Predictors of HIV stigma among health workers in the Cape Coast metropolis, Ghana

  • James Prah | james.prah@ucc.edu.gh University Hospital of Cape Coast, University of Cape Coast, Ghana.
  • Anna Hayfron-Benjamin Department of Nursing, School of Nursing and Midwifery, College of Health and Allied Sciences, University of Cape Coast, Ghana.
  • Mohammed Abdulai University Hospital of Cape Coast, University of Cape Coast, Ghana.
  • Obed Lasim Department of Health Information Management, College of Health and Allied Sciences, University of Cape Coast, Ghana.
  • Yvonne Nartey Department of Internal Medicine, Cape Coast Teaching Hospital, Cape Coast, Ghana.
  • Dorcas Obiri-Yeboah Department of Microbiology and Immunology, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Ghana.

Abstract

Stigma against people living with HIV (PLHIV) among health workers remains a barrier to the provision of needed care to HIV patients worldwide. We sought to investigate predictors of HIV stigma among health workers in Cape Coast, Ghana. This was a cross sectional study conducted in three hospitals from November 2016 to February 2017. The study made use of a pre-existing self-administered questionnaire. Multiple regression analysis and Pearson’s coefficient tests were performed to determine the relationship between the dependent variable, i.e. the stigmatized attitudes of health workers, and some independent variables, and to determine which of the independent variables predict stigma amongst health care workers. A total of 331 health workers of different categories participated. Respondents’ personal opinions on HIV, fears/worries of getting infected and category of staff {F(3,327)= 23.934 P<0.00}, R2 = 0.180) significantly predicted their stigmatizing behaviour. Compared to other health workers, nurses had higher scores for stigmatizing behaviour. The study found evidence of discriminatory and stigmatizing behaviour towards PLHIV by health workers. Stigma reduction programmes aimed at health workers should be strengthened at all health facilities that provide care to PLHIV.

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References

Link BG, Phelan JC. Stigma and its public health implications. Lancet. 2006;367:528–9. DOI: https://doi.org/10.1016/S0140-6736(06)68184-1

National Guidelines for Antiretroviral therapy- Ghana. (2016). available from: https://aidsfree.usaid.gov/sites/default/files/gh_guidelines_arv_therapy.pdf. Accessed on October 2018

NACP (2018). National HIV Prevalence & AIDS Estimates 2017-2022. Accra, Ghana, Ghana Health Services, Ministry of Health

International Center for Research on Women (ICRW) (2005) 'HIV-related stigma across contexts: common at its core' Available from: https://www.icrw.org/wp-content/uploads/2016/10/Common-at-its-Core-HIV-Related-Stigma-Across-Contexts.pdf Accessed on October 2018

Berger BE, Ferrans CE, Lashley FR. Measuring stigma in people with HIV: Psychometric assessment of the HIV stigma scale. Res Nurs Health. 2001;24:518–29. DOI: https://doi.org/10.1002/nur.10011

Health Policy Initiative. (2010). HIV stigma: A health policy approach. Retrieved from http://www.healthpolicyinitiative.com/Publications/Documents?1257_1_EOP_Bri

ef_HIV_Stigma_Health_Policy_Approach_FINAL_Sep.pdf

UNAIDS_terminology_guidelines_en.pdf. Available from: http://www.unaids.org/sites/default/files/media_asset/2015_terminology_guidelines_en.pdf Accessed: October 2018

DeCarlo P, Ekstrand M. How does stigma affect HIV prevention and treatment? Available from: https://caps.ucsf.edu/wordpress/wp-content/uploads/2016/11/StigmaFSUpdatefinal_20161020.pdf Accessed: October 2018

UNAIDS (2017) ‘Agenda for zero discrimination in health-care settings’[pdf]

UNAIDS. Global HIV & AIDS statistics — 2018 fact sheet. Available from: http://www.unaids.org/en/resources/fact-sheet Accessed: October 2018

USAID. Available from: http://www.healthpolicyinitiative.com/ Accessed: October 2018

Olalekan AW, Akintunde AR, Olatunji MV. Perception of Societal Stigma and Discrimination Towards People Living with HIV/AIDS in Lagos, Nigeria: a Qualitative Study. Mater Socio-Medica. 2014;26:191–4. DOI: https://doi.org/10.5455/msm.2014.26.191-194

UNAIDS. Key human rights programmes. Available from: http://www.unaids.org/sites/default/files/media_asset/Key_Human_Rights_Programmes_en_May2012_0.pdf Accessed: October 2018

Zamberia AM. HIV-related stigma and access to health care among people living with HIV in Swaziland. Dev South Afr. 2011;28:669–80. DOI: https://doi.org/10.1080/0376835X.2011.623914

Zaidi MA, Griffiths R, Newson-Smith M, Levack W. Impact of stigma, culture and law on healthcare providers after occupational exposure to HIV and hepatitis C. Cult Health Sex. 2012;14:379–91. DOI: https://doi.org/10.1080/13691058.2011.646304

Nyblade L, Stangl A, Weiss E, Ashburn K. Combating HIV stigma in health care settings: what works? J Int AIDS Soc. 2009;6:12-15. DOI: https://doi.org/10.1186/1758-2652-12-15

Report on robbed of choice forced and coerced sterilization experiences of women living with HIV in Kenya. Available from: http://kelinkenya.org/wp-content/uploads/2010/10/Report-on-Robbed-Of-Choice-Forced-and-Coerced-Sterilization-Experiences-of-Women-Living-with-HIV-in-Kenya.pdf Accessed: October 2018

Banteyerga H, Kidanu A, Nyblade L, et al. Exploring HIV and AIDS stigma and related discrimination in Ethiopia: causes, manifestations, consequences, and coping mechanisms. Addis Ababa Miz-Hasab Res Cent. 2004;6–69.

