Stigma Related To HIV Among Community Health Workers In Chile

Abstract

Purpose When healthcare workers have stigmatizing attitudes toward people living with HIV it may lead to discriminatory behavior that interferes with prevention, treatment, and care. This research examined the HIV-related stigmatizing attitudes reported by health workers in Santiago, Chile. Methods The study used focus group data from the first phase of a larger study to develop and test a HIV prevention intervention for Chilean health workers. Ten focus groups were conducted with Health workers in two communities in Santiago, Chile. Content analysis was used to analyze the data. Results Two central themes emerged: Societal stigma and discrimination towards people living with HIV and healthcare system’s policies related to HIV. Both inaccurate fears of transmission among the general public and Chilean Health workers and societal prejudices against homosexuals contributed to stigmatization and discrimination. Conclusions Health workers did not recognize their own stigmatizing attitudes or discriminatory behaviors, but their discussion indicated that these behaviors and attitudes did exist. Healthcare system issues identified included problems with confidentiality due to the desire to inform other health workers about client HIV status. Health workers must be sensitized to the current stigmatization and misinformation associated with HIV and its negative impacts on persons living with HIV and the general community. Implications All clinical and non-clinical workers at community clinics need mandatory education for HIV prevention that focuses on changing attitudes as well as sharing knowledge. Also, the Chilean law protecting people living with HIV and the confidentiality of their medical care needs to be publicized, along with guidelines for its enactment in clinics and other health facilities.

A Qualitative Study of Barriers to Effectiveness of Interventions to Prevent Mother-to-Child Transmission of HIV in Arba Minch, Ethiopia

“…Stigma is still a major feature of the AIDS milieu in many communities and people living with HIV experience stigma at various levels, including health workers [34][35][36]. Subtle stigmatizing attitudes and discriminatory behavior from health workers, which are often overlooked, can limit the potential impact of interventions for people living with HIV.…”

Depression explanatory models of primary care patients and doctors: Relationship with self-stigma, communication effectiveness, and recovery

“…However, Stevelink et al (2012) gave the SSDS a negative rating for reliability because intraclass correlation coefficients (ranging from .49 to .63) were below the review's .70 quality criterion. While the SSDS's limited reliability is admittedly a constraint, I chose to use it for the reasons detailed in the previous paragraph and also because it was developed in an Australian context (Barney et al, 2010).…”

“…The problem could have been avoided by using either the Depression Self-Stigma Scale (DSSS: Kanter et al, 2008) or the Self-Stigma of Depression Scale (SSDS: Barney et al, 2010) instead of combining items from the SSDS with the ISMI (Ritsher et al, 2003). The rationale was to retain the content validity of the SSDS because it had been developed in Australia from people with direct or indirect experience of depression while incorporating the psychometrically superior ISMI (Stevelink et al, 2012). However the resulting instrument was too long and in eliminating items to make it of optimal length, several important subscales (i.e., self-blame and stereotype endorsement) had to be dropped from analysis due to low…”

“…Two scales have been specifically developed for selfstigma in people with depression -the Depression Self-Stigma Scale (DSSS) by Kanter, Rusch, and Brondino (2008) and the Self-Stigma of Depression Scale (SSDS) by Barney, Griffiths, Christensen, and Jorm (2010 as mentioned earlier, has shown that personal self-stigma has more impact on a person with depression than anticipated stigma from others. Stevelink et al (2012) . also rated the content validity of the DSSS negatively because depression patients were not involved during item generation or selection.…”

“…However, in a review of self-stigma instruments by Stevelink, Wu, Voorend, and Van Brakel (2012), the SSMIS was given indeterminate ratings for construct validity and reliability. The ISMI had relatively better ratings, even though none of the 21 self-stigma scales reviewed by Stevelink et al fulfilled all seven criteria that the authors were purported to be using.…”