AIDS-related stigmatisation in the healthcare setting: A study of primary healthcare centres that provide services for prevention of mother-to-child transmission of HIV in Lagos, Nigeria

John E Ehiri, Halimatou S. Alaofè, Victoria Yesufu, Mobolanle Balogun, Juliet Iwelunmor, Nidal A.Z. Kram, Breanne E. Lott, Olayinka Abosede

Research output: Contribution to journalArticle

Abstract

Objective To assess AIDS stigmatising attitudes and behaviours by prevention of mother-to-child transmission (PMTCT) service providers in primary healthcare centres in Lagos, Nigeria. Design Cross-sectional survey. Setting Thirty-eight primary healthcare centres in Lagos, Nigeria. Participants One hundred and sixty-one PMTCT service providers. Outcome measures PMTCT service providers' discriminatory behaviours, opinions and stigmatising attitudes towards persons living with HIV/AIDS (PLWHAs), and nature of the work environment (HIV/AIDS-related policies and infection-control guidelines/supplies). Results Reported AIDS-related stigmatisation was low: few respondents (4%) reported hearing coworkers talk badly about PLWHAs or observed provision of poor-quality care to PLWHAs (15%). Health workers were not worried about secondary AIDS stigmatisation due to their occupation (86%). Opinions about PLWHAs were generally supportive; providers strongly agreed that women living with HIV should be allowed to have babies if they wished (94%). PMTCT service providers knew that consent was needed prior to HIV testing (86%) and noted that they would get in trouble at work if they discriminated against PLWHAs (83%). A minority reported discriminatory attitudes and behaviours; 39% reported wearing double gloves and 41% used other special infection-control measures when providing services to PLWHAs. Discriminatory behaviours were correlated with negative opinions about PLWHAs (r=0.21, p<0.01), fear of HIV infection (r=0.16, p<0.05) and professional resistance (r=0.32, p<0.001). Those who underwent HIV training had less fear of contagion. Conclusions This study documented generally low levels of reported AIDS-related stigmatisation by PMTCT service providers in primary healthcare centres in Lagos. Policies that reduce stigmatisation against PLWHA in the healthcare setting should be supported by the provision of basic resources for infection control. This may reassure healthcare workers of their safety, thus reducing their fear of contagion and professional resistance to care for individuals who are perceived to be at high risk of HIV.

Original languageEnglish (US)
Article numbere026322
JournalBMJ open
Volume9
Issue number5
DOIs
StatePublished - May 17 2019

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Stereotyping
Nigeria
Primary Health Care
Acquired Immunodeficiency Syndrome
Mothers
HIV
Delivery of Health Care
Infection Control
Fear
Quality of Health Care
Occupations
Hearing
HIV Infections

Keywords

  • AIDS-related stigmatization
  • global maternal and child health
  • HIV/AIDS
  • Nigeria
  • prevention of mother-to-child transmission of HIV
  • sub-Saharan Africa

ASJC Scopus subject areas

  • Medicine(all)

Cite this

AIDS-related stigmatisation in the healthcare setting : A study of primary healthcare centres that provide services for prevention of mother-to-child transmission of HIV in Lagos, Nigeria. / Ehiri, John E; Alaofè, Halimatou S.; Yesufu, Victoria; Balogun, Mobolanle; Iwelunmor, Juliet; Kram, Nidal A.Z.; Lott, Breanne E.; Abosede, Olayinka.

In: BMJ open, Vol. 9, No. 5, e026322, 17.05.2019.

Research output: Contribution to journalArticle

Ehiri, John E ; Alaofè, Halimatou S. ; Yesufu, Victoria ; Balogun, Mobolanle ; Iwelunmor, Juliet ; Kram, Nidal A.Z. ; Lott, Breanne E. ; Abosede, Olayinka. / AIDS-related stigmatisation in the healthcare setting : A study of primary healthcare centres that provide services for prevention of mother-to-child transmission of HIV in Lagos, Nigeria. In: BMJ open. 2019 ; Vol. 9, No. 5.
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abstract = "Objective To assess AIDS stigmatising attitudes and behaviours by prevention of mother-to-child transmission (PMTCT) service providers in primary healthcare centres in Lagos, Nigeria. Design Cross-sectional survey. Setting Thirty-eight primary healthcare centres in Lagos, Nigeria. Participants One hundred and sixty-one PMTCT service providers. Outcome measures PMTCT service providers' discriminatory behaviours, opinions and stigmatising attitudes towards persons living with HIV/AIDS (PLWHAs), and nature of the work environment (HIV/AIDS-related policies and infection-control guidelines/supplies). Results Reported AIDS-related stigmatisation was low: few respondents (4{\%}) reported hearing coworkers talk badly about PLWHAs or observed provision of poor-quality care to PLWHAs (15{\%}). Health workers were not worried about secondary AIDS stigmatisation due to their occupation (86{\%}). Opinions about PLWHAs were generally supportive; providers strongly agreed that women living with HIV should be allowed to have babies if they wished (94{\%}). PMTCT service providers knew that consent was needed prior to HIV testing (86{\%}) and noted that they would get in trouble at work if they discriminated against PLWHAs (83{\%}). A minority reported discriminatory attitudes and behaviours; 39{\%} reported wearing double gloves and 41{\%} used other special infection-control measures when providing services to PLWHAs. Discriminatory behaviours were correlated with negative opinions about PLWHAs (r=0.21, p<0.01), fear of HIV infection (r=0.16, p<0.05) and professional resistance (r=0.32, p<0.001). Those who underwent HIV training had less fear of contagion. Conclusions This study documented generally low levels of reported AIDS-related stigmatisation by PMTCT service providers in primary healthcare centres in Lagos. Policies that reduce stigmatisation against PLWHA in the healthcare setting should be supported by the provision of basic resources for infection control. This may reassure healthcare workers of their safety, thus reducing their fear of contagion and professional resistance to care for individuals who are perceived to be at high risk of HIV.",
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AU - Yesufu, Victoria

