Center, University of Seville, 41009 Seville, Spain; (N.J.-P.); (J.C.P.-L.); (M.P.-C.)
- Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain;
| | - Rocío Romero-Castillo
- Red Cross Nursing University Center, University of Seville, 41009 Seville, Spain; (N.J.-P.); (J.C.P.-L.); (M.P.-C.)
| | - Nerea Jiménez-Picón
- Red Cross Nursing University Center, University of Seville, 41009 Seville, Spain; (N.J.-P.); (J.C.P.-L.); (M.P.-C.)
| | - Juan Carlos Palomo-Lara
- Red Cross Nursing University Center, University of Seville, 41009 Seville, Spain; (N.J.-P.); (J.C.P.-L.); (M.P.-C.)
| | - Aurora Castro-Méndez
- Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain;
| | - Manuel Pabón-Carrasco
- Red Cross Nursing University Center, University of Seville, 41009 Seville, Spain; (N.J.-P.); (J.C.P.-L.); (M.P.-C.)
- Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain;
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Arora AK, Ortiz-Paredes D, Engler K, Lessard D, Mate KK, Rodriguez-Cruz A, Kronfli N, Vedel I, Cox J, Quesnel-Vallée A, Lebouché B. Barriers and Facilitators Affecting the HIV Care Cascade for Migrant People Living with HIV in Organization for Economic Co-Operation and Development Countries: A Systematic Mixed Studies Review. AIDS Patient Care STDS 2021; 35:288-307. [PMID: 34375137 PMCID: PMC8380795 DOI: 10.1089/apc.2021.0079] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Migrants in countries affiliated with the Organization for Economic Co-operation and Development (OECD) have a higher risk of acquiring HIV, experience delayed HIV diagnosis, and have variable levels of engagement with HIV care and treatment when compared to native-born populations. A systematic mixed studies review was conducted to generate a multilevel understanding of the barriers and facilitators affecting HIV Care Cascade steps for migrant people living with HIV (MLWH) in OECD countries. Medline, Embase, Scopus, CINAHL, and the Cochrane Library were searched on March 25, 2020. Screening, critical appraisal, and analysis were conducted independently by two authors. We used qualitative content analysis and the five-level Socio-Ecological Model (i.e., individual, interpersonal, organizational, community, and policy) to categorize barriers and facilitators. Fifty-nine studies from 17 OECD countries were included. MLWH faced similar barriers and facilitators regardless of their host country, ethnic and geographic origins, or legal status. Most barriers and facilitators were associated with the individual and organizational levels and centered around retention in HIV care and treatment. Adapting clinical environments to better address MLWH's competing needs via multidisciplinary models would address retention issues across OECD countries.
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Affiliation(s)
- Anish K. Arora
- Department of Family Medicine, Faculty of Medicine & Health Sciences, McGill University, Montréal, Canada
- Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, Montréal, Canada
- Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montréal, Canada
- Strategy for Patient-Oriented Research Mentorship Chair in Innovative Clinical Trials in HIV Care, Canadian Institutes of Health Research, Montréal, Canada
| | - David Ortiz-Paredes
- Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, Montréal, Canada
- Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montréal, Canada
| | - Kim Engler
- Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, Montréal, Canada
- Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montréal, Canada
- Strategy for Patient-Oriented Research Mentorship Chair in Innovative Clinical Trials in HIV Care, Canadian Institutes of Health Research, Montréal, Canada
| | - David Lessard
- Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, Montréal, Canada
- Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montréal, Canada
- Strategy for Patient-Oriented Research Mentorship Chair in Innovative Clinical Trials in HIV Care, Canadian Institutes of Health Research, Montréal, Canada
| | - Kedar K.V. Mate
- Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, Montréal, Canada
- Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montréal, Canada
- Strategy for Patient-Oriented Research Mentorship Chair in Innovative Clinical Trials in HIV Care, Canadian Institutes of Health Research, Montréal, Canada
| | - Adriana Rodriguez-Cruz
- Department of Family Medicine, Faculty of Medicine & Health Sciences, McGill University, Montréal, Canada
- Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, Montréal, Canada
- Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montréal, Canada
- Strategy for Patient-Oriented Research Mentorship Chair in Innovative Clinical Trials in HIV Care, Canadian Institutes of Health Research, Montréal, Canada
| | - Nadine Kronfli
- Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, Montréal, Canada
- Chronic Viral Illness Service, Division of Infectious Diseases, Department of Medicine, McGill University Health Centre, Montréal, Canada
| | - Isabelle Vedel
- Department of Family Medicine, Faculty of Medicine & Health Sciences, McGill University, Montréal, Canada
| | - Joseph Cox
- Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, Montréal, Canada
- Chronic Viral Illness Service, Division of Infectious Diseases, Department of Medicine, McGill University Health Centre, Montréal, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine & Health Sciences, McGill University, Montréal, Canada
| | - Amélie Quesnel-Vallée
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine & Health Sciences, McGill University, Montréal, Canada
- Department of Sociology, Faculty of Arts, McGill University, Montréal, Canada
| | - Bertrand Lebouché
- Department of Family Medicine, Faculty of Medicine & Health Sciences, McGill University, Montréal, Canada
- Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, Montréal, Canada
- Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montréal, Canada
- Strategy for Patient-Oriented Research Mentorship Chair in Innovative Clinical Trials in HIV Care, Canadian Institutes of Health Research, Montréal, Canada
- Chronic Viral Illness Service, Division of Infectious Diseases, Department of Medicine, McGill University Health Centre, Montréal, Canada
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Folayan MO, Ibigbami O, El Tantawi M, Brown B, Aly NM, Ezechi O, Abeldaño GF, Ara E, Ayanore MA, Ellakany P, Gaffar B, Al-Khanati NM, Idigbe I, Ishabiyi AO, Jafer M, Khan ATA, Khalid Z, Lawal FB, Lusher J, Nzimande NP, Osamika BE, Quadri MFA, Roque M, Al-Tammemi AB, Yousaf MA, Virtanen JI, Zuñiga RAA, Okeibunor JC, Nguyen AL. Factors Associated with Financial Security, Food Security and Quality of Daily Lives of Residents in Nigeria during the First Wave of the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7925. [PMID: 34360217 PMCID: PMC8345729 DOI: 10.3390/ijerph18157925] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 07/16/2021] [Accepted: 07/18/2021] [Indexed: 12/19/2022]
