AIDS-related stigmatization in the healthcare setting: a study of primary healthcare centers that provide services for prevention of mother-to-child transmission of HIV in Lagos, Nigeria
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Date
2019
Authors
Ehiri, JE
Alaofè, HS
Yesufu, H
Balogun, MR
Iwelunmor, J
Kram, NA-Z
Lott, BE
Abosede, O
Journal Title
Journal ISSN
Volume Title
Publisher
BMJ Open
Abstract
Objective: To assess AIDS stigmatising attitudes and behaviours by prevention of mother-to-child transmission (PMTCT) service providers in primary healthcare centres in Lagos, Nigeria.
Design: Cross-sectional survey.
Setting: Thirty-eight primary healthcare centres in Lagos, Nigeria.
Participants: One hundred and sixty-one PMTCT service providers.
Outcome measures: PMTCT service providers’ discriminatory behaviours, opinions and stigmatising attitudes towards persons living with HIV/AIDS (PLWHAs), and nature of the work environment (HIV/AIDS-related policies and infection-control guidelines/supplies).
Results: Reported AIDS-related stigmatisation was low: few respondents (4%) reported hearing coworkers talk
badly about PLWHAs or observed provision of poor quality care to PLWHAs (15%). Health workers were not worried about secondary AIDS stigmatisation due to their occupation (86%). Opinions about PLWHAs were generally supportive; providers strongly agreed that women living with HIV should be allowed to have babies if they wished (94%). PMTCT service providers knew that consent was needed prior to HIV testing (86%) and noted that they would get in trouble at work if they discriminated against PLWHAs (83%). A minority reported discriminatory attitudes and behaviours; 39% reported
wearing double gloves and 41% used other special infection-control measures when providing services to
PLWHAs. Discriminatory behaviours were correlated with negative opinions about PLWHAs (r=0.21, p<0.01), fear of
HIV infection (r=0.16, p<0.05) and professional resistance (r=0.32, p<0.001). Those who underwent HIV training had
less fear of contagion.
Conclusions: This study documented generally low levels of reported AIDS-related stigmatisation by PMTCT
service providers in primary healthcare centres in Lagos. Policies that reduce stigmatisation against PLWHA in the
healthcare setting should be supported by the provision of basic resources for infection control. This may reassure
healthcare workers of their safety, thus reducing their fear of contagion and professional resistance to care for
individuals who are perceived to be at high risk of HIV.
Description
Scholarly article
Keywords
Primary health care centre , AIDS stigmatising , HIV/AIDS , Prevention of mother-to-child transmission , Research Subject Categories::MEDICINE::Social medicine
Citation
Ehiri JE, Alaofè HS, Yesufu V, Balogun MR, Iwelunmor J, Kram NA-Z, Lott BE, Abosede O. AIDS-related stigmatization in the healthcare setting: a study of primary healthcare centers that provide services for prevention of mother-to-child transmission of HIV in Lagos, Nigeria. BMJ Open 2019; 9:e026322. doi:10.1136/bmjopen-2018-026322