Ethnographic experiences of HIV-positive nurses in managing stigma at a clinic in rural Uganda

Abstract

This paper explores the workplace experiences of HIV-positive nurses and their attempts to manage HIV/AIDS stigma. An HIV diagnosis can have a major impact on an individual's psychological and emotional wellbeing. Moreover, caring for those suffering from chronic HIV-related illnesses comes with additional stress, which makes providing care more complex. Stigma-reduction and assisting with psychosocial support and wellbeing is an integral part of ensuring that care providers who are HIV-positive have good outcomes both for themselves and their patients. An ethnographic study with HIV-positive nurses was conducted from August 2005 to December 2007 at a Health Centre IV HIV clinic in rural Luweero district, Uganda. Data were gathered through clinical participant observation, informal conversations, recorded life histories, open-ended in-depth interviews and topical focus group discussions. Nurses are in a position to help people through negative life events, yet they may personally experience the same types of negative life events. In the absence of a system to provide support for HIV and AIDS clinical care providers, a group of HIV-positive nurses initiated a support process by creating safe spaces for interacting and seeking psychosocial support among themselves in a relatively secretive way. This process provided the nurses with a solid foundation for developing interventions to assist them through difficult times.

Stigma in AIDS Nursing Care in Sub-Saharan Africa and the Caribbean

“…Emphasizing the strengths and assets brought to bear on the situation rather than the defensive and protective strategies employed by care providers has been advocated (Mill et al, 2011). Indeed, some observers have called for proactive strategies to replace reactive ones (LeBel, 2008), or at least to complement them (Kyakuwa, 2009). Similarly Castro and Farmer (2005) have argued that it is the introduction of quality care that improves access, rather than the existence of stigma that impedes it.…”

Concealment tactics among HIV-positive nurses in Uganda

“…As the nurses often repeated, 'What is the point in disclosing to everyone at the workplace, where there is so much prejudice, fear, and no psychosocial support for staff?' To be seen receiving the same treatment as their patients would entail displaying their own vulnerability and alleged lack of self-control in their own lives (Kyakuwa 2009). …”

After-Crisis: Redundancies and Continuities in HIV-Related Skills, Knowledge, and Structures in Nairobi, Kenya

“…Local structures, including NGOs, community-based organizations (CBOs), and HIV support groups, served to channel assistance in the form of direct funding, psychosocial support, HIV counseling, income-generating activities, and job opportunities (Heyer et al 2010;Kyakuwa 2009;Moyer 2015;Nguyen et al 2009;Oosterhoff 2008;Oosterhoff et al 2008). Organizations often received funding to carry out so-called demonstration projects, with the (misguided) presumption that local funding would materialize or temporary laborers would be regularized if positive effects were demonstrated.…”