Abstract
An online survey was conducted to identify factors associated with financial insecurity, food insecurity and poor quality of daily lives of adults in Nigeria during the first wave of the COVID-19 pandemic. The associations between the outcome (experience of financial loss, changes in food intake and impact of the pandemic on daily lives) and the explanatory (age, sex, education level, anxiety, depression, HIV status) variables were determined using logistic regression analysis. Of the 4439 respondents, 2487 (56.0%) were financially insecure, 907 (20.4%) decreased food intake and 4029 (90.8%) had their daily life negatively impacted. Males (AOR:0.84), people who felt depressed (AOR:0.62) and people living with HIV -PLHIV- (AOR:0.70) had significantly lower odds of financial insecurity. Older respondents (AOR:1.01) had significantly higher odds of financial insecurity. Those depressed (AOR:0.62) and PLHIV (AOR:0.55) had significantly lower odds of reporting decreased food intake. Respondents who felt anxious (AOR:0.07), depressed (AOR: 0.48) and who were PLHIV (AOR:0.68) had significantly lower odds of reporting a negative impact of the pandemic on their daily lives. We concluded the study findings may reflect a complex relationship between financial insecurity, food insecurity, poor quality of life, mental health, and socioeconomic status of adults living in Nigeria during the COVID-19 pandemic.
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Affiliation(s)
- Morenike Oluwatoyin Folayan
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife 220282, Nigeria
| | - Olanrewaju Ibigbami
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Department of Mental Health, Obafemi Awolowo University, Ile-Ife 220282, Nigeria
| | - Maha El Tantawi
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria 21527, Egypt
| | - Brandon Brown
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Department of Social Medicine, Population and Public Health, School of Medicine, University of California, Riverside, CA 92501, USA
| | - Nourhan M. Aly
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria 21527, Egypt
| | - Oliver Ezechi
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Department of Clinical Sciences, Nigerian Institute of Medical Research, Lagos 101212, Nigeria
| | - Giuliana Florencia Abeldaño
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Institute for Research on Public Health, School of Medicine, University of Sierra Sur, Oaxaca 70805, Mexico
| | - Eshrat Ara
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Government College for Women, Moulana Azad Road, Srinagar Kashmir, J&K 190001, India
| | - Martin Amogre Ayanore
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Department of Health Policy Planning and Management, University of Health and Allied Sciences, PMB 31 Ho, Ghana
| | - Passent Ellakany
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
| | - Balgis Gaffar
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Department of Preventive Dentistry, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
| | - Nuraldeen Maher Al-Khanati
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Syrian Private University, Damascus 36822, Syria
| | - Ifeoma Idigbe
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Department of Clinical Sciences, Nigerian Institute of Medical Research, Lagos 101212, Nigeria
| | - Anthonia Omotola Ishabiyi
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban 4001, South Africa
| | - Mohammed Jafer
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Department of Preventive Dental Sciences, Faculty of Dentistry, Jazan University, Jazan 45142, Saudi Arabia
- Department of Health Promotion, Faculty of Health, Medicine and Life Sciences, Maastricht University, 6200 MD Maastricht, The Netherlands
| | - Abeedha Tu-Allah Khan
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- School of Biological Sciences, University of the Punjab, Quaid-i-Azam Campus, Lahore 54590, Pakistan
| | - Zumama Khalid
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- School of Biological Sciences, University of the Punjab, Quaid-i-Azam Campus, Lahore 54590, Pakistan
| | - Folake Barakat Lawal
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Department of Periodontology and Community Dentistry, University of Ibadan, Ibadan 200212, Nigeria
| | - Joanne Lusher
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- School of Health and Life Sciences, University of the West of Scotland, London E142BE, UK
| | - Ntombifuthi P. Nzimande
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Department of Economic and Human Geography, Faculty of Geosciences, University of Szeged, H-6722 Szeged, Hungary
| | - Bamidele Emmanuel Osamika
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Department of Psychology, Faculty of Environment, Management and Social Sciences, Lead City University, Ibadan 200255, Nigeria
| | - Mir Faeq Ali Quadri
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Division of Dental Public Health, Department of Preventive Dentistry, Jazan University, Jazan 45142, Saudi Arabia
| | - Mark Roque
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Department of Maternity & Childhood Nursing, College of Nursing, Taibah University, Madinah 42223, Saudi Arabia
| | - Ala’a B. Al-Tammemi
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Department of Family and Occupational Medicine, Faculty of Medicine, Doctoral School of Health Sciences, University of Debrecen, H-4032 Debrecen, Hungary
| | - Muhammad Abrar Yousaf
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Institute of Zoology, University of the Punjab, Quaid-i-Azam Campus, Lahore 54590, Pakistan
| | - Jorma I. Virtanen
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Faculty of Medicine, University of Turku, FI-20014 Turku, Finland
| | - Roberto Ariel Abeldaño Zuñiga
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Post Graduate School, University of Sierra Sur, Oaxaca 70800, Mexico
| | - Joseph Chukwudi Okeibunor
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Research Development and Innovations, Assistant Regional Director Cluster, WHO Regional Office for Africa, Brazzaville BP 06, Congo
| | - Annie Lu Nguyen
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (O.I.); (M.E.T.); (B.B.); (N.M.A.); (O.E.); (G.F.A.); (E.A.); (M.A.A.); (P.E.); (B.G.); (N.M.A.-K.); (I.I.); (A.O.I.); (M.J.); (A.T.-A.K.); (Z.K.); (F.B.L.); (J.L.); (N.P.N.); (B.E.O.); (M.F.A.Q.); (M.R.); (A.B.A.-T.); (M.A.Y.); (J.I.V.); (R.A.A.Z.); (J.C.O.); (A.L.N.)
