HIV-related stigma and discrimination refers to prejudice, negative attitudes and abuse directed at people living with HIV and AIDS.The consequences of stigma and discrimination are wide-ranging. Some people are shunned by family, peers and the wider community, while others face poor treatment in healthcare and education settings, erosion of their human rights, and psychological damage. As a person who work in a hospital, what can we do to reduce the consequences of stigma ?
In Thailand, we have a friendly health facilities to provide services for HIV/AIDS patients. The health facilities that join the the friendly program have to qualify for the standards/criteria that established by HIV-department, Ministry of Public Health. The providers will be trained how to work with HIV/AIDS patients, especially in how to provide friendly services. HIV-department also works with outreach workers (OW). They will be trained how to reach the high risk group to promote the friendly health service program. They will trained to understand what in the patient mind are, the words that sensitive for them, and how to cope/ deal with it.
I think working through outreach workers could help a lot.
I'm not sure the following will be completely on target, but there are a few pointers for health care personnel in clinical settings: Int J STD & AIDS 2007; 18: 293-296. I can send you a copy, if this would be easier for you: I'm at [email protected]
Good luck. John :)
Health providers have great role to play in the reduction of HIV related stigma and discrimination. There are important steps that health providers especially physicians and nurses need to do in treating patients infected with the virus.
1. Health providers should themselves believe that the virus is not transmittable through mere physical contact. The study on health providers that I did with my colleagues ( text posted) show that health providers try to avoid HIV positive people in providing services; doctors assign nurses instead to take care of such patients and nurses show negative feeling to such people. Health providers show a lot of fear to patients that are already HIV positive; even they use stigmatizing terms; discriminate them by delaying services. This fear and negative attitude that providers show is also observed by other patients whom they take such feelings to the community.
2. Health providers should do everything possible to comfort HIV positive patients including giving counseling. If providers take care of such patients it is likely that communities would do the same.
3. Health providers should be part of the mobilization actors in raising awareness of the community on handling people affected by the virus—living with the virus and affected families.
4. Health providers can take universal precaution measures, but have to be loving and caring for HIV and AIDS patients.
You could also consider the impact of medications on the patient and the visual stigma this carries - I would look at the work of Dr. Marilou Gagnon
Gagnon, M. (2010). Managing the Other within the Self: Bodily Experiences of HIV/AIDS. Dans T. Rudge & D. Holmes (Éds), Abjectly Boundless : Boundaries, Bodies and Health Work. London : Ashgate Publication.
Gagnon, M. & Holmes, D. (2008). Governing Masses: Routine HIV Testing and the Deployment of Another Public Health Counteroffensive in the War Against HIV/AIDS. Policy, Politics and Nursing Practice, 9(4), 264-274.
Holmes, D. & Gagnon, M. (2008). Evidence to Practice & Practice to Evidence: Misunderstanding the Epistemic Incommensurability [Commentary]. Journal of Evaluation in Clinical Practice, 14, 663-664.
Gagnon, M. & Holmes, D. (2008). Moving Beyond Biomedical Understanding of Lipodystrophy in People Living with HIV/AIDS. Research and Theory for Nursing Practice, 22 (4), 228-240.
A physician or a nurse can reduce the consequences of HIV-related stigma and discrimination becoming culturally sensitive and competent. They should become the first advocates for patients dealing with stigma and discrimination in order to educate others.
health care workers has a great role in reducing stigma and discrimination by supporting the clients seeking the services with positive hope and behavior on the truth of HIV ,there is no need the stigmatize them selves since HIV has been advocated for long now.There fore its our role to conduct health education and giving the chance to clients to explain why there is still stigma among them selves and the factors or reasons should be advocated for change
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