HIV and Stigma
HIV is often accompanied by unfavorable attitudes and behaviors of people around in the society. This paper tries to describe the different forms of stigma and discrimination that is prevalent not only in the community, but also in the health facilities in Nepal, resulting in various complexities in the lives of the infected/ affected people. This paper also illustrates some experiences of stigma and discrimination faced by HIV infected/affected people in their societies reinforcing the findings from previous studies, which suggest that despite the strong focus on reducing stigma related to HIV, efforts remain inadequate.
This paper bases its findings on data acquired from an ongoing qualitative study, where peer ethnographic interviews are conducted by peers from the HIV network. These peer interviews help in gaining a better understanding of the types of stigma experienced by the HIV infected and affected people. The data used for this study was acquired from the interviews conducted in different parts of Kathmandu valley, Surkhet, Nepalgunj, Biratnagar and Sunsari districts.
The data from the interviews shows that the existence of stigma was observed and reported widely at different levels in the society namely individual, family, community, and health facility. Majority of the participants were found not to have disclosed their HIV status due to the fear of discrimination and those who had disclosed their status, expressed various distressing situations that they had to face in their family as well as community. Also, different experiences of stigma were found amongst the infected/affected people as per their gender. In addition to these, there were also significant differences between the attitudes of health workers towards the HIV infected/affected people as compared to other patients, which had affected their access into and quality of health care services.
For more than a decade, the government along with various organizations working in the HIV sector have been raising awareness in the community to reduce stigma towards the HIV infected, however, this study signifies that along with perking up of the community awareness activities, there is a need for the organizations to target their education programs to health workers as well. Findings from the study are indicative that where importance of educating the health workers is unquestionable to reduce the fueling of stigma attached to HIV, fostering the relationship between the healthcare providers and patients is also vital. Lack of adequate supportive environment in the health centres is identified as one of the causes of stigma and thus an important issue to be addressed in order to reduce the complications of stigma related to HIV.