- Department of Family Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 91803, USA
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Senyurek G, Kavas MV, Ulman YI. Lived experiences of people living with HIV: a descriptive qualitative analysis of their perceptions of themselves, their social spheres, healthcare professionals and the challenges they face daily. BMC Public Health 2021; 21:904. [PMID: 33980195 PMCID: PMC8117647 DOI: 10.1186/s12889-021-10881-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 04/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Human immunodeficiency virus (HIV) infection rates have been gradually increasing in Istanbul, Turkey. Many people living with HIV (PLWH) here encounter difficulties, for example, in adapting to the chronic disease and obtaining continuous access to healthcare services. In this study, we aimed to explore the challenges PLWH face in their daily lives and understand their perceptions of themselves, healthcare professionals and services, and their social spheres via their expressed lived experiences in the healthcare setting. METHOD Individual semi-structured in-depth interviews were conducted face-to-face with 20 PLWH in Istanbul. All the interviews were voice-recorded and transcribed verbatim except one, upon participant request, for which the interviewer took notes. These logs and the interviewer's notes were analyzed thematically using the inductive content analysis method. RESULTS The themes concerned experiences in three distinct contexts: 1) Interactions with healthcare providers; 2) Participants' responses to their HIV diagnosis; and 3) Interactions with their social networks. Firstly, the results highlighted that the participants perceived that healthcare professionals did not inform them about the diagnosis properly, failed to protect patients' confidentiality and exhibited discriminative behaviors towards them. Secondly, after the diagnosis the participants had difficulty in coping with their unsettled emotional state. While many ceased sexual activities and isolated themselves, some sought support. Lastly, living with HIV affected their relationships with their families and friends either positively or negatively. Moreover, they had to face the difficulties concerning spouse/partner notification issues about which many needed professional support. CONCLUSION Healthcare professionals' discriminative or inappropriate attitudes and customs in healthcare institutions are perceived to impair PLWH's utilization of healthcare services. Structural factors such as social pressure, societal ignorance about HIV, limited access to HIV prevention, and regulatory barriers might contribute to these challenges. The results suggest that it is necessary to raise healthcare professionals' and society's awareness about HIV and develop national policies to establish a well-functioning referral system and appropriate spouse/partner notification services.
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Affiliation(s)
- Gamze Senyurek
- Department of Medical Humanities, Amsterdam UMC, De Boelelaan 1089a
- , 1081 HV, Amsterdam, Netherlands.
| | - Mustafa Volkan Kavas
- Department of History of Medicine and Ethics, Faculty of Medicine, Ankara University, Morfoloji Binasi, Tip Tarihi ve Etik AD. 06230, Altindag, Ankara, Turkey
| | - Yesim Isil Ulman
- Department of History of Medicine and Ethics, School of Medicine, Acibadem Mehmet Ali Aydinlar University, Kayisdagi Cad. No:32, Atasehir, Istanbul, Turkey
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Reuveny R. Climate-related migration and population health: social science-oriented dynamic simulation model. BMC Public Health 2021; 21:598. [PMID: 33771138 PMCID: PMC7996123 DOI: 10.1186/s12889-020-10120-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 12/23/2020] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Social science models find the ecological impacts of climate change (EICC) contribute to internal migration in developing countries and, less so, international migration. Projections expect massive climate-related migration in this century. Nascent research calls to study health, migration, population, and armed conflict potential together, accounting for EICC and other factors. System science offers a way: develop a dynamic simulation model (DSM). We aim to validate the feasibility and usefulness of a pilot DSM intended to serve as a proof-of-concept and a basis for identifying model extensions to make it less simplified and more realistic. METHODS Studies have separately examined essential parts. Our DSM integrates their results and computes composites of health problems (HP), health care (HC), non-EICC environmental health problems (EP), and environmental health services (ES) by origin site and by immigrants and natives in a destination site, and conflict risk and intensity per area. The exogenous variables include composites of EICC, sociopolitical, economic, and other factors. We simulate the model for synthetic input values and conduct sensitivity analyses. RESULTS The simulation results refer to generic origin and destination sites anywhere on Earth. The effects' sizes are likely inaccurate from a real-world view, as our input values are synthetic. Their signs and dynamics are plausible, internally consistent, and, like the sizes, respond logically in sensitivity analyses. Climate migration may harm public health in a host area even with perfect HC/ES qualities and full access; and no HP spillovers across groups, conflict, EICC, and EP. Deviations from these conditions may worsen everyone's health. We consider adaptation options. CONCLUSIONS This work shows we can start developing DSMs to understand climate migration and public health by examining each case with its own inputs. Validation of our pilot model suggests we can use it as intended. We lay a path to making it more realistic for policy analysis.
