The Impact of Stigma and Discrimination on Adherence to Medication amongst People Living with HIV in Tiv Land, North Central Nigeria

Abstract

In spite the identification of stigma as a factor impeding public utilisation of HIV counselling, testing, and treatment services in Nigeria, gaps still exist in knowledge on the impact of stigma, and discrimination on adherence to medication amongst people living with HIV (PLWH). This study adopted mixed methods to examine the impact of stigma and discrimination on adherence to medication amongst PLWH in Nigeria. A sample of 1,621 respondents was collected using multi-stage and purposive sampling methods. Structured interviews using questionnaires and in-depth interviews (using a guide) were utilised for data collection. SPSS (version 21) was used for quantitative data analysis while the qualitative data was analysed thematically. There are 46.3% men and 53.7% women respondents. Generally, their income is low, 70.7% are earning less than N25, 000 (approximately $125 USD) per month. Some of the HIV patients are stigmatised. In reaction, they avoid public places, travel long distances away from their immediate community to collect drugs and to avoid been noticed around the centers. They sometimes miss taking drugs regularly as prescribed, suffer depression and die. Stigma and discrimination impede adherence to medication amongst PLHW in Nigeria. More efforts should be made to create awareness to reduce stigma and discrimination of HIV patients, while augmenting their income to meet up with the challenges of adherence to medication. The overall benefits would be enhanced mechanism of HIV prevention, treatment and control in the study area.

Evaluation of accuracy and performance of self-reported HIV and antiretroviral therapy status in the Nigeria AIDS Indicator and Impact Survey (2018)

“…Following ARV testing of blood samples from all participants who tested HIV positive, a high proportion (28.4%) of individuals who self-reported being HIV negative had detectable ARV biomarkers, indicating possible intentional concealment of their HIV-positive status. This is not surprising due to pervasive HIV stigma and discrimination in Nigeria [ 18 – 20 ] . Additionally, studies have shown HIV-positive individuals may decide to conceal their status, especially in healthcare-related activities such as surveys, due to concerns about breach of confidentiality, fear of denial of quality healthcare, and judgement from healthcare providers [ 21 , 22 ].…”

Towards Improving the Health Outcome of Hivaids Patients Receiving Antiretroviral Drugs in Low-Income Communities: Will Incorporating Food Supplementation Make a Difference?

“…In Nigeria specifically and Sub-Saharan Africa in general, the victory over the spread of HIV/AIDS has been very slow due to poverty and its manifestations [10,15,16]. Given these conditions of lack of food among HIV/AIDS patients receiving treatment in low income communities, recuperation period would be longer; thereby hiking the possibility of stigmatisation and tendency to avoid treatment centres where they (HIV patients) would be sighted collecting drugs; they travel longer distances to other drug centres outside their immediate communities, incurring additional burden of high transportation cost leading to inability to replenish exhausted stock of drugs and treatment failure among low income earners [17]. To improve the health outcome of low income HIV patients who are receiving treatment but unable to adequately feed themselves, I suggest that food supplementation should be incorporated into the treatment package.…”