HIV-related stigma and discrimination amongst healthcare providers in Guangzhou, China

Dong, Xiaomei; Yang, Jianwei; Lin, Peng; Pang, Minhui; Zhang, Jiayi; Zhang, Zhan; Rao, Jiaming; Wang, Haiqing; Chen, Xiongfei

doi:10.1186/s12889-018-5654-8

Cited by 45 publications

(34 citation statements)

References 20 publications

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“…There have been reports of doctors refusing admission and treatment of patients with Covid 19 due to risk of infection (2931). Similar stigmatisation of patients with HIV by healthcare providers has been reported (32). The stigmatisation was manifested as "differential strengthens the justification for exclusion of the stigmatised.…”

Section: Discussionsupporting

confidence: 69%

A qualitative inquiry into stigma among patients with Covid-19 in Chennai, India

Gopichandran¹,

Subramaniam²

2021

IJME

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ntroduction: The Covid-19 pandemic has left a serious impact on the lives of people globally. One key social consequence of the infection has been the stigma associated with it. Objectives: This study was conducted to explore the lived experiences of stigma among persons who have recovered from Covid-19 in Chennai, India. Methods: In depth telephonic interviews were conducted among 12 persons who had recovered from Covid-19 in Chennai. The participants were encouraged to narrate their experiences of stigma. The telephonic interviews were transcribed and coded by both the researchers. The codes were then grouped into meaningful themes and the lived experiences of stigma described with the help of rich narrative quotes. Results: The common manifestations of stigma were exclusion from public spaces and essential services, loss of livelihood, loss of social support and, in an extreme case, physical violence. The stigma was also manifested in health facilities in the form of neglect, and rude and insensitive treatment of patients. The factors that aggravated the stigma included fear of infection, lack of information, legitimisation of segregation by forced public health interventions, involvement of police in contact tracing, and isolation. Stigma was associated with psychosocial consequences such as loneliness, uncertainty, anxiety, anger, and humiliation. Demonstration of empathy, advances in communication technology, solidarity in communities and protecting confidentiality could potentially mitigate stigma. The intersectionality of age, gender, poverty, and disability worsened the experience of stigma. Conclusions: People who had recovered from Covid-19 experienced various degrees of social stigma. The future impact of the pandemic will depend strongly on the ability of health systems to address stigma.

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Section: Discussionsupporting

confidence: 69%

A qualitative inquiry into stigma among patients with Covid-19 in Chennai, India

Gopichandran¹,

Subramaniam²

2021

IJME

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“…In addition to the barriers above, concerns regarding privacy disclosure in the hospitals, which may bring about stigma and discrimination, were raised by most participants. HIV and AIDS-related stigma and discrimination were still common in healthcare settings [37][38][39]. A qualitative study in France reported that physicians' aggressive words in face-to-face interactions could bring up negative personal experiences for subjects with ongoing follow-up for HIV infection and PEP history [30].…”

Section: Resultsmentioning

confidence: 99%

Drug users’ perceptions, demands, and suggestions for non-occupational post-exposure prophylaxis (nPEP) services in China: a qualitative study

Jiao

Zhang³

et al. 2019

Preprint

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Background Drug users are regarded as a high-risk population of HIV infection. Non-occupational post-exposure prophylaxis (nPEP) is internationally regarded as an effective biomedical prevention against HIV but still a small-scale pilot project in China at present. The aim of this study was to understand drug users’ perceptions demands and suggestions for nPEP service in China.Methods Nineteen eligible drug users were recruited in this qualitative study. Semi-structured in-depth interviews were conducted by trained interviewers. All of the interviews were audio-taped, transcribed verbatim and analyzed using thematic framework analysis.Results Most of participants had not heard of nPEP and none of them had used this service. After being informed basic knowledge of nPEP, about half of the participants reported willingness to use it. The facilitators included scare of HIV infection and regarding nPEP as a remedial measure in emergency. The barriers included low willingness for fatigue and lethargy after taking drugs, high price and side effects of nPEP medication, long course of nPEP treatment, and fear of privacy disclosure. Most of the participants thought the availability of nPEP would not increase the occurrence of unprotected intercourse and supported the routinization of nPEP services. Most participants chose social media for nPEP propaganda and pharmacies for providing nPEP.Conclusions It is imperative to strengthen propaganda and education of nPEP among drug users, and to encourage them to proactively use nPEP after exposure. Price regulation, side effect management and privacy protection need to be managed well when nPEP is routinized.

