Abstract

Background: Nigeria has an estimated 3.2million people living with HIV/AIDS with a national prevalence of 3.1% in 2015. HIV/AIDS stigma and discrimination especially in the healthcare setting represent a distinct component of the social impact of the illness contributing to the burden of illness by influencing the effectiveness of case finding and treatment and sometimes with attendant psychological impact.
Objective: To assess healthcare providers’ and clients’ perspectives, attitudes and practices relating to HIV/AIDS stigma and discrimination in public health facilities in Anambra State.
Methodology: This was a cross-sectional descriptive study carried out in public health facilities in Anambra State. It employed both qualitative and quantitative methods of data collection where focus group discussion was done for both the healthcare providers and HIV clients and in-depth interview for the leaders of various support groups. Interviewer-administered and self-administered questionnaires were used for 288 clients and 135 healthcare providers respectively. Data was analyzed using SPSS version 20 and results presented in tables
Results: The study showed that majority of the HCW (41.5%) had ‘no knowledge’ of HIV/AIDS stigma and discrimination while only 14.8% had ‘excellent knowledge’ of HIV/AIDS stigma and discrimination. Negative attitude was 23.7% while discriminatory practices was 16.3% and were significantly associated only with the duration of working in the HIV unit, (p=0.015) and (p=0.015) respectively. Only 34% of the clients experienced stigma and discrimination and this was significantly associated with educational level (p=0.027), age group (p=0.02), tribe (p=0.045). Majority of the respondents that experienced stigma and discrimination reported some form of depression, the commonest being mild depression (55.1%) and there was statistical significant association between both (p= 0.000).
Conclusion: The level of HIV/AIDS stigma and discrimination need to be regularly monitored in the healthcare facilities to ensure it is maintained at a low level all the time so as not to jeopardise the fight against the scourge. Healthcare workers have a great role to play starting with improvement of their knowledge base on stigma and discrimination likewise the clients need to be further educated, encouraged, with constant counselling and routine attention given by the clinical psychologist as they are prone to psychological depression associated with their condition.

ASSESSMENT OF HEALTHCARE PROVIDERS’ AND CLIENTS’ PERSPECTIVES ON HIV/AIDS STIGMA AND DISCRIMINATION IN PUBLIC HEALTH FACILITIES IN ANAMBRA STATE