Abstract
BackgroundStigma and discrimination against people living with human immunodeficiency virus (HIV) are obstacles in the way of effective responses to HIV. Understanding the extent of stigma / discrimination and the underlying causes is necessary for developing strategies to reduce them. This study was conducted to explore stigma and discrimination against PLHIV amongst healthcare providers in Jimma zone, Southwest Ethiopia.MethodsA cross-sectional study, employing quantitative and qualitative methods, was conducted in 18 healthcare institutions of Jimma zone, during March 14 to April 14, 2011. A total of 255 healthcare providers responded to questionnaires asking about sociodemographic characteristics, HIV knowledge, perceived institutional support and HIV-related stigma and discrimination. Factor analysis was employed to create measurement scales for stigma and factor scores were used in one way analysis of variance (ANOVA), T-tests, Pearson’s correlation and multiple linear regression analyses. Qualitative data collected using key-informant interviews and Focus Group Discussions (FGDs) were employed to triangulate with the findings from the quantitative survey.ResultsMean stigma scores (as the percentages of maximum scale scores) were: 66.4 for the extra precaution scale, 52.3 for the fear of work-related HIV transmission, 49.4 for the lack of feelings of safety, 39.0 for the value-driven stigma, 37.4 for unethical treatment of PLHIV, 34.4 for discomfort around PLHIV and 31.1 for unofficial disclosure. Testing and disclosing test results without consent, designating HIV clients and unnecessary referral to other healthcare institutions and refusal to treat clients were identified. Having in-depth HIV knowledge, the perception of institutional support, attending training on stigma and discrimination, educational level of degree or higher, high HIV case loads, the presence of ART service in the healthcare facility and claiming to be non-religious were negative predictors of stigma and discrimination as measured by the seven latent factors.ConclusionsHigher levels of stigma and discrimination against PLHIV were associated with lack of in-depth knowledge on HIV and orientation about policies against stigma and discrimination. Hence, we recommend health managers to ensure institutional support through availing of clear policies and guidelines and the provision of appropriate training on the management of HIV/AIDS.
Highlights
Stigma and discrimination against people living with human immunodeficiency virus (HIV) are obstacles in the way of effective responses to HIV
Since the beginning of the HIV epidemic, stigma and discrimination have been identified as the major obstacles in the way of effective responses to HIV
Efforts to reduce stigma and discrimination related to HIV/AIDS will help countries reach key targets for universal access and Millennium Development Goal 6, they will protect and promote human rights, foster respect for persons living with HIV (PLHIV) and other affected groups, and reduce the transmission of HIV
Summary
Study design A cross sectional quantitative study, supplemented by qualitative Key-informant interview and FGD, was conducted in Limmu Genet District Hospital and in 17 health centers of Jimma zone from March 14 to April 14, 2011. Ethiopia has laws and regulations that protect PLHIV against discrimination These include both general non-discrimination provisions and provisions that mention HIV in relation to schooling, housing, employment, healthcare etc. The quantitative part of the study included all healthcare providers working in Limmu Genet District Hospital (74 healthcare providers) and in the 17 randomly selected health centers (190 healthcare providers) during the study period. The stigma scores were standardized as the percentage of the maximum scale (%SM) scores to facilitate comparison This enables future researchers to compare their findings with those in this study even if they make use of different number of items and/or response categories. He used a diary record of the data collection and data analysis procedures
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