Management of stigma and disclosure of HIV/AIDS status in healthcare settings

Abstract

This paper aims to examine the management strategies adopted by older people living with HIV/AIDS (PHAs) to conceal their positive status in healthcare settings, and their responses taken and means used to cope with the stigmatizing and exclusionary effects as a result of the disclosure of their status by/to healthcare workers. Under the auspices of a local NGO in Hong Kong, a total of seven male older PHAs aged 55 or above from pre-existing HIV/AIDS self-help groups were recruited for two separate focus groups. A thematic approach was adopted for data analysis and specific themes identification. An analysis of the data revealed that older PHAs did exercise their own agency in preventing against and managing stigma in their access to and use of health care services. Two more specific themes around "sign of disapproval" and "discriminatory practice" as barriers to access were also identified. Because of the small sample size, the pattern of stigmatization experiences and coping strategies cannot claim to be representative of the complete picture of the stigma associated with HIV/AIDS. This is the first exploratory study of the stigmatization and devaluation suffered by older PHAs in healthcare settings in the context of Hong Kong. It also explored in details the pros and cons of the stigma management strategies employed by this vulnerable group of patients. The implications for practice both on the side of healthcare workers and policy makers and that of PHAs were discussed.