Abstract
Stigma and discrimination (S&D) undermine quality of life of people living with HIV (PLHIV) and their access to health services. In this context, an understanding of current stigmatizing attitudes among HCW towards PLHIV from the perspective of Malaysia healthcare setting is crucial to plan for service delivery improvement that is non-stigmatizing and non-discriminatory. The objective of this study was to examine and measure the level of S&D towards PLHIV among HCW in selected government facilities.
 
 A cross-sectional study was undertaken from July to August 2020 in five government hospitals and six government health clinics in Malaysia. Two sets of a validated self-administered questionnaires, one for HCW and another one for PLHIV were used to assess HIV-related S&D. This survey was conducted via web-based platform.
 
 Overall, 3880 HCW and 1173 PLHIV participated in this study. This study found significant proportion of HCW were having stigmatizing attitudes towards PLHIV. This includes fear of taking blood from PLHIV (87%) and double gloving when attending PLHIV (64%) probably due to fear of contracting HIV. In addition, 45% of HCW agreed that women living with HIV (WLHIV) should be prohibited from having children. Although HCW have fears for contracting HIV, their consciences and integrity allowed them to display some positive attitudes towards PLHIV with the majority of HCW 84% and 79% stated that they having observed others in their facility expressed willingness to care and providing good care to PLHIV. On PLHIV experience, only 12% of them reported that they had ever experienced stigma when accessing health services.
 
 The findings of this study shared a worrying magnitude of stigma towards PLHIV among HCW in Malaysia. Nevertheless, ethics and professionalism are upheld through giving good care and services to PLHIV. However, stigma reduction intervention programmes are still needed for HCW to ensure continuous excellent service delivery.
Highlights
Despite global progress in the treatment and care of human immunodeficiency virus (HIV), people living with HIV (PLHIV) still continue to report experiencing HIV-related Stigma and discrimination (S&D) within the healthcare setting (Vorasane et al, 2017)
An understanding of current stigmatizing attitudes among healthcare workers (HCW) towards PLHIV from the perspective of Malaysia healthcare setting is crucial to plan for service delivery improvement that is non-stigmatizing and non-discriminatory
3880 HCW and 1173 PLHIV participated in this study
Summary
Despite global progress in the treatment and care of human immunodeficiency virus (HIV), PLHIV still continue to report experiencing HIV-related S&D within the healthcare setting (Vorasane et al, 2017). Reducing HIV-related S&D in healthcare setting is paramount because they are the first line of care, treatment and support services that PLHIV can access to help them manage their response to HIV (Houstan et al, 2019). Aside from access to services, other critical reasons for reducing HIV-related S&D is the negative effect on self-esteem and mental health (Vorasane et al, 2017). Research has shown that HIV-related S&D in healthcare setting may occur in many different forms, including: denial of care to a PLHIV (Ogden & Nyblade, 2005), verbal abuse to a PLHIV (Mukasa, 2006; Nyblade, Stangl, Weiss & Ashburn, 2009), lower standards of care to a PLHIV (Maluwa, Aggleton & Parker, 2002; Chambers et al, 2015), placement of a PLHIV at the end of a queue (Ogden & Nyblade, 2005), disclosure of a patient’s HIV status to colleagues/family members without consent, irrespective of when PLHIV arrived at the facility and gossiping about the patient (Mukasa, 2006)
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