A comparison in HIV-associated stigma among healthcare workers in urban and rural Gujarat

Kartavya J Vyas,Gulab R Patel,Deepak Shukla,William C Mathews

doi:10.1080/17290376.2010.9724959

Abstract

The present study measures levels of stigma within health care settings in urban and rural Gujarat, in an attempt to understand how this may have contributed to the state's increasing HIV incidence. Two sites were studied: a rural hospital in Bardoli and an urban hospital in Surat. HIV-associated stigma among healthcare workers (N=170) was assessed using a Stigma Index. Overall, analyses suggest an increase in medical education was found to be associated with higher stigmatisation (p<0.001). Furthermore, a statistically significant difference between stigma scores of HCWs in rural and urban Gujarat was not observed.

Highlights

Of India’s over 1.15 billion population – one-sixth of the world’s population – 5.7 million are infected with HIV
There is little information pertaining to how HIV/AIDSrelated stigma and discrimination are affecting or contributing to the recent surges of the epidemic in rural India, in Gujarat – a state on the verge of becoming one of the states in India with the highest prevalence (Basic Health Statistics, 2007; National Health and Family Welfare, 2009)
Our analyses suggest that HIV-associated stigma is just as prevalent in rural Gujarat as in urban Gujarat

Summary

Introduction

Of India’s over 1.15 billion population – one-sixth of the world’s population – 5.7 million are infected with HIV. Since first being diagnosed in Chennai in 1986, the infection has seen a tremendous growth in both numbers and distribution in the urban and rural areas of southern and western India (Steinbrook, 2007). Research on HIV/AIDS stigma had been predominantly limited to the urban epicentres of India. There is little information pertaining to how HIV/AIDSrelated stigma and discrimination are affecting or contributing to the recent surges of the epidemic in rural India, in Gujarat – a state on the verge of becoming one of the states in India with the highest prevalence (Basic Health Statistics, 2007; National Health and Family Welfare, 2009). The total number of HIV-positive cases reported to the Gujarat AIDS Control Programme more than doubled from 2002 (N=2 528) to 2006. It is hypothesised that because of the high traffic of rural commuters to and from cities like Ahmadabad 255 km to the north (where 13% of commercial sex workers are HIV-infected) and Mumbai 263 km to the south (where 54% of commercial sex workers are HIV-infected and injection drug use is more accessible), the epidemic may build a stronghold here (Fung et al, 2007; Madhivanan et al, 2005; Pallikadavath et al, 2005)

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