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Affiliation(s)
- Rafael Reuveny
- School of Public and Environmental Affairs, Indiana University, Bloomington, USA.
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Bolster-Foucault C, Ho Mi Fane B, Blair A. Structural determinants of stigma across health and social conditions: a rapid review and conceptual framework to guide future research and intervention. HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION IN CANADA-RESEARCH POLICY AND PRACTICE 2021; 41:85-115. [PMID: 33688694 DOI: 10.24095/hpcdp.41.3.03] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Stigma has been identified as a key determinant of health and health inequities because of its effects on access to health-enabling resources and stress exposure. Though existing reports offer in-depth summaries of the mechanisms through which stigma influences health, a review of evidence on the upstream drivers of stigma across health and social conditions has been missing. The objective of this review is to summarize known structural determinants of stigma experienced across health and social conditions in developed country settings. METHODS We conducted a rapid review of the literature. English- and French-language peer-reviewed and grey literature works published after 2008 were identified using MEDLINE, Embase, PsycINFO, Google and Google Scholar. Titles and abstracts were independently screened by two reviewers. Information from relevant publications was extracted, and a thematic analysis of identified determinants was conducted to identify broad domains of structural determinants. A narrative synthesis of study characteristics and identified determinants was conducted. RESULTS Of 657 publications identified, 53 were included. Ten domains of structural determinants of stigma were identified: legal frameworks, welfare policies, economic policies, social and built environments, media and marketing, pedagogical factors, health care policies and practices, biomedical technology, diagnostic frameworks and public health interventions. Each domain is defined and summarized, and a conceptual framework for how the identified domains relate to the stigma process is proposed. CONCLUSION At least 10 domains of structural factors influence the occurrence of stigma across health and social conditions. These domains can be used to structure policy discussions centred on ways to reduce stigma at the population level.
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Affiliation(s)
- Claire Bolster-Foucault
- Public Health Agency of Canada, Montréal, Quebec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Quebec, Canada
| | | | - Alexandra Blair
- Public Health Agency of Canada, Montréal, Quebec, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Arefaynie M, Damtie Y, Kefale B, Yalew M. Predictors of Discrimination Towards People Living with HIV/AIDS Among People Aged 15–49 Years in Ethiopia: A Multilevel Analysis. HIV AIDS (Auckl) 2021; 13:283-292. [PMID: 33758550 PMCID: PMC7979683 DOI: 10.2147/hiv.s299812] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 02/18/2021] [Indexed: 11/23/2022] Open
Affiliation(s)
- Mastewal Arefaynie
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
- Correspondence: Mastewal Arefaynie Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, EthiopiaTel +251 912867518 Email
| | - Yitayish Damtie
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Bereket Kefale
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Melaku Yalew
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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Srinivasan K, Heylen E, Raj T, Nyblade L, Devadass D, Pereira M, Ekstrand ML. Reduction in Stigma Drivers Partially Mediates the Effect of a Stigma Reduction Intervention Among Nursing Students in India: The DriSti Cluster Randomized Controlled Trial. J Acquir Immune Defic Syndr 2021; 86:182-190. [PMID: 33105394 PMCID: PMC7884286 DOI: 10.1097/qai.0000000000002543] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 10/09/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND HIV stigma in health care settings acts as a significant barrier to health care. Stigma drivers among health professionals include transmission fears and misconceptions and pre-existing negative attitudes toward marginalized groups vulnerable to HIV. The DriSti intervention, consisted of 2 sessions with videos and interactive exercises on a computer tablet and one interactive face-to-face group session, mostly tablet administered, was designed to target key stigma drivers that included instrumental stigma, symbolic stigma, transmission misconceptions and blame to reduce HIV stigma, and discrimination among nursing students (NS) and ward staff and tested in a cluster randomized trial. SETTING This report focuses on second and third year NS recruited from a range of nursing schools that included private, nonprofit, and government-run nursing schools in south India. RESULTS Six hundred seventy-nine NS received intervention and 813 NS were in the wait-list control group. Twelve months outcome analyses showed significant reduction among intervention participants in endorsement of coercive policies (P < 0.001) and in the number of situations in which NS intended to discriminate against PLWH (P < 0.001). Mediation analysis revealed that the effects of intervention on endorsement of coercive policies and intent to discriminate against PLWH were partially mediated by reductions in key stigma drivers. CONCLUSIONS This brief scalable stigma reduction intervention targeting key stigma drivers fills a critical gap in identifying the mechanistic pathways that aid in stigma reduction among health professionals.
