HIV/AIDS - Related Stigma and Discrimination in Nigeria: Review of Research Studies and future directions for Prevention Strategies

Emmanuel Monjok, Andrea Smesny, E. James Essien

Abstract

Human Immunodeficiency Virus (HIV) infection and AIDS remain a major public health crisis in Nigeria which harbors more people living with HIV than any other country in the world, except South Africa and India.  A significant challenge to the success of achieving universal access to HIV prevention, treatment, care and support by 2010 is HIV-AIDS stigma and discrimination. Eight studies looking at some degree of measurement of stigma and discrimination in Nigeria were reviewed in an attempt to investigate the cultural context of stigma, health seeking behavior and the role both perceived and community stigma play in HIV prevention.  Results suggest that reducing stigma does increase the individual as well as community acceptance of people living with HIV-AIDS (PLWHAs), but long term studies are needed.  Some suggestions are recommended for future research on culture specific stigma studies in Nigeria (Afr J Reprod Health 2009; 13[3]:21-35).

 

RĖSUMĖ

Stigmatisation liée au VIH/SIDA et la discrimination au Nigéria: Compte-rendu des études de recherche et la direction future pour les stratégies de la prevention. L’infection  du virus de l’immunodéficience humaine (VIH) et le SIDA reste une crise majeure de la santé publique au Nigéria, un pays qui abrite un plus grand nombre des gens séropositifs que les autres pays du monde, à part l’Afrique du Sud et l’Inde.  La stigmatisation et la discrimination causeés par le VIH/SIDA constituent un défi important aux efforts pour l’accès universel à la prévention, au traitement, au soin et au soutien jusqu’en l’année 2010. Nous avons fait un compte-rendu de huit études qui examinaient à quelque niveau de mesures de la stigmatisation au Nigéria afin d’évaluer le contexte culturel de la stigmatisation, le comportement qui favorise la santé et le rôle que jouent à la fois la sstigmatisation perçu et la stigmatisation de la communauté dans la prévention du VIH.  Les résultats ont montré que la réduction de la stigmatisation augmente, en effet, l’acceptation de l’individu ainsi que l’acceptation par la communauté des gens séropositfs: mais il faut des études à long terme.  Nous avons fait quelques recommendations pour les recherches futures à l’égard des études de la stigmatisation propre à la culture au Nigéria (Afr J Reprod Health 2009; 13[3]:21-35).

 

KEYWORDS: HIV/AIDS, Stigma, discrimination, Nigeria

 

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References

WHO/UNAIDS: AIDS epidemic update; special report on HIV/AIDS, WHO/UNAIDS, 2006

UNAIDS, Country progress report (Nigeria UNGASS Report); 2007 accessed from www.unaids.org.

Federal Ministry of Health (FMoH), Nigeria, HIV/AIDS; what it means for Nigeria (background, Projections, impact, intervention & policy), December, 2002.

USAIDS/PEPFAR; Nigeria; 2008 Country profile accessed from www.pepfar.gov /press/81548.htm.

United Nations General Assembly, sixtieth session, 24 October, 2005, ARES/60/1.

Fifty-Ninth World Health Assembly, 27 May, 2005. Resolution WHA59.19.

PEPFAR latest Treatment Results; www. pepfar.gov/press/10629.htm and www. pepfar.gov/documents/organization/106385.p df, accessed November 21, 2008.

PEPFAR: Prevention of Mother-to-Child Transmission, www. pepfar.gov/documents/ organization/79663.pdf or www.pepfar.gov/ press/79674.htm, accessed November 21, 2008.

Mann. J. Statement at an informal meeting on AIDS to the 42nd session of the UN General Assembly, October 20, 1987

Goffman,E. Stigma: Notes on the

Management of Spoiled Identity .New York; Simon &Shuster Inc. 1963

Jones,E; Farina A, Hastorf,A,et al. Social Stigma: The psychology of Marked Relationships. New York. Freeman & Company, 1984

Crocker,J, Major B, Steele C. Social Stigma. In Gilbert D, Fiske, ST & Lindzey G(Eds); The Handbook of social Psychology(4th edition. Vol,2, pp.504-553) New York, 1998.

Link, B Phelan JC. “On stigma and its public health implications”. Paper presented at the stigma and Global Health: Developing Agenda Conference, Bethseda, Maryland, USA, September, 2001, accessed from http:// www.stigmaconference.nih.gov/linkpaper.ht m.

Cameron, E. Legal rights, Human rights and AIDS: The first decade. Report from South

Africa 2. AIDS Analysis Africa 1993; 3: 3-4

Jayaraman,KS. Indian State plans compulsory HIV testing, segregation and branding. Nature Medicine 1998; 4(4): 378

Zierler S, Cunningham WE, Andersen R, Shapiro MF, Nakazono, TY, Morton S, et al. Violence victimization after HIV infection in a US probability sample of Adults patients in Primary care. Am J Public Health 2000; 90(2): 208-215.

UNAIDS: HIV and AIDS-related

Stigmatization, Discrimination and Denial: form, context and determinants (Research studies from Uganda and India); Best Practices Collection, UNAIDS 2000, accessed from www.unaids.org.

Gilmore, N, Somerville, MA. Stigmatization, Scapegoating and Discrimination in Sexually Transmitted Diseases:Overcoming “them” and “us”. Social Science and Medicine, 1994; 39(9): 1339-1358.

Ogunyombo, D. Living with AIDS- an unforgiveable crime?. Growing Up, 1999,

(3): 8

Malcolm A, Aggleton P, Bronfman,M, Galvao,J, Mane, P Verral,J. HIV-related Stigmatization and Discrimination: Its form and context. Critical Public Health, 1998; 8(4): 347-370.

Scrambler,G. Stigma and Disease: Changing Paradigms. The Lancet, 1998; 352(9133): 1054-1055

Herek GM, Glunt EK. An epidemic of stigma: Public reactions to AIDS. American Psychologist, 1998; 43: 886-892.

Parker R, Aggleton P. HIV and AIDS-related stigma and discrimination: A conceptual framework and implications for action.

Social Science and Medicine, 2003; 57: 13-

Parker R, Bajenja E, Karamagi E, Tindyebwa D. AIDS –Related stigma: Perceptions of family caregivers and health volunteers in Western Uganda. World Health and

Population Report, April 2007.

Valdiserri OR. HIV/AIDS Stigma: An impediment to public health. Am J Public Health, 2000; 92(3): 341-342.

De Cock, K. Kaiser daily HIV/AIDS report, accessed from http://www.thebody.com/ content/news/art 7478.html, November 21, 2008

Nyblade,L, MacQuarrie, K. Can we measure HIV/AIDS-Stigma and Discrimination? Current knowledge about quantifying stigma in developing countries. ICRW: The policy Project, 2006

Etiebet MA, Fransman D, Forsyth B, Goetzee N, Hussey G. Integrating prevention of Mother-to-Child HIV transmission into antenatal care: Learning from the experience of women in South Africa. AIDS Care, 2004; 16: 37-46.

