The Results of Stigma and Discrimination Against HIV Infected People Reduction Program in Akatamnauy Hospital, Sakon Nakhon Province, 2019

Abstract

          The objectives of this research were to study situation, methods of solving problems, and to apply the solutions to reduce the stigma and discrimination related to HIV. The study was conducted during March - December 2019 and divided into 3 phases. Phase 1 aimed to study stigma and discrimination related to HIV-infected persons among 205 service-related staff and 124 HIV-infected persons attending ARV clinic at Akatamnauy hospital. Data collection instrument was a questionnaire developed by the Department of Disease Control, Ministry of Public Health. Data were collected using smart phones or other electronic devices. Analysis of data was performed using frequency and percentages through the Redcap program. Phase 2 studied how to solve stigma and discrimination by using a training workshop program to promote health service facility without a stigma and discrimination related to HIV among
205 staff. Phase 3 was an intervention comprising of activities derived from session 4 and 5 of the training workshop and was implemented to improve services.

          This report is an interim result of the study comprising of phase 1, 2 and planning and early implementation of phase 3. Results of Phase 1 showed that 61.64% of hospital staff concerned about being infected with HIV from service provision, 87.86% had negative attitude, 66.14% observed more protection than usual in other staff while providing services, and 20.51% observed others’ discrimination practice during service. Among the HIV-infected people who received services in ARV clinic during the past 12 months, proportion of them reported facing with the following events which related to their HIV-infected status (events could occur at the hospital or any other health facility), 22.58% experienced discrimination while receiving service, 37.10% decided not go to hospital or health facility due to self-stigma, 17.21% had been exposed to disclosure of their confidentiality, and 7.56% had been stigmatized and discriminated with subject related to pregnancy and reproductive health. Results from Phase 2 and phase 3 of the study indicated that implementation of the health promotion program without stigma and discrimination in the health care service unit for training of staff had make participants felt that if the same situation happens to them they would not be satisfied and feel devalued. Such phenomenon might affect service provider and organization might be subjected to complaints. Therefore it is necessary for the hospital to develop joint solutions. Policy to reduce stigma and discriminate should be
communicated. Complicated issues should be managed using guidelines and agreements which were developed together. Such guidelines and agreement should be raised up as an agenda for the leading team meeting to discuss and come up with consensus and direct to implementation. As for the issues that
need budget for implementation in the long term, it was proposed for budget in the action plan of 2020 fiscal year.