Nyblade L, MacQuarrie K, Phillip F, et al. Measuring HIV stigma: results of a field test in Tanzania. Washington, DC: US Agency for International Development; 2005 Available at: https://www.icrw.org/wp-content/uploads/2016/10/Working-Report-Measuring-HIV-Stigma-Results-of-a-Field-Test-in-Tanzania.pdf Accessed: October 2018

Mill J. Shrouded in Secrecy: Breaking the News of HIV Infection to Ghanaian Women. Journal of Transcultural Nursing 2003;14:6–16. DOI: https://doi.org/10.1177/1043659602238345

Ulasi CI, Preko PO, Baidoo JA, et al.. HIV/AIDS-related stigma in Kumasi, Ghana. Health and Place. 2009; 15: 255–262. DOI: https://doi.org/10.1016/j.healthplace.2008.05.006

Awusabo-Asare K, Marfo C. Attitudes to and management of HIV/AIDS among health workers in Ghana: the case of Cape Coast municipality. Health Transition Review 1997;7:271–280.

Government of Ghana. 1992. The Constitution of Ghana. Accra, Ghana: Government of Ghana.

Government of Ghana. 2008. "National Guidelines for the Implementation of HIV Counselling and Testing in Ghana." Accra, Ghana: Government of Ghana.

Dawson-Amoah CG. Determinants of HIV Stigma among healthworkers in Ghana. 2015. Available from: http://scholarworks.waldenu.edu/cgi/viewcontent.cgi?article=2530&context=dissertations Accessed: October 2018

Nyblade L, Jain A, Benkirane M, et al. A brief, standardized tool for measuring HIV-related stigma among health facility staff: results of field testing in China, Dominica, Egypt, Kenya, Puerto Rico and St. Christopher & Nevis. J Int AIDS Soc 2013:16:18718 DOI: https://doi.org/10.7448/IAS.16.3.18718

Ghana-hrh-country-profile.pdf. Available from: http://www.moh.gov.gh/wp-content/uploads/2016/02/Ghana-hrh-country-profile.pdf Accessed: October 2018

Doka PJS, Danjin M, Dongs IS. HIV/AIDS-related stigma and discrimination among health-care providers in a tertiary health facility. J Med Sci 2017;37:44-49 DOI: https://doi.org/10.4103/jmedsci.jmedsci_99_16

Andrewin A, Chien L-Y. Stigmatization of patients with HIV/AIDS among doctors and nurses in Belize. AIDS Patient Care STDs. 2008;22:897–906. DOI: https://doi.org/10.1089/apc.2007.0219

Famoroti TO, Fernandes L, Chima SC. Stigmatization of people living with HIV/AIDS by healthcare workers at a tertiary hospital in KwaZulu-Natal, South Africa: a cross-sectional descriptive study. BMC Med Ethics. 2013; 14:S6. DOI: https://doi.org/10.1186/1472-6939-14-S1-S6

Oe A. HIV related stigmatizing attitude and practice among health care workers in Northern Nigeria. J Infect Dis Immun. 2011;3:226–32.

Holzemer WL, Makoae LN, Greeff M, et al. MeasuringHIV stigma for PLHAs and nurses over time in five African countries SAHARA-J 2009;6:76-82 DOI: https://doi.org/10.1080/17290376.2009.9724933

Sayles JN, Ryan GW, Silver JS, et al. Experiences of social stigma and implications for healthcare among a diverse population of HIV positive adults. J Urban Health 2007; 84: 814-828. DOI: https://doi.org/10.1007/s11524-007-9220-4

Obi SN, Ifebunandu NA. Consequences of HIV testing without consent. Int J STD AIDS. 2006;17:93–6. DOI: https://doi.org/10.1258/095646206775455649

Ekstrand ML, Ramakrishna J, Bharat S, Heylen E. Prevalence and drivers of HIV stigma among health providers in urban India: implications for interventions. J Int AIDS Soc 2013 ;16:18717 DOI: https://doi.org/10.7448/IAS.16.3.18717

Health Policy Plus. 2017. Legal Audit Update on HIV Law and Policy in Ghana: A Summary of Developments in Ghanaian HIV and Human Rights Law Since 2010. Washington, DC: Palladium, Health Policy Plus.

Published
2020-04-29
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Original Articles
Keywords:
Stigma, Discrimination, PLHIV, Cape Coast, Ghana
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How to Cite
Prah, J., Hayfron-Benjamin, A., Abdulai, M., Lasim, O., Nartey, Y., & Obiri-Yeboah, D. (2020). Predictors of HIV stigma among health workers in the Cape Coast metropolis, Ghana. Journal of Public Health in Africa, 11(1). https://doi.org/10.4081/jphia.2020.1020