HIV-AIDS stigma and discrimination in health care sector in Belarus

Background

Stigma and discrimination are barriers to effective HIV treatment and care in Belarus. Results of the Stigma Index Survey conducted among people living with HIV (PLHIV) reveal that 40.5% of respondents experienced disclosure of their diagnosis and confidentiality breach by health care workers (HCW); 15.5% were refused medical care.

Methods

Public health department of Belarusian State Medical University and NGO “Fialta” investigated the extent and possible reasons of HIV-related stigma in health sector, by conducting a survey on knowledge, misconceptions, attitudes and motivations regarding HIV/AIDS among 40 HCW not routinely involved in HIV-care. This was followed by two one-day sensitizing workshops addressing Belarusian law on HIV/AIDS, emphasizing medical rules/regulations, patients’ rights and confidentiality, stigma and discrimination, including sensitizing role plays.

Results

Though the sample size was small, research findings indicate needs to address levels of stigma and discrimination among HCW in Belarus: a quarter of respondents are not willing to provide services to PLHIV at all; more than half are inclined to violate patients’ rights and test patients for HIV without informed consent; majority revealed some negative stereotypes in regards to PLHIV that lead to discrimination outside their professional duties (for example, changing HIV-positive hairdresser, advising their children to reduce contacts with HIV-positive schoolmate); about 2/3 would isolate PLHIV if they are not their friends or relatives. Possible reasons from workshops’ findings: HCW don’t realize what stigma is and don’t know their actions/attitudes are discriminative; lack of knowledge about HIV-infection resulted in fear of contact with PLHIV; negative stereotypes regarding PLHIV exist among population as they “traditionally” represent risk-groups (injection drug users, commercial sex workers, etc.), thus, “they are immoral and dangerous”.

Conclusions

Introducing stigma-reducing interventions (sensitizing workshops, educational briefings) in health sector would help to improve the situation. Conducting in-depth interviews among HCW is necessary to analyse stigma-related issues more thoroughly.