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Affiliation(s)
- Krishnamachari Srinivasan
- Division of Mental Health and Neurosciences, St John's Research Institute and St. John's Medical College, Bangalore, India
| | - Elsa Heylen
- Division of Prevention Sciences, Department of Medicine, University of California, San Francisco, CA
| | - Tony Raj
- Division of Medical Informatics, St John's Research Institute, and St. John's Medical College, Bangalore, India; and
| | - Laura Nyblade
- Global Health Division, International Development Group, RTI International, Washington, DC
| | - Dhinagaran Devadass
- Division of Medical Informatics, St John's Research Institute, and St. John's Medical College, Bangalore, India; and
| | - Matilda Pereira
- Division of Prevention Sciences, Department of Medicine, University of California, San Francisco, CA
| | - Maria L Ekstrand
- Division of Prevention Sciences, Department of Medicine, University of California, San Francisco, CA
- Division of Medical Informatics, St John's Research Institute, and St. John's Medical College, Bangalore, India; and
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Iyamu T, Nunu K. Healthcare data management conceptual framework for service delivery. EDUCATION AND INFORMATION TECHNOLOGIES 2021; 26:3513-3527. [PMID: 33456311 PMCID: PMC7803662 DOI: 10.1007/s10639-020-10413-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 12/09/2020] [Indexed: 06/12/2023]
Abstract
In the context of South Africa, what we do know is that huge amount of healthcare data does exist and that they are consciously and unconsciously scattered in bits and pieces across facilities within the country. This has directly or indirectly resulted to underutilisation of data, which affects service delivery to the community. For example, many patients have been wrongly diagnosed, and some others have been given wrong medications due to duplication of prescriptions, which were influenced by lack of real-time information. Consequently, there have been loss and damages to lives, contributing to the mortality rate in the country. This study was undertaken on the premise of these challenges, to develop a conceptual framework that can guide how data could be managed towards improved services within the South African healthcare facilities. The interpretive approach was employed. Qualitative data were gathered from existing works. Structuration theory was applied as a lens to guide the analysis of the data. From the findings, a framework was developed, primarily to guide and advance the waysin which data are stored, retrieved, managed, and used for healthcare improved services.
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Affiliation(s)
- Tiko Iyamu
- Department of Information Technology, Cape Peninsula University of Technology, Cape Town, South Africa
| | - Khaya Nunu
- Department of Information Technology, Cape Peninsula University of Technology, Cape Town, South Africa
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Diress GA, Ahmed M, Linger M. Factors associated with discriminatory attitudes towards people living with HIV among adult population in Ethiopia: analysis on Ethiopian demographic and health survey. SAHARA J 2020; 17:38-44. [PMID: 33357027 PMCID: PMC7759280 DOI: 10.1080/17290376.2020.1857300] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Extensive discriminatory attitudes in a population can affect people’s willingness to be tested for Human Immunodeficiency Virus (HIV), their initiation of antiretroviral therapy, social support as well as the quality of life of people infected with HIV. This study aimed to assess factors associated with discriminatory attitudes towards people living with HIV/AIDS (PLWHA). Secondary data analysis was conducted using data from the 2016 Ethiopia Demographic Health Survey. A total of 26,623 adult populations were included. Multivariable logistic regression analysis was conducted to identify factors associated with discriminatory attitudes. The proportion of participants having discriminatory attitudes towards PLWHA was 93.8% among men and 64.5% among women. This study revealed that rural residence, no formal education, lack of media access, not previously tested for HIV and lack of comprehensive HIV knowledge increase the odds of having discriminatory attitudes. In conclusion, there is a high-level discriminatory attitude towards PLWHA. Improvement in HIV-related knowledge and dealing with wrong perceptions and myths are extremely vital to reduce discriminatory attitudes towards HIV-infected people. Information, education and communication programmes need to intensify its educational campaigns to dispel these misconceptions.
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Affiliation(s)
- Gedefaw Alen Diress
- Department of Public Health, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Mohammed Ahmed
- Department of Public Health, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Melese Linger
- Department of Public Health, College of Health Science, Woldia University, Woldia, Ethiopia
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Sánchez-Ojeda MA, Navarro-Prado S, Martín-Salvador A, Luque-Vara T, Fernández-Gómez E, Plaza del Pino FJ. Nursing Students' Attitudes towards Immigrants' Social Rights. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238875. [PMID: 33260327 PMCID: PMC7730376 DOI: 10.3390/ijerph17238875] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 11/22/2020] [Accepted: 11/26/2020] [Indexed: 11/25/2022]
Abstract
The migrant population has increased in recent years and, as a result, so has cultural diversity. Universities are incorporating specific modules addressing cultural diversity. However, the native population has negative attitudes towards immigrants, as they believe that immigrants receive more social benefits and abuse healthcare services. Nurses may have these attitudes too, which may affect the way they treat patients. The objective of this study was to determine nursing students’ attitudes towards the rights of the migrant population. This is a descriptive ex post facto study using a cross-sectional design, with 821 nursing students in Melilla, Ceuta, and Almeria, Spain. An anonymous questionnaire was used for data collection. Students recognize the same rights for both the immigrant and native populations. More than 80% of the sample upholds the right of undocumented immigrants and their families to access publicly funded healthcare. Attitudes were more positive among students with a Berber background and first-year students. Students approved of the right of immigrants and their families to healthcare and education. The students’ negative attitudes towards the social rights of immigrants need to be addressed with intercultural training to reduce their prejudices as future professionals in a multicultural society.
