EFFECT OF ACESS TO ANTIRETROVIRAL THERAPY ON STIGMA, JIMMA UNIVERSITY HOSPITAL, SOUTHWEST ETHIOPIA

Abstract

BACKGROUND: People living with HIV/AIDS have been stigmatized since the beginning of the epidemic leading to severe social consequences related to their rights, health care services, freedom, self- identity and social interactions. Provision of antiretroviral drugs is believed to contribute in lessening the effect of stigma and discrimination in those who are enrolled in care and treatment. The objective of this study was to determine the level of stigma faced by people living with HIV/AIDS and to explore the effect of access to antiretroviral therapy on stigma against people living with HIV/AIDS. METHODS: A cross-sectional study was conducted from August 7 to September 1, 2007 in Jimma University Hospital antiretroviral therapy clinic. A sample of 270 patients attending the antiretroviral therapy during the study period was included in the study. An Amharic version of structured questionnaire containing a 40-point HIV stigma scale was to collect the data. Data were coded, entered in to a computer and analyzed using SPSS for windows 12.0.1. RESULTS: Of the total 270 respondents, 149 (55.2%) were on antiretroviral therapy while 121 (44.8%) were treatment naïve but were having follow up in the antiretroviral clinic based on the national antiretroviral therapy guideline. Females comprised 148 (54.2%) of the respondents. Majority of the respondents 208 (77.0%) were in the age group 25-49. The prevalence of actual stigma in people living with HIV/AIDS was low 45 (16.6%) when compared with the fear of being stigmatized (perceived stigma) which was195 (72.2%). The prevalence of disclosure concern and internalized stigma were 231 (86.3%) and 232 (85.9%), respectively. However, 245(90.7%) of the respondents reported a favorable attitudinal change on stigma with access to antiretroviral treatment. There was a statistically significant association between duration of antiretroviral therapy and favorable effect of access to antiretroviral therapy on stigma reduction (p<0.005). CONCLUSION: This study revealed that the fear of being stigmatized in people living with HIV/AIDS is much higher than the actual stigma. Access to antiretroviral drugs has a stigma alleviating effect on people living with HIV/AIDS. Apart from pretest and posttest counseling, psychosocial support and follow-up for PLWHA has to be strengthened, as this would help them to cope up with the internalized and perceived stigmata, which were higher in this study.