Chime Onyinye Hope, Arinze-Onyia Susan Uzoamaka, Ossai Edmund Ndudi
Department of Community Medicine, Enugu State University Teaching Hospital, Enugu, Nigeria.
Department of Community Medicine, Enugu State University College of Medicine, Enugu, Nigeria.
Pan Afr Med J. 2019 Dec 16;34:200. doi: 10.11604/pamj.2019.34.200.17652. eCollection 2019.
Contrary to assertions that stigma may no longer be experienced due to substantial advancement in antiretroviral access and treatment, self-stigma still exists among people living with HIV/AIDS (PLWHA) in Nigeria. The use of peer health workers to improve care in underserviced settings has been implemented by a number of programs, but its effect has not been extensively assessed. This study compared the level of self-stigma among PLWHA in peer support and non-support groups in Enugu State Nigeria.
A cross-sectional study using quantitative and qualitative instruments was conducted among PLWHA attending ARV clinics. Quantitative data was assessed using pre-tested structured interviewer-administered questionnaires. Chi-square test of statistical significance was used in the analysis. Four focus group discussions and eight key informant interviews were conducted among PLWHA and healthcare workers respectively. Manual content analysis was used to analyse the qualitative data.
Comparable proportions of respondents in peer support (31.4%) and non-peer support groups (30.2%) had self-stigma (p=0.709). Disclosure was higher among respondents in non-peer support groups (96%) against 94.5% in peer support groups (p=0.331). Health workers interviewed were of the opinion that self-stigma cuts across members of both groups. Participants in the FGD reported that the media and economic empowerment have helped reduce self-stigma among PLWHA.
Though peer support groups may be a starting place for the development of social support interventions for PLWHA, it might not be sufficient to combat self-stigma. Interventions aimed at economic empowerment of PLWHA and public enlightenment are essential for effective mitigation against self-stigma.
尽管有观点认为，由于抗逆转录病毒药物的可及性和治疗取得了重大进展，污名化现象可能不再存在，但在尼日利亚，艾滋病毒/艾滋病感染者（PLWHA）中仍然存在自我污名化现象。许多项目都采用了同伴健康工作者来改善服务不足地区的护理，但尚未对其效果进行广泛评估。本研究比较了尼日利亚埃努古州同伴支持组和非支持组中艾滋病毒/艾滋病感染者的自我污名化程度。
对参加抗逆转录病毒治疗诊所的艾滋病毒/艾滋病感染者进行了一项采用定量和定性工具的横断面研究。定量数据通过预先测试的结构化访谈问卷进行评估。分析中使用了卡方检验统计显著性。分别对艾滋病毒/艾滋病感染者和医护人员进行了四次焦点小组讨论和八次关键信息访谈。采用人工内容分析法对定性数据进行分析。
同伴支持组（31.4%）和非同伴支持组（30.2%）中具有自我污名化的受访者比例相当（p = 0.709）。非同伴支持组中受访者的披露率更高（96%），而同伴支持组为94.5%（p = 0.331）。接受访谈的医护人员认为，自我污名化在两组成员中都存在。焦点小组讨论的参与者报告称，媒体和经济赋权有助于减少艾滋病毒/艾滋病感染者中的自我污名化现象。
尽管同伴支持组可能是为艾滋病毒/艾滋病感染者开展社会支持干预措施的起点，但可能不足以对抗自我污名化。旨在增强艾滋病毒/艾滋病感染者经济权能和公众启蒙的干预措施对于有效减轻自我污名化至关重要。
