RESEARCH PAPER
Social stigma, discrimination, and their determinants among people living with HIV and AIDS in Sudurpashchim Province, Nepal
 
More details
Hide details
1
Department of Public Health, Nobel College, Kathmandu, Nepal
 
2
HERD International, Kathmandu, Nepal
 
 
Submission date: 2021-06-05
 
 
Acceptance date: 2021-09-19
 
 
Publication date: 2022-07-05
 
 
HIV & AIDS Review 2022;21(3):230-238
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Human immunodeficiency virus (HIV)-related stigma and discrimination adversely affect health, quality of life, social support, and well-being of people living with HIV/acquired immuno¬deficiency syndrome (AIDS) (PLWHA). This study assessed the perceived stigma and discrimination, and their determinants among PLWHA living in Sudurpashchim Province of Nepal.

Material and methods:
This study adapted cross-sectional survey in 2020 to sample 167 PLWHA using semi-structure questionnaire. Information about socio-demographic characteristics, stigma domain, and discrimination domain were obtained through face-to-face interviews. Bivariate and multivariate logistic regression models were applied to identify factors associated with perceived stigma and discrimination among PLWHA.

Results:
The overall stigma was 70%, and discrimination was 34%. In the multivariate logistic regression, male gender (AOR = 2.4; 95% CI: 1.04-6.62%; p-value = 0.009), age (AOR = 1.09; 95% CI: 1.03-1.15%; p-value < 0.001), high level of public health concerns (AOR = 12.9; 95% CI: 8.9-37.5%; p < 0.001), and high level of negative self-image (AOR = 10.3; 95% CI: 8.8-39.6%; p < 0.001) were factors significantly associated with higher perceived stigma. Similarly, female gender (AOR = 15.4; 95% CI: 8.2-35.3%; p < 0.001) and high level of perceived community support (AOR = 8.86; 95% CI: 3.86-32.1%; p < 0.001) were factors significantly associated with higher perceived discrimination.

Conclusions:
Stigma and discrimination remain pervasive among PLWHA in Sudurpashchim Pro¬vince and most originate from communities, presenting negative impacts on PLWHA. Unprecedented measures to enhance the awareness of PLHIV, their families, and community about perceived stigma and associated factors are needed to reduce stigma, and to achieve the commitments of fast-tracking towards ending the AIDS epidemic.

 
REFERENCES (30)
1.
Stangl AL, Lloyd JK, Brady LM, Holland CE, Baral S. A systematic review of interventions to reduce HIV‐related stigma and discrimination from 2002 to 2013: how far have we come? J Int AIDS Soc 2013; 16: 18734.
 
2.
Tran BX, Phan HT, Latkin CA, et al. Understanding global HIV stigma and discrimination: are contextual factors sufficiently studied? (GAP research). Int J Environ Res Public Health 2019; 16: 1899.
 
3.
Joint United Nations Programme on HIV/AIDS. On the fast-track to end AIDS by 2030: focus on location and population. Technical report; 2015.
 
4.
Adane B, Yalew M, Damtie Y, Kefale B. Perceived stigma and associated factors among people living with HIV attending ART Clinics in public health facilities of Dessie City, Ethiopia. HIV AIDS (Auckl) 2020; 12: 551-557.
 
5.
Fido NN, Aman M, Brihnu Z. HIV stigma and associated factors among antiretroviral treatment clients in Jimma town, Southwest Ethiopia. HIV AIDS (Auckl) 2016; 8: 183-193.
 
6.
Feyissa GT, Abebe L, Girma E, Woldie M. Stigma and discrimination against people living with HIV by healthcare providers, Southwest Ethiopia. BMC Public Health 2012; 12: 522.
 
7.
Subedi B, Timilsina BD, Tamrakar N. Perceived stigma among people living with HIV/AIDS in Pokhara, Nepal. HIV AIDS (Auckl) 2019; 11: 93-103.
 
8.
Jugeo N, Moalusi KP. My secret: the social meaning of HIV/AIDS stigma. SAHARA J 2014; 11: 76-83.
 
9.
Rinehart R, Rao D, Amico RK, et al. Experienced HIV-related stigma and psychological distress in Peruvian sexual and gender minorities: a longitudinal study to explore mediating roles of internalized HIV-related stigma and coping styles. AIDS Behav 2019; 23: 661-674.
 
10.
Jha CK, Madison J. Disparity in health care: HIV, stigma, and marginalization in Nepal. J Int AIDS Soc 2009; 12: 16.
 
11.
Shrestha S, Poudel KC, Poudel-Tandukar K, et al. Perceived family support and depression among people living with HIV/AIDS in the Kathmandu Valley, Nepal. J Int Assoc Provid AIDS Care 2014; 13: 214-222.
 
