Changing Sources of Stigma against Patients with HIV/AIDS in the Rapid Expansion of Antiretroviral Treatment Services in Vietnam

Abstract

Stigmatization against HIV/AIDS greatly hinders efforts to increase the accessibility and utilization of HIV/AIDS services to meet the 90-90-90 goal. This study assessed the stigmatization and discrimination experienced by people living with HIV (PLWH) across multiple social settings such as family, community, and healthcare facilities in Vietnam. A total of 1,016 patients (63.8% males, mean age = 35.4) participated in a cross-sectional study using a culturally tailored HIV stigma measure in three HIV-epidemic-concentrated cities in Vietnam. Zero-inflated Poisson models were used to examine factors associated with the number of types of stigma that patients experienced. 86.2% PLWH reported experiencing stigma against HIV/AIDS, more frequently from their community (62.8%) and family (30.2%) than from health care facilities (8%). The level of stigma from community reported by PLWH is associated with socioeconomic status (e.g., income, occupation). The poor and middle economic classes and unemployed patients reported more stigmatization and discrimination from the community. Across all settings, PLWH experienced fewer stigmatization over the course of ART indicating the benefits of rapidly expanded ART programs. PLWH reported more stigmatization and discrimination at the provincial level of the health administration. Those with the history of drug injection reported significantly less stigmatization from healthcare setting. More culturally tailored interventions to reduce stigmatization overall to improve the quality of life and health outcomes of PLWH should be warranted to achieve the 90-90-90 goal. Improving HIV-related knowledge of the general population and providing opportunities for PLWH to be reintegrated into should be considered. Using mass media with positive messages and images would also foster positive attitudes towards HIV/AIDS among the population and could potentially change social values. Continuous training of health staffs' attitude could minimize the occurrence of stigmatization and discrimination at healthcare facilities.

Evaluation of SARS-CoV-2 Antibodies and the Impact of COVID-19 on the HIV Care Continuum, Economic Security, Risky Health Behaviors, and Mental Health Among HIV-Infected Individuals in Vietnam

“…For example, our findings suggest that social support (i.e., informational and emotional support) should be improved, especially for patients who are transferred to other hospitals because of COVID-19. HIV infection is often stigmatized [ 47 – 50 ], and health care providers are sometimes the only source of support for PLHIV outside their families. Further assessment is needed to understand effective social support interventions that can reduce the psychological burden of hospital transfer.…”

The patient voice: a survey of worries and anxieties during health system transition in HIV services in Vietnam

“…Therefore, the Vietnamese Ministry of Health issued a stigma reduction guideline in health care settings in 2017 and encouraged HIV clinics to develop an action plan for stigma reduction. However, PLHIV experience stigma from their community more frequently than from health care providers [9]. Over the past decade, there has been remarkable progress in research on interventions for stigma reduction, and an increase in the number and quality of intervention strategies [26].…”

“…Additionally, most PLHIV, except those experiencing poverty, will be expected to pay up to 20% of costs in copayments [5]. Furthermore, owing to the lack of privacy of health care, PLHIV may face difficulties keeping their HIV status confidential if they regularly visit local HIV clinics [8,9].…”

Determinants Model in Reducing HIV-Related Stigma in Health care Workers: A Systematic Review

“…HIV/AIDS prevalence globally is still rather high [1], [2]. The World Health Organization (WHO) data mention around 54% of HIV-positive cases were new cases [3], [4].A myriad of efforts was done to reduce HIV/AIDS cases [5], however, stigmas are still an important aspect and often become the main hurdle in reducing HIV/AIDS cases [6], [7], [8], [9].…”