Tackling Stigma and discrimination in health care settings

Nenet Ortega - CNS
Two decades ago, people living with HIV and AIDS (PLHIV) including their families had been stigmatized in all areas of social life, from communities where they lived and in areas where they normally do their daily grind.

In early 2010, several studies and researches had been done to back up claims that PLHIVs and significant others are indeed stigmatized and discriminated.  Studies done utilized the UNAIDS developed stigma and discrimination tool , which reflected that indeed discrimination happens at all levels, with varying degree of human rights violation  This was validated  by the stigma index project which shows that the degree of discrimination and stigma against PLHIVs have not changed. In most of the cases, stigmatization and discrimination is most rampant in healthcare settings—both in public and private settings. There are deliberate discriminations because of existing policies implemented by the hospitals and facilities. For instance, tagging medical records with either “highly infectious or simply putting a red tag”.

Today, in a parallel session at ICAAP 11, several practices implemented in different countries were shared and hopefully serve as an inspiration to other health providers in doing a similar approach in their own facilities.  There are common components of the design in addressing stigma and discrimination in health settings.

Stigma and discrimination related issues and concerns are still the same as what we had ten or twenty years ago. The difference is in the intervention utilized years ago which were reactive and piecemeal. Today more proactive, inclusive and engaging approaches are utilized. For instance, the healthcare providers and clients both go through a baseline assessment of their knowledge about HIV/AIDS, and a pre- test of specific stigma index. Output of the baseline assessment is utilized to develop a training curriculum for the health providers and for the clients as well. Trainings are held separately to provide more time for positive clients to interact with their peers to foster support and sharing. Health providers and their clients sit down together to craft their plan of activities that they can do together. Clients trained as trainers handle sessions educating their peers while health providers attend to the clinical needs.  Services are comprehensive, similar to a “one stop shop”.  Services given by health workers cover maternal care, ART and opportunistic infection treatment while trained clients on board provide the necessary psychosocial services all in one roof.

Nenet Ortega, Citizen News Service - CNS
November 2013

Note: This article was first published in 11th ICAAP INSIGHT, the official daily conference newspaper of 11th International Congress on AIDS in Asia and the Pacific (11th ICAAP) in Bangkok, Thailand. This newspaper was managed by Inis Communication and CNS.