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Affiliation(s)
- María Angustias Sánchez-Ojeda
- Department of Nursing, Faculty of Health Sciences, University of Granada, 52017 Melilla, Spain; (M.A.S.-O.); (A.M.-S.); (T.L.-V.); (E.F.-G.)
| | - Silvia Navarro-Prado
- Department of Nursing, Faculty of Health Sciences, University of Granada, 52017 Melilla, Spain; (M.A.S.-O.); (A.M.-S.); (T.L.-V.); (E.F.-G.)
- Correspondence: ; Tel.: +34-696006900
| | - Adelina Martín-Salvador
- Department of Nursing, Faculty of Health Sciences, University of Granada, 52017 Melilla, Spain; (M.A.S.-O.); (A.M.-S.); (T.L.-V.); (E.F.-G.)
| | - Trinidad Luque-Vara
- Department of Nursing, Faculty of Health Sciences, University of Granada, 52017 Melilla, Spain; (M.A.S.-O.); (A.M.-S.); (T.L.-V.); (E.F.-G.)
| | - Elisabet Fernández-Gómez
- Department of Nursing, Faculty of Health Sciences, University of Granada, 52017 Melilla, Spain; (M.A.S.-O.); (A.M.-S.); (T.L.-V.); (E.F.-G.)
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Ezeamama AE, Zalwango SK, Tuke R, Pad RL, Boivin MJ, Musoke PM, Giordani B, Sikorskii A. Toxic Stress and Quality of Life in Early School-Aged Ugandan Children With and Without Perinatal Human Immunodeficiency Virus Infection. New Dir Child Adolesc Dev 2020; 2020:15-38. [PMID: 32662113 DOI: 10.1002/cad.20355] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Caregiver's and child's self-reported quality of life (QOL) was defined using standardized questionnaires in a sample (N = 277) of 6-10 years old HIV-infected, HIV-exposed uninfected, and HIV-unexposed uninfected children from Uganda. Psychosocial stress (acute stress and cumulative lifetime adversity) and physiologic stress (dysregulations across 13 biomarkers), perinatal HIV status, and their interaction were related to child QOL via general linear models. Lower child- and caregiver-reported psychosocial stress were dose-dependently associated with higher QOL (acute stress: mean difference coefficient b = 8.1-14.8, effect size [ES] = 0.46-0.83). Lower allostasis was dose-dependently associated with higher QOL (b = 6.1-9.7, ES = 0.34-0.54). Given low caregiver acute stress, QOL for HIV-infected was similar to HIV-uninfected children; however, given high caregiver acute stress, a QOL disadvantage (b = -7.8, 95% CI: -12.8, -2.8; ES = -0.73) was evident for HIV-infected versus uninfected children. Testing of caregiver stress reduction interventions is warranted to increase wellbeing in dependent children.
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Affiliation(s)
| | | | - Robert Tuke
- Michigan State University, East Lansing, MI, USA
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Hospitalization Experience of Muslim Migrants in Hospitals in Southern Spain-Communication, Relationship with Nurses and Culture. A Focused Ethnography. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082791. [PMID: 32316654 PMCID: PMC7215724 DOI: 10.3390/ijerph17082791] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 04/05/2020] [Accepted: 04/15/2020] [Indexed: 11/17/2022]
Abstract
The coast of southern Spain is one of the main entry points for Africans who want to reach Europe; in this area, there is an important immigrant community of African origin, mostly Muslims. The objective of this study is to describe and understand the hospitalization experience of Muslim migrants in public hospitals in southern Spain, especially their relationship with the nurses who care for them. Data were collected from May 2016 to June 2017. This study followed the principles associated with focused ethnography. During data collection, open interviews with 37 Muslim patients were conducted. Three themes emerged from the inductive data analysis: lack of communication with nurses, discriminatory experiences at the hospital and their experience of Islam in the hospital. We conclude that caring for Muslim patients requires specific training not only for nurses but also for other health professionals; existing communication problems must be addressed by establishing the role of the intercultural mediator as an idiomatic and cultural bridge between patients and nurses. In addition, hiring health professionals with migrant backgrounds would help convert hospitals into spaces for intercultural coexistence.
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Ekstrand ML, Raj T, Heylen E, Nyblade L, Devdass D, Pereira M, Mazur A, Srinivasan K. Reducing HIV stigma among healthcare providers in India using a partly tablet-administered intervention: the DriSti trial. AIDS Care 2020; 32:14-22. [PMID: 32151146 DOI: 10.1080/09540121.2020.1739221] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
HIV stigma has long been recognized as a significant barrier in the worldwide fight against HIV. Across cultures, stigma has been shown to cause psychological distress and act as a barrier to engagement in care. Health professionals can serve as a crucial source of HIV stigma, with drivers that include fears and transmission misconceptions and pre-existing negative attitudes towards marginalized groups. To increase their impact, stigma reduction interventions need to be scalable and sustainable as well as adaptable to different cultural contexts. The DriSti intervention was designed to meet these needs through an easily adaptable, mostly tablet-administered, interactive intervention delivered to ward staff (n = 1,557) and nursing students (n = 1,625) in 62 Indian institutions, using a cRCT design, with wait-list controls. Six-month outcome analyses, showed significant reductions in misconceptions (p < .001) and worry about acquiring HIV at work (p < .001). Intervention participants also reported significantly greater reductions in endorsement of coercive policies (p < .001) and in the number of situations in which they intended to discriminate against PLWH (p < .001) than control participants. This brief, scaleable intervention could be adapted for similar populations in the region, using different mHealth platforms and thus has important implications for current global stigma reduction initiatives and training curricula.
