Abstract
BackgroundDespite existing efforts to provide antiretroviral treatment (ART) for all HIV-diagnosed people, stigma deprives them of the highest attainable health status and challenges the effectiveness of ART program in Vietnam. This study aimed to assess five dimensions of HIV-related stigma and explore its associated factors among ART patients in a multisite survey. Implications of this study support the development of HIV policies to improve patients’ access, utilization, and outcomes of ART program toward the 90-90-90 goal in Vietnam.MethodsA total of 1133 ART patients who were recruited by convenience sampling method from 8 ART clinics in Hanoi and Nam Dinh in a cross-sectional study from January to August 2013. Multivariate logistic regression was employed to identify factors associated with stigmatization.ResultsThe majority of participants reported experiencing stigmatization due to shame (36.9%), blame/judge (21.6%), and discrimination (23.4%). Further, 91.5% of participants disclosed their HIV status with others. The likelihood of experiencing stigmatization did not only associate with the patients’ socioeconomic status (e.g., age, occupation, education) and HIV status disclosure, but also their health problems. Those with anxiety or depression and perceived lower quality of life were more likely to experience stigma.ConclusionsTo maximize the efficiency of the ART program, it is essential to develop interventions that reduce stigma involving individuals, families, and communities, and recognize and address complex health problems especially those patients showing depressive symptoms. Increasing quality of life of HIV-positive patients by providing vocational training, financial, family, and peer support will reduce the likelihood of experiencing stigma.
Highlights
Despite existing efforts to provide antiretroviral treatment (ART) for all Human immunodeficiency virus (HIV)-diagnosed people, stigma deprives them of the highest attainable health status and challenges the effectiveness of ART program in Vietnam
The World Health Organization created 90-90-90 treatment goal as a global commitment: 90% of people living with HIV (PLWH) know their HIV status, 90% of HIV-positive people receive antiretroviral treatment (ART), and 90% of PLWH on treatment have their viral loads suppressed [1]
We selected eight outpatient clinics which met the following inclusion criteria: (1) the clinic belongs to the public health system in Vietnam, (2) the clinic provides ART service, and (3) the clinic implements their ART programs following the official guidelines from the Vietnamese Ministry of Health [19]
Summary
Despite existing efforts to provide antiretroviral treatment (ART) for all HIV-diagnosed people, stigma deprives them of the highest attainable health status and challenges the effectiveness of ART program in Vietnam. The World Health Organization created 90-90-90 treatment goal as a global commitment: 90% of people living with HIV (PLWH) know their HIV status, 90% of HIV-positive people receive antiretroviral treatment (ART), and 90% of PLWH on treatment have their viral loads suppressed [1]. According to UNAIDS, in 2017, Vietnam has approximately 250,000 PLWH, 50% of those are receiving ART, and 43% of PLWH are virally suppressed [13] With these statistics, Vietnam is far from meeting its commitment which is to expand HIV treatment by 2020, become the first country in Asia to meet 90-90-90 goal, and end the AIDS epidemic by 2030. The effectiveness of this strategy is still unknown because of the strong HIV stigma that remains in the community
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