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“…Yet little is known about multi-level barriers to PrEP uptake and maintenance in China. Further, there is widespread HIV-and gay-related stigma and discrimination in clinical settings (26)(27)(28) that may inhibit effective delivery of PrEP drugs and related services for GBMSM (29).…”

Section: Introductionmentioning

confidence: 99%

A community-engaged mHealth intervention to increase uptake of HIV Pre-Exposure Prophylaxis (PrEP) among gay, bisexual and other men who have sex with men in China: Study protocol for a pilot randomized controlled trial

Xiong

Muessig

et al. 2020

Preprint

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Introduction: Emtricitabine-Tenofovir was officially approved as the first medicine for HIV pre-exposure prophylaxis (PrEP) in China on August 11, 2020. The large number of key populations who would benefit from PrEP in the context of limited health system capacity and public awareness will pose challenges for timely PrEP scale-up. This suggests an urgent need for innovative and accessible intervention tools for promoting PrEP. Our overall goal is to develop and pilot test a theory-informed, tailored mobile phone intervention to increase engagement in PrEP education and initiation among Chinese gay, bisexual, and other men who have sex with men (GBMSM). We also aim to generate hypotheses of potential behavioral pathways to PrEP uptake among Chinese GBMSM. Methods and analysis: This two-phase study includes a formative assessment (Phase 1) using in-depth interviews (N=30) and a 12-week experimental pilot study (Phase 2) using a two-arm randomized controlled trial design (N=60). The primary intervention is delivered through a WeChat-based mini-app (a program built into a Chinese multipurpose social media application) developed by young GBMSM from a 2019 crowdsourcing hackathon. This participatory event brought together GBMSM, tech experts, health professionals, and other key stakeholders. This study will further investigate the specific needs and concerns among GBMSM in terms of using PrEP as an HIV prevention strategy, how their concerns and PrEP use behaviors may change with exposure to the mini-app intervention at 8-week and 12-week follow-up, and how we can further refine this intervention tool to better meet GBMSM needs for broader implementation. Ethics and dissemination: This study and its protocols have been reviewed and approved by the Institutional Review Boards of the University of North Carolina at Chapel Hill, USA (IRB#19-3481), the Guangdong Provincial Dermatology Hospital, China (IRB#2020031), and the Guangzhou Eighth People Hospital, China (IRB#202022155). Study staff will work with local GBMSM community-based organizations to disseminate the study results to participants and the community via social media, offline workshops, and journal publication. This research addresses a critical need as GBMSM bear a disproportionate burden of HIV infections and remain underserved in the healthcare system in China. Trial Registration: The study was registered on clinicaltrials.gov (Trial#: NCT04426656) on June 11, 2020. https://clinicaltrials.gov/ct2/show/NCT04426656. Prospectively registered.

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HIV-related stigma and discrimination amongst healthcare providers in Guangzhou, China

Cited by 45 publications

References 20 publications

A qualitative inquiry into stigma among patients with Covid-19 in Chennai, India

A qualitative inquiry into stigma among patients with Covid-19 in Chennai, India

Drug users’ perceptions, demands, and suggestions for non-occupational post-exposure prophylaxis (nPEP) services in China: a qualitative study

A community-engaged mHealth intervention to increase uptake of HIV Pre-Exposure Prophylaxis (PrEP) among gay, bisexual and other men who have sex with men in China: Study protocol for a pilot randomized controlled trial

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