Abstract
BackgroundPeople living with HIV and AIDS (PLWHA) experience some form of stigma which could lead to poor medication adherence.ObjectivesThis study assessed the various domains of stigma experienced by PLWHAs attending an HIV clinic at General Hospital, Lagos Island, their medication adherence patterns and their coping mechanisms for ensuring adherence to antiretroviral therapy.MethodA cross-sectional study design with a sample size of 200 was used. Respondents were selected using systematic random sampling. Interviewers administered structured questionnaires were used to collect information on the domains of stigma. Data was analysed using EPI info©. This was followed by a focus group discussion (FGD) with seven participants at the clinic using an interview guide with open-ended questions.ResultsOverall, stigma was experienced by 35% of the respondents. Within this group, 6.6%, 37.1%, 43.1% and 98.0% of the respondents reported experiencing negative self image stigma, personalised stigma, disclosure stigma and public attitude stigma respectively. Almost 90% of the respondents were adherent. The FGD revealed that disclosure was usually confined to family members and the coping mechanism for achieving adherence was to put antiretroviral (ARVs) in unlabelled pill boxes.ConclusionThis study found that stigma was low and that the most common domain of stigma experienced was public attitude stigma. Medication adherence of respondents was good as a result of the coping mechanism, which involves putting ARVs in unlabelled pill boxes.
Highlights
SettingStigma and unfair discrimination associated with HIV infection occurs globally as a result of poor knowledge of its transmission, fears relating to illness and incurable diseases, inadequate access to treatment and religious beliefs
For current HIV prevention initiatives and treatment adherence in Nigeria to be effective, there is need for research to illuminate the cultural context of AIDS stigma in Nigeria.[7]
The contents were grouped as sections (A) Socio-demographic Information, (B) Medication Adherence Assessment, (C) Stigma Assessment
Summary
SettingStigma and unfair discrimination associated with HIV infection occurs globally as a result of poor knowledge of its transmission, fears relating to illness and incurable diseases, inadequate access to treatment and religious beliefs. Stigma in the context of HIV tends to create a hidden epidemic of the disease based on socially-shared ignorance, fear, misinformation and denial.[5] The issues of stigma and discrimination described by Jonathan Mann as the third phase of the HIV pandemic (the first two being the hidden but accelerating spread of HIV and the visible rise of AIDS cases) poses a serious threat to prevention and treatment.[6] Because stigma hampers society’s ability to respond effectively to HIV infection, understanding and counteracting it will remain a critical public health issue in any country. For current HIV prevention initiatives and treatment adherence in Nigeria to be effective, there is need for research to illuminate the cultural context of AIDS stigma in Nigeria.[7]
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