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Stigma and discrimination: Barriers to the utilisation of a nutritional program in HIV care services in the Tigray region, Ethiopia

Tesfay, Fisaha, Javanparast, S, Mwanri, L and Ziersch, A 2020, Stigma and discrimination: Barriers to the utilisation of a nutritional program in HIV care services in the Tigray region, Ethiopia, BMC Public Health, vol. 20, no. 1, pp. 1-13, doi: 10.1186/s12889-020-09040-6.

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Title Stigma and discrimination: Barriers to the utilisation of a nutritional program in HIV care services in the Tigray region, Ethiopia
Author(s) Tesfay, FisahaORCID iD for Tesfay, Fisaha orcid.org/0000-0003-0399-1711
Javanparast, S
Mwanri, L
Ziersch, A
Journal name BMC Public Health
Volume number 20
Issue number 1
Article ID 904
Start page 1
End page 13
Total pages 13
Publisher BMC
Place of publication London, Eng.
Publication date 2020-06-10
ISSN 1471-2458
Keyword(s) Stigma
Discrimination
Ethiopia
Nutritional programs
Disclosure of HIV status
HIV/AIDS
Science & Technology
Life Sciences & Biomedicine
Public, Environmental & Occupational Health
HIV
AIDS
SUB-SAHARAN AFRICA
QUALITY-OF-LIFE
HIV/AIDS STIGMA
ANTIRETROVIRAL THERAPY
HEALTH DISPARITIES
FUNDAMENTAL CAUSES
SOCIAL CONDITIONS
PEOPLE
POPULATION
ADHERENCE
Summary Background: In Ethiopia, stigmatising attitudes towards people living with HIV have reduced over time. This is mainly due to improved HIV knowledge and the expansion of access to HIV care and support services. However, HIV stigma and discrimination remain a key challenge and have negative impacts on access to and utilisation of HIV services including nutritional programs in the HIV care setting. A small number of studies have examined the experience of stigma related to nutritional programs, but this is limited. This study explored HIV status disclosure and experience of stigma related to a nutritional program in HIV care settings in Ethiopia and impacts on nutritional program utilisation. Methods: As part of a larger study, qualitative in-depth interviews were conducted with 20 adults living with HIV, 15 caregivers of children living with HIV and 13 program staff working in the nutritional program in three hospitals in the Tigray region of Northern Ethiopia. Framework thematic analysis was employed to analyse the data and NVivo 11 was used to analyse the qualitative interview data. This study is presented based on the consolidated criteria for reporting of qualitative research (COREQ). Results: The study found varying levels of positive HIV status disclosure, depending on who the target of disclosure was. Disclosing to family members was reported to be less problematic by most participants. Despite reported benefits of the nutritional program in terms of improving weight and overall health status, adults and caregivers of children living with HIV revealed experiences of stigma and discrimination that were amplified by enrolment to the nutritional program and concerns about unwanted disclosure of positive HIV status. This was due to: a) transporting, consuming and disposing of the nutritional support (Plumpynut/sup) itself, which is associated with HIV in the broader community; b) required increased frequency of visits to HIV services for those enrolled in the nutritional program and associated greater likelihood of being seen there. Conclusion: There was evidence of concerns about HIV-related stigma and discrimination among individuals enrolled in this program and their family members, which in turn negatively affected the utilisation of the nutritional program and the HIV service more broadly. Stigma and discrimination are a source of health inequity and undermine access to the nutritional program and other HIV services. Nutritional programs in HIV care should include strategies to take these concerns into account by mainstreaming stigma prevention and mitigation activities. Further research should be done to identify innovative ways of facilitating social inclusion to mitigate stigma and improve utilisation.
Language eng
DOI 10.1186/s12889-020-09040-6
Indigenous content off
Field of Research 1117 Public Health and Health Services
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2020 The Author(s)
Free to Read? Yes
Use Rights Creative Commons Attribution licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30139164

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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.