The association between ethnicity, stigma, beliefs about medicines and adherence in people living with HIV in a rural area in Indonesia

Sianturi, Elfride Irawati; Perwitasari, Dyah A; Islam, Md. Aminul; Taxis, Katja

doi:10.1186/s12889-019-6392-2

Cited by 28 publications

(31 citation statements)

References 24 publications

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“…2 Previous survey-based studies in Papua showed low levels of health literacy, 24 and lower levels of adherence to medication than in other parts of Indonesia. 25 We also found that enacted stigma was significantly associated with non-adherence among Papuans. 26 To improve the situation for Papuans living with HIV, more in-depth knowledge is needed on barriers and facilitators to access medication and remain on treatment in particular in the changing organisation of healthcare taking into account the local culture.…”

Section: Introductionmentioning

confidence: 54%

Daily struggle to take antiretrovirals: a qualitative study in Papuans living with HIV and their healthcare providers

et al. 2020

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ObjectiveThe aim of the study was to explore the experiences of Papuans living with HIV to take antiretroviral therapy (ART) from the patient and the healthcare providers (HCPs) perspective.DesignThis was a qualitative study covering all five tribes located in Papua Provinces one of two Indonesian provinces on Papua Island. Semistructured interviews were conducted with Papuans living with HIV and their HCPs. Interviews were transcribed verbatim and coded to find themes.ResultsOverall, we conducted interviews with 13 Papuans living with HIV (mean age: 33 years, 61% female) and 14 HCPs (mean age: 42 years, 64% female) within five customary areas. HCPs included three physicians, nine nurses, two others. Two main themes were identified: (1) personal factors and (2) healthcare environment-related factors. Personal factors were beliefs and knowledge of ART, stigma from family, community and HCPs as well as practical problems such as transportation because of long distance. Within the theme of healthcare environment, the competences and attitudes of HCPs were particularly relevant. The findings are important in refining HIV treatment strategies implemented in Papua, especially when extending HIV care provided by community centres.ConclusionsDespite free access to ART, Papuans living with HIV struggle to remain on treatment. Considering local culture and religion in strategies to reduce stigma should be a priority.

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Section: Introductionmentioning

confidence: 54%

Daily struggle to take antiretrovirals: a qualitative study in Papuans living with HIV and their healthcare providers

et al. 2020

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“…HIV, leprosy, schizophrenia, and diabetes. These four conditions were purposively chosen because of their diverse nature and etiology (infectious vs non-communicable), and causes of stigmatization in the Indonesian society [36][37][38][39]44].…”

Section: Methodsmentioning

confidence: 99%

“…It also has high prevalence of noncommunicable health conditions like diabetes mellitus (6.7% in adults) [33] and schizophrenia (around 1%) [34]. Besides the high burden, these four health conditions are also stigmatized in the Indonesian society because of the prevalent social norms, and associated negative stereotypes and misinformation [35][36][37][38][39].…”

Section: The Context Of Indonesiamentioning

confidence: 99%

Intersectionality and health-related stigma: insights from experiences of people living with stigmatized health conditions in Indonesia

Sing

Peters

Syurina

et al. 2020

Int J Equity Health

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Background Health-related stigma is a complex phenomenon, the experience of which intersects with those of other adversities arising from a diversity of social inequalities and oppressive identities like gender, sexuality, and poverty – a concept called “intersectionality”. Understanding this intersectionality between health-related stigma and other forms of social marginalization can provide a fuller and more comprehensive picture of stigma associated with health conditions. The main objective of this paper is to build upon the concept of intersectionality in health-related stigma by exploring the convergence of experiences of stigma and other adversities across the intersections of health and other forms of social oppressions among people living with stigmatized health conditions in Indonesia. Methods This qualitative study interviewed 40 people affected by either of four stigmatizing health conditions (HIV, leprosy, schizophrenia, and diabetes) in Jakarta and West Java, Indonesia between March and June 2018. Data was analyzed thematically using an integrative inductive-deductive framework approach. Results The main intersectional inequalities identified by the participants were gender and socioeconomic status (n = 21), followed by religion (n = 13), age (n = 11), co-morbidity (n = 9), disability (n = 6), and sexuality (n = 4). Based on these inequalities/identities, the participants reported of experiencing oppression because of prevailing social norms, systems, and policies (macro-level), exclusion and discrimination from societal actors (meso-level), and self-shame and stigma (micro-level). While religion and age posed adversities that negatively affected participants in macro and meso levels, they helped mitigate the negative experiences of stigma in micro level by improving self-acceptance and self-confidence. Conclusion This study uncovered how the experience of health-related stigma intersects with other oppressions originating from the various social inequalities in an individual’s life. The findings highlight the importance of acknowledging and understanding the multi-dimensional aspect of lives of people living with stigmatized health conditions, and warrant integrated multi-level and cross-cutting stigma reduction interventions to address the intersectional oppressions they experience.

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“…Few studies have reported the negative experiences of stigma among people with HIV, [29][30][31][32][33][34] and leprosy. 3,4,11,[35][36][37] in Indonesia.…”

Section: Introductionmentioning

confidence: 99%

Qualitative Exploration of Experiences and Consequences of Health-related Stigma among Indonesians with HIV, Leprosy, Schizophrenia and Diabetes

Sing

Irwanto²,

Peters³

et al. 2020

Kesmas: National Public Health Journal

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Health-related stigma causes a negative impact on the lives of affected people and undermines the effectiveness of public health programs. This study aimedto explore experiences and consequences of stigma among people affected by four health conditions relevant in Indonesia– HIV (Human ImmunodeficiencyVirus), leprosy, schizophrenia and diabetes. In this qualitative study 40 people affected by the four health conditions in Jakarta and West Java, Indonesia–,were interviewed between March and June 2018. Data were analyzed thematically by following an integrative inductive-deductive approach. The experiencesand consequences of people with stigma were similar, but such experience were more severe among people affected by HIV, leprosy, and schizophrenia.Those with diabetes either experienced no or less severe stigma. The participants revealed that they experienced enacted stigma in healthcare, employment,and social interactions in the structural and interpersonal levels. They also experience the stigma in the form of internalized and anticipated stigma at an individual level. Incidences of human rights violations were evident. Social, behavioral, psychological, and medical consequences were also reported.

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The association between ethnicity, stigma, beliefs about medicines and adherence in people living with HIV in a rural area in Indonesia

Cited by 28 publications

References 24 publications

Daily struggle to take antiretrovirals: a qualitative study in Papuans living with HIV and their healthcare providers

Daily struggle to take antiretrovirals: a qualitative study in Papuans living with HIV and their healthcare providers

Intersectionality and health-related stigma: insights from experiences of people living with stigmatized health conditions in Indonesia

Qualitative Exploration of Experiences and Consequences of Health-related Stigma among Indonesians with HIV, Leprosy, Schizophrenia and Diabetes

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