12.
Paudel V, Baral KP. Women living with HIV/AIDS (WLHA), battling stigma, discrimination and denial and the role of support groups as a coping strategy: a review of literature. Reprod Health 2015; 12: 53.
 
13.
Ghimire U, Manandhar J. Inequalities in health outcomes and access to services by caste/ethnicity, province, and wealth quintile in Nepal. Ministry of Health and Population; 2019.
 
14.
Sapkota VP, Bhusal UP, Acharya K. Trends in national and subnational wealth related inequalities in use of maternal health care services in Nepal: an analysis using demographic and health surveys (2001-2016). BMC Public Health 2021; 21: 8.
 
15.
Vaidya NK, Wu J. HIV epidemic in Far-Western Nepal: effect of seasonal labor migration to India. BMC Public Health 2011; 11: 310.
 
16.
NCASC. Nepal HIVision 2020: Nepal National HIV Strategic Plan 2016-2021. Kathmandu; 2016.
 
17.
Thapa S, Thapa DK, Buve A, Hannes K, Nepal C, Mathei C. HIV-related risk behaviors among labor migrants, their wives and the general population in Nepal. J Community Health 2017; 42: 260-268.
 
18.
Thapa S, Bista N, Hannes K, Buve A, Vermandere M, Mathei C. Vulnerability of wives of Nepalese labor migrants to HIV infection: integrating quantitative and qualitative evidence. Women Health 2016; 56: 745-766.
 
19.
Rongkavilit C, Wright K, Chen X, Naar-King S, Chuenyam T, Phanuphak P. HIV stigma, disclosure and psychosocial distress among Thai youth living with HIV. Int J STD AIDS 2010; 21: 126-132.
 
20.
Zelaya CE, Sivaram S, Johnson SC, Srikrishnan AK, Solomon S, Celentano DD. HIV/AIDS stigma: reliability and validity of a new measurement instrument in Chennai, India. AIDS Behav 2008; 12: 781-788.
 
21.
Yathiraj AB, Unnikrishnan B, Ramapuram JT, et al. HIV-related stigma experienced by people living with HIV/AIDS in coastal South India. HIV AIDS Rev 2018; 17: 30-35.
 
22.
Logie C, Gadalla TM. Meta-analysis of health and demographic correlates of stigma towards people living with HIV. AIDS Care 2009; 21: 742-753.
 
23.
Odimegwu CO, Alabi O, De Wet N, Akinyemi JO. Ethnic heterogeneity in the determinants of HIV/AIDS stigma and discrimination among Nigeria women. BMC Public Health 2018; 18: 763.
 
24.
Halli SS, Khan CH, Moses S, et al. Family and community level stigma and discrimination among women living with HIV/AIDS in a high HIV prevalence district of India. J HIV AIDS Soc Serv 2017; 16: 4-19.
 
25.
Stewart R, Pulerwitz R, Esu-Williams E. Addressing HIV/AIDS stigma and discrimination in a workplace program, emerging findings. Washington: Population Council; 2002.
 
26.
Oke OO, Akinboro AO, Olanrewaju FO, Oke OA, Omololu AS. Assessment of HIV-related stigma and determinants among people living with HIV/AIDS in Abeokuta, Nigeria: a cross-sectional study. SAGE Open Med 2019; 2019: 2050312119869109.
 
27.
Nachega JB, Morroni C, Zuniga JM, et al. HIV-related stigma, isolation, discrimination, and serostatus disclosure: a global survey of 2035 HIV-infected adults. J Int Assoc Provid AIDS Care 2012; 11: 172-178.
 
28.
Ramlagan S, Matseke G, Rodriguez VJ, et al. Determinants of disclosure and non-disclosure of HIV-positive status, by pregnant women in rural South Africa. SAHARA J 2018; 15: 155-163.
 
29.
Gilbert L, Walker L. ‘My biggest fear was that people would reject me once they knew my status…’: stigma as experienced by patients in an HIV/AIDS clinic in Johannesburg, South Africa. Health Soc Care Community 2010; 18: 139-146.
 
30.
Eller LS, Rivero-Mendez M, Voss J, et al. Depressive symptoms, self-esteem, HIV symptom management self-efficacy and self-compassion in people living with HIV. AIDS Care 2014; 26: 795-803.
 
eISSN:1732-2707
ISSN:1730-1270
Journals System - logo
Scroll to top