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Affiliation(s)
- Maria L Ekstrand
- Division of Prevention Sciences, Department of Medicine, University of California, San Francisco, CA, USA.,Division of Medical Informatics, St. John's Research Institute, Bangalore, India
| | - Tony Raj
- Division of Medical Informatics, St. John's Research Institute, Bangalore, India
| | - Elsa Heylen
- Division of Prevention Sciences, Department of Medicine, University of California, San Francisco, CA, USA
| | - Laura Nyblade
- Global Health Division, International Development Group, RTI International, USA
| | - Dhinagaran Devdass
- Division of Medical Informatics, St. John's Research Institute, Bangalore, India
| | - Matilda Pereira
- Division of Medical Informatics, St. John's Research Institute, Bangalore, India
| | - Amanda Mazur
- Division of Prevention Sciences, Department of Medicine, University of California, San Francisco, CA, USA
| | - Krishnamachari Srinivasan
- Division of Mental Health and Neurosciences, Department of Psychiatry, St. John's Research Institute, Bangalore, India
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Mehdiyar M, Andersson R, Hjelm K. HIV-positive migrants' experience of living in Sweden. Glob Health Action 2020; 13:1715324. [PMID: 31996102 PMCID: PMC7034485 DOI: 10.1080/16549716.2020.1715324] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 01/06/2020] [Indexed: 10/31/2022] Open
Abstract
Background: There is a limited knowledge of the impact of being human immunodeficiency virus (HIV)-positive on migrants living in Sweden. It is therefore important to gain a general awareness of this issue in order to maintain the wellbeing of this vulnerable group of patients and to develop an adequate social support network.Objective: The aim of this study was to explore HIV-positive migrants' experiences of their life situations, living in Sweden.Method: A qualitative, exploratory study was performed using semi-structured interviews with 14 HIV-positive migrants, aged 29-55 years, and analyzed with qualitative content analysis. The participants were recruited from three clinics for infectious diseases in western Sweden.Results: The results are presented in the following three categories: ´Vulnerability in social relationships', 'Fear of disclosure", and 'Resilience'. The results illustrated the participants' experiences of vulnerability in their social relationships, fear of disclosing HIV status, feeling lonely and stigmatized, and lacking social network and support. Furthermore, the results illustrated participants' challenges in finding a partner, due to their fear of being recognized because of their HIV-infection. However, the result indicated participants' struggling for a normal life with integrity, and that their need to look positively at life.Conclusions: In the actual study loneliness, fear of disclosure, perceived stigma, and the lack of a social network had significant impact on the life situations of the HIV positive migrants. Fear of disclosure and the challenge of finding a partner and friends were the main obstacles. It is crucial to increase access for these patients to supporting networks that will promote their empowerment and trust.
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Affiliation(s)
- Manijeh Mehdiyar
- Department of Infectious Diseases, Institute of Biomedicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Rune Andersson
- Department of Infectious Diseases, Institute of Biomedicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Departments of Clinical Microbiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Katarina Hjelm
- Department of Public Health and Caring Science, Uppsala University, Uppsala, Sweden
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Vignier N, Dray Spira R, Pannetier J, Ravalihasy A, Gosselin A, Lert F, Lydie N, Bouchaud O, Desgrees Du Lou A, Chauvin P. Refusal to provide healthcare to sub-Saharan migrants in France: a comparison according to their HIV and HBV status. Eur J Public Health 2019; 28:904-910. [PMID: 29982518 DOI: 10.1093/eurpub/cky118] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background In this study, we aim to measure and compare the frequency of reported denial of care in sub-Saharan African migrants living in the Paris area, according to their HIV and HBV status and social and migration characteristics. Methods The ANRS-PARCOURS study is a life-event survey conducted in 2012-13 in healthcare facilities in the Paris area, among three groups of sub-Saharan migrants recruited in primary care centres (N = 760; reference group), in dedicated centres for HIV care (N = 922; HIV group) and in centres for chronic hepatitis B care (N = 777; CHB group). Characteristics associated with refusal of care since arrival in France were identified using a logistic regression model. Results Compared to the reference group (6%, P < 0.001), the reported refusal of care was twice as high in the HIV group (12%) and the CHB group (10%). In the multivariate analysis, men and women living with HIV were at greater risk of being denied care (aOR = 2.20[1.14-4.25] and 2.24[1.25-4.01]). Women covered by the specific health insurance (HI) for precarious or undocumented migrants were also at higher risk (aOR = 2.07[1.10-3.89] and 2.69[1.18-6.10], respectively). The risk was also increased in men who remained for at least one year without permit of residence or without HI and among those who were threatened in their country. Conclusion Refusals to provide healthcare are frequent and deleterious situations especially for migrants living with HIV. Health decision makers, public insurance bodies and health professional councils must address this issue to improve equity in the healthcare system.
