TY - JOUR
T1 - AIDS-related stigmatisation in the healthcare setting
T2 - A study of primary healthcare centres that provide services for prevention of mother-to-child transmission of HIV in Lagos, Nigeria
AU - Ehiri, John E.
AU - Alaofè, Halimatou S.
AU - Yesufu, Victoria
AU - Balogun, Mobolanle
AU - Iwelunmor, Juliet
AU - Kram, Nidal A.Z.
AU - Lott, Breanne E.
AU - Abosede, Olayinka
N1 - Funding Information:
Acknowledgements We are grateful to the Lagos State Ministry of Health for granting us permission to conduct this study. We acknowledge the support of Dr Adenike Oluwo, Director, Medical Services and Disease Control, Lagos State Primary Health Care Board, as well as Drs. Oluseyi Temowo (Director) and Oladipupo Fisher (Head of Projects), Lagos State AIDS Control Agency. This study would not have been possible without their backing and facilitation. We thank Medical Officers of Health of LGAs in eastern and western districts of Lagos and their staff for volunteering their time to support this study. Our special thanks go to Professor Oluwatoyin Ogundipe, Vice Chancellor of the University of Lagos, and the leadership of the University of Lagos College of Medicine for their kind hospitality. We are grateful to all prevention of mother-to-child transmission service providers who volunteered their time to participate in this study. Tanyha Zepada, Senior Database Specialist at the University of Arizona’s Mel and Enid Zuckerman College of Public Health, built the data collection instrument on Research Electronic Data Capture (REDCap) and managed the study database. Contributors All authors made significant contributions to the study and manuscript preparation. JEE conceptualised and designed the study; JEE and VY collected the data; JEE and MRB administered the study; HSA analysed the data; HSA, JEE and JI interpreted the data; HSA, JEE, VY, NA-ZK and BEL drafted the original manuscript; and JEE, HSA, JI, MRB, NA-ZK, BEL and OA reviewed and edited the manuscript.
Funding Information:
Funding Research leading to this publication was funded by the Fulbright Scholar program, a program of the United States Department of State, Bureau of Educational and Cultural Affairs.
Publisher Copyright:
© 2019 Author(s).
PY - 2019/5/17
Y1 - 2019/5/17
N2 - 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.
AB - 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.
KW - AIDS-related stigmatization
KW - HIV/AIDS
KW - Nigeria
KW - global maternal and child health
KW - prevention of mother-to-child transmission of HIV
KW - sub-Saharan Africa
UR - http://www.scopus.com/inward/record.url?scp=85066038697&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85066038697&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2018-026322
DO - 10.1136/bmjopen-2018-026322
M3 - Article
C2 - 31110094
AN - SCOPUS:85066038697
SN - 2044-6055
VL - 9
JO - BMJ open
JF - BMJ open
IS - 5
M1 - e026322
ER -