effects OF STIGMATIZATION ON HIV/AIDS PATIENTS
EFFECTS OF STIGMATIZATION ON HIV/AIDS PATIENTS
This study looks on the Nigerian community's attitudes about stigma and discrimination against people living with HIV/AIDS in the Alimosho area of Lagos State. Two hundred and fifty people who are currently living with HIV/AIDS were interviewed in the research region using questionnaires.
In the analysis of field data, frequency tables and a regression model were utilised. This study investigated three hypotheses. This study found two significant findings: first, that attitudes in the Nigerian community have a favourable impact on stigma and prejudice against people living with HIV/AIDS.
However, HIV/AIDS positive people who are stigmatised and discriminated against are likely to have community attitudes surrounding and influencing them. Second, persons who have reported their HIV/AIDS status are gossiped about, verbally harassed, and ignored by Nigerian society.
The project so suggests the following: first, instead of neglect, gossip, and verbal abuse, males who are HIV/AIDS negative could form intimate connections with people who are HIV/AIDS positive, which will eventually lead to weddings in Nigerian culture. Finally, persons who are HIV/AIDS positive should be welcomed by those who are HIV/AIDS free in every Nigerian community.
1.1 BACKGROUND OF THE STUDY
The world was taken aback by the HIV pandemic and its devastation. Because there is currently no known reversal or cure for the virus, it has succeeded in increasing social stratification among people, and this stratification cuts across the whole existence of the human race.
HIV/AIDS is most likely the most stigmatised disease in history. None of our actions will be successful unless we understand the nature and impact of stigma (Cameron, 2007). The epidemic had re-defined and is currently re-defining the family structure in many regions of the world, particularly in Sub-Saharan Africa.
The first two HIV/AIDS cases in Nigeria were discovered in 1985 and reported at an international AIDS conference in 1986. The Nigerian Health Sector established the National AIDS Advisory Committee in 1987, which was quickly followed by the formation of the National Expert Advisory Committee on AIDS (NEACA) (UNDP, 2009).
The global HIV pandemic is spreading, with an estimated 35 million people infected worldwide (UNAIDS, 2013). It is estimated that roughly half of all HIV patients (15.5 million) live in the United States. Since the outbreak, about 78 million individuals have been infected with the HIV virus, and nearly 39 million have died as a result of the virus.
At the end of 2013, 35.0 million (33.2-37.2 million) persons worldwide were infected with HIV. Globally, an estimated 0.8% of persons aged 15-49 years are infected with HIV, while the epidemic's impact varies greatly across nations and regions. Sub-Saharan Africa continues to be the most severely affected, with approximately one in every twenty adults living with HIV, accounting for nearly 71% of all HIV patients globally (USAID, 2013).
HIV stigma and discrimination have a negative impact on all aspects of life for HIV-positive people and their families. In many circumstances, an HIV diagnosis can be as traumatic as the illness itself, resulting in job loss, school expulsion, violence, social ostracism, property loss, and denial of health care and emotional support. People who are afraid are less likely to engage in preventive behaviour, come in for testing, disclose their status to others, seek care, and stick to treatment.
With the shifting global face of the pandemic and the introduction of highly active antiretroviral therapy (HAART), HIV has transitioned from a subacute and deadly infection to a major but chronic illness in the developed world (Klein et al. 2003).
HAART enhances quality of life and has altered HIV patients' perceptions of their life expectancy and future (Preau et al. 2007). HIV-positive patients now have new prospects, such as the potential of fatherhood and extended life expectancy, as a result of this shift in attitude and the medical improvements provided by HAART.
These advancements raise the very real risk of difficulties in coping with outdated views maintained by health care professionals, friends, and family concerning these patients' medical prognosis and capacity to give birth to a child who does not carry HIV. The most visible of these difficulties is HIV/AIDS stigma.
HIV/AIDS stigma is described as prejudice, discounting, discrediting, and discrimination directed against those suspected of having AIDS or HIV, their loved ones and friends, and the groups and communities to which they belong (Herek and Capitanio 1998).
Stigma is a socially constructed experience in which the stigmatised person does not feel completely integrated or accepted into culture or society (Goffman 1963). Berger et al. (2001) believe that HIV stigma encompasses both societal views towards HIV and personal experiences with HIV stigma.
Regardless of whether a person has actually experienced HIV stigma, it appears that the impression of HIV stigma is most significantly connected to these bad consequences (Kinsler et al. 2007; Rao et al. 2008; Remien et al. 2006; Riggs et al. 2007).
HIV stigma is associated with increased perceived stress (Remien et al., 2006; Riggs et al., 2007). Previous research on HIV-positive populations has discovered that perceived HIV stigma from health providers inhibits attempts to receive health care services, which may have a substantial influence on the health of HIV-positive individuals (Kinsler et al. 2007).
Variables related to mental health may also be significant to the experience of HIV stigma. Due to the confluence of medical sickness and social marginalisation, HIV-positive people are at a higher risk for depression than HIV-negative individuals (Catz et al. 2002). HIV stigma is associated with lower self-esteem, lack of self-efficacy, hopelessness, and greater psychological distress in mixed-gender groups (Emlet 2006; Lee et al. 2002; Rao et al. 2008).
Similarly, anxious symptoms may arise as a result of stressful events such as stigmatisation or discrimination (Au et al. 2004). Psychological distress is also important to assess because it has been linked to poor coping, disease progression, and quality of life outcomes in HIV-positive patients, as well as a perceived lack of support in HIV-positive people (Catz et al. 2002; Emlet 2006; Prachakul et al. 2007; Remien et al. 2006).