AU - Balogun, Mobolanle

AU - Iwelunmor, Juliet

AU - Kram, Nidal A.Z.

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N2 - Objective To assess AIDS stigmatising attitudes and behaviours by prevention of mother-to-child transmission (PMTCT) service providers in primary healthcare centres in Lagos, Nigeria. Design Cross-sectional survey. Setting Thirty-eight primary healthcare centres in Lagos, Nigeria. Participants One hundred and sixty-one PMTCT service providers. Outcome measures PMTCT service providers' discriminatory behaviours, opinions and stigmatising attitudes towards persons living with HIV/AIDS (PLWHAs), and nature of the work environment (HIV/AIDS-related policies and infection-control guidelines/supplies). Results Reported AIDS-related stigmatisation was low: few respondents (4%) reported hearing coworkers talk badly about PLWHAs or observed provision of poor-quality care to PLWHAs (15%). Health workers were not worried about secondary AIDS stigmatisation due to their occupation (86%). Opinions about PLWHAs were generally supportive; providers strongly agreed that women living with HIV should be allowed to have babies if they wished (94%). PMTCT service providers knew that consent was needed prior to HIV testing (86%) and noted that they would get in trouble at work if they discriminated against PLWHAs (83%). A minority reported discriminatory attitudes and behaviours; 39% reported wearing double gloves and 41% used other special infection-control measures when providing services to PLWHAs. Discriminatory behaviours were correlated with negative opinions about PLWHAs (r=0.21, p<0.01), fear of HIV infection (r=0.16, p<0.05) and professional resistance (r=0.32, p<0.001). Those who underwent HIV training had less fear of contagion. Conclusions This study documented generally low levels of reported AIDS-related stigmatisation by PMTCT service providers in primary healthcare centres in Lagos. Policies that reduce stigmatisation against PLWHA in the healthcare setting should be supported by the provision of basic resources for infection control. This may reassure healthcare workers of their safety, thus reducing their fear of contagion and professional resistance to care for individuals who are perceived to be at high risk of HIV.

AB - Objective To assess AIDS stigmatising attitudes and behaviours by prevention of mother-to-child transmission (PMTCT) service providers in primary healthcare centres in Lagos, Nigeria. Design Cross-sectional survey. Setting Thirty-eight primary healthcare centres in Lagos, Nigeria. Participants One hundred and sixty-one PMTCT service providers. Outcome measures PMTCT service providers' discriminatory behaviours, opinions and stigmatising attitudes towards persons living with HIV/AIDS (PLWHAs), and nature of the work environment (HIV/AIDS-related policies and infection-control guidelines/supplies). Results Reported AIDS-related stigmatisation was low: few respondents (4%) reported hearing coworkers talk badly about PLWHAs or observed provision of poor-quality care to PLWHAs (15%). Health workers were not worried about secondary AIDS stigmatisation due to their occupation (86%). Opinions about PLWHAs were generally supportive; providers strongly agreed that women living with HIV should be allowed to have babies if they wished (94%). PMTCT service providers knew that consent was needed prior to HIV testing (86%) and noted that they would get in trouble at work if they discriminated against PLWHAs (83%). A minority reported discriminatory attitudes and behaviours; 39% reported wearing double gloves and 41% used other special infection-control measures when providing services to PLWHAs. Discriminatory behaviours were correlated with negative opinions about PLWHAs (r=0.21, p<0.01), fear of HIV infection (r=0.16, p<0.05) and professional resistance (r=0.32, p<0.001). Those who underwent HIV training had less fear of contagion. Conclusions This study documented generally low levels of reported AIDS-related stigmatisation by PMTCT service providers in primary healthcare centres in Lagos. Policies that reduce stigmatisation against PLWHA in the healthcare setting should be supported by the provision of basic resources for infection control. This may reassure healthcare workers of their safety, thus reducing their fear of contagion and professional resistance to care for individuals who are perceived to be at high risk of HIV.

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