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Affiliation(s)
- Nicolas Vignier
- Department of Social Epidemiology, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), Sorbonne Université, Paris, France.,Department of Infectious and Tropical Diseases, Groupe hospitalier Sud Ile-de-France, Sorbonne Université, Melun, France
| | - Rosemary Dray Spira
- Department of Social Epidemiology, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), Sorbonne Université, Paris, France
| | - Julie Pannetier
- Santé, vulnérabilité et relations de genre (Sagesud), Sorbonne Paris Cités, IRD, CEPED, ERL INSERM 1244 SAGESUD, Université Paris Descartes, Paris, France
| | - Andrainolo Ravalihasy
- Santé, vulnérabilité et relations de genre (Sagesud), Sorbonne Paris Cités, IRD, CEPED, ERL INSERM 1244 SAGESUD, Université Paris Descartes, Paris, France
| | - Anne Gosselin
- Santé, vulnérabilité et relations de genre (Sagesud), Sorbonne Paris Cités, IRD, CEPED, ERL INSERM 1244 SAGESUD, Université Paris Descartes, Paris, France
| | - France Lert
- Center for Research in Epidemiology and Population Health (CESP-U 1018), INSERM, Université Paris Sud, Villejuif, France
| | - Nathalie Lydie
- Direction de la prévention et de la promotion de la santé-Unité Santé sexuelle, Santé Publique France, French National Agency of Public Health, Saint-Maurice, France
| | - Olivier Bouchaud
- Department of Infectious and Tropical diseases, and Laboratoire Educations et Pratiques de Santé (LEPS EA 3412), Paris 13 University, Avicenne Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Bobigny, France
| | - Annabel Desgrees Du Lou
- Santé, vulnérabilité et relations de genre (Sagesud), Sorbonne Paris Cités, IRD, CEPED, ERL INSERM 1244 SAGESUD, Université Paris Descartes, Paris, France
| | - Pierre Chauvin
- Department of Social Epidemiology, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), Sorbonne Université, Paris, France
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Ekstrand ML, Heylen E, Mazur A, Steward WT, Carpenter C, Yadav K, Sinha S, Nyamathi A. The Role of HIV Stigma in ART Adherence and Quality of Life Among Rural Women Living with HIV in India. AIDS Behav 2018; 22:3859-3868. [PMID: 29789984 DOI: 10.1007/s10461-018-2157-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
HIV stigma continues to be a barrier to physical and mental health among people living with HIV globally, especially in vulnerable populations. We examined how stigma is associated with health outcomes and quality of life among rural women living with HIV in South India (N = 600). Interviewer-administered measures assessed multiple dimensions of stigma, as well as loneliness, social support, ART adherence, time since diagnosis, and quality of life. Internalized stigma and a lack of social support were associated with a lower quality of life, while the association between internalized stigma and adherence was mediated by the use of stigma-avoidant coping strategies, suggesting that keeping one's diagnosis a secret may make it more difficult to take one's medications. These findings suggest that these women constitute a vulnerable population who need additional services to optimize their health and who might benefit from peer support interventions and stigma-reduction programs for family and community members.
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Affiliation(s)
- Maria L Ekstrand
- University of California, San Francisco, 550 16th St, 3rd floor, San Francisco, CA, 94158, USA.
- St John's Research Institute, Bangalore, India.
| | - Elsa Heylen
- University of California, San Francisco, 550 16th St, 3rd floor, San Francisco, CA, 94158, USA
| | - Amanda Mazur
- University of California, San Francisco, 550 16th St, 3rd floor, San Francisco, CA, 94158, USA
| | - Wayne T Steward
- University of California, San Francisco, 550 16th St, 3rd floor, San Francisco, CA, 94158, USA
| | | | | | - Sanjeev Sinha
- All India Institute of Medical Sciences, New Delhi, India
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Risal A, Irwan AM, Sjattar EL. STIGMA TOWARDS PEOPLE LIVING WITH HIV/AIDS AMONG COUNSELING OFFICERS IN SOUTH SULAWESI, INDONESIA. BELITUNG NURSING JOURNAL 2018; 4:552-558. [DOI: 10.33546/bnj.543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Revised: 09/03/2018] [Accepted: 09/26/2018] [Indexed: 09/02/2023] Open
Abstract
Background: Human Immunodeficiency Virus (HIV) / Acquired Immunodeficiency Syndrome (AIDS) has become a global problem nowadays. To reduce its spread, Voluntary Counseling and Testing (VCT) and Provider-Initiated Testing and Counseling (PITC) have been provided. However, these interventions remain ineffective to discover new cases, as the stigma among health officers may exist.
Objective: To compare the stigma towards people living with HIV/AIDS between VCT and PITC officers.
Methods: This was a descriptive comparative study conducted in Makassar City, Parepare City and Sidenreng Rappang Regency, South Sulawesi Province, Indonesia. There were 139 samples were selected using a convenience sampling technique, which consisted of 66 VCT counseling officers and 73 PITC officers. The questionnaire from Health Policy Project in Thailand was used to measure the HIV/AIDS related-stigma. Data were analyzed using descriptive statistics and Mann Whitney test.
Results: Findings showed that there was a statistically significant difference in stigma between the group of VCT and PITC on people living with HIV/AIDS (PLWHA), which the mean of stigma in the PITC group (73.07) was higher than the mean value in the VCT group (66.61).
Conclusion: There was a significant difference in stigma between VCT and PITC officers towards PLWHA. It is suggested that PITC curriculum should be evaluated, and supervision and monitoring in both VCT and PITC groups should be implemented regularly to reduce the stigma towards PLWHA.
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