Although lack of support from others has previously been measured as a broad construct, little research has been conducted to investigate specific forms of negative judgement that may also be associated with HIV stigma for HIV-positive patients, such as experiences of being judged for attempting to become pregnant despite HAART's profound effect on reducing mother-to-child HIV transmission and increasing maternal life expectancy.
HIV stigma may be compounded by the demographic overrepresentation of HIV-positive patients in socially marginalised groups, such as ethnic minority groups and people with low income or education (Ogilvie et al., 2007; Remis et al., 2006).
Wingood et al. (2007) discovered that HIV stigma and acts of discrimination had a negative impact on the emotional, sexual, and physical health of 366 primarily African-American HIV-positive patients in the United States. Blake et al. (2007) discovered in a similar sample that HIV-positive patients reported feelings of shame and embarrassment when seeking health treatment and when disclosing their HIV status to family and friends.
Similarly, all participants in a longitudinal study of 29 HIV-positive African-American patients have experienced HIV stigma (Buseh and Stevens 2006). According to Buseh and Stevens (2006), stigma was caused in part by the treatment HIV-positive patients received from society's institutions, including a lack of concern from staff members in official venues such as hospitals, welfare offices, and jails. Patients who received social support from family members, on the other hand, were more resistive to the detrimental effects of HIV-related stigma.
1.2 STATEMENT OF THE STUDY
People living with HIV do not live full lives, and there are very few things they can do just because they have HIV. Most persons with HIV discover that they are not loved, accepted, or supported by those closest to them.
The public's attitude towards the virus's victims is even more pitiful than the infection itself. Stigmatisation of people with HIV/AIDS is more prevalent in most social groupings than the ever-present social stratification based on disability, race, gender, or sexuality.
Because we do not live in a perfect society, persons living with HIV face a great deal of stigma, prejudice, and discrimination. This is frequently the most difficult aspect of living with HIV.
Living with HIV now is not the same as living with HIV ten or twenty years ago. And living with HIV in Nigeria is very different from living with HIV in other parts of the world, particularly in affluent nations. With the outbreak of the more lethal ‘Ebola' virus, emphasis has switched away from HIV/AIDS and onto this new disease, which kills within a month if not treated.
Despite this, the emergence of ‘Ebola' has not decreased the stigma associated with the illness. However, it was reported that during the height of the Ebola crisis in Nigeria, people who were unwell and tested in hospitals leaped for pleasure when they learned they had HIV/AIDS rather than Ebola. This, however, has not reduced the stigma associated with the infection among patients.
1.3 RESEARCH QUESTIONS
1. What coping techniques do persons living with HIV/AIDS employ?
2. What are the various types of stigmatisation that they face?
3. Is there a link between the stigmatisation of HIV/AIDS patients and their living conditions?
4. Has the stigmatisation of HIV/AIDS patients damaged their economic productivity?
1.4 OBJECTIVES OF THE STUDY
The primary goal is to investigate the impact of stigma on HIV/AIDS patients in Alimosho Local government. However, the goals are as follows:
1. To investigate the coping techniques used by HIV/AIDS patients.
2. To determine the extent of stigmatisation that HIV patients in Alimosho Local Government face.
3. Determine whether there is a link between HIV patients and their living situations.
4. To determine whether the stigma has any effect on their productivity level, and
5. Recognise the role of societal structures (such as family, economic, and cultural institutions) in the creation and perpetuation of HIV/AIDS stigma.
1.5 significance OF THE STUDY
Stigma and discrimination against people living with HIV have been linked to bad health outcomes ranging from increased depressive symptoms to risky sexual conduct (Kinsler, Wong, Sayles, Davis, & Cunningham, 2007; Sayles et al., 2008; Vanable, Carey, Blair, & Littlewood, 2006).
Furthermore, it has been discovered that experiencing stigma or discrimination in a healthcare setting has a negative impact on the health behaviours of people living with HIV, such as accessing treatment, seeking HIV or HCV testing, and adhering to medical regimes (Butt, 2008; Fortenberry et al., 2002; Pascoe & Smart Richman, 2009).
Because of the continued impact of stigma and prejudice, it is critical that our understanding of these issues remains current and evolves in tandem with changes in healthcare delivery in order to give the greatest quality treatment to HIV patients. This paper will examine the available evidence on HIV-related stigma and discrimination in the health care system, with a focus on the experiences and consequences for persons living with HIV.
The outcomes of this study will be extremely beneficial to the government and other organisations such as non-governmental organisations (NGO's), human rights activists, and so on. It would specifically assist the Nigerian government in planning, given that the challenges experienced by people living with HIV/AIDS are exposed and effectively handled.
Furthermore, the public will be educated about the virus and how to acquire it, as many people believe in unscientific misconceptions about the virus and individuals who have it. This study will propose solutions for how persons infected with the virus might be less stigmatised, as stigma kills faster than the infection itself.
1.6 DEFINITIONS OF TERMS
STIGMATISATION – The humiliation or disgrace associated with something socially undesirable. There may be a ‘we and them' mentality. People who are stigmatised are identified as different and blamed for their differences. Fear of this happening can cause persons with HIV to be hesitant to notify others they have HIV or to avoid interaction with others. They may wind up suffering in silence rather than receiving the assistance they require.
PATIENT – A person undergoing medical treatment, particularly in a hospital. It could also refer to someone who is afflicted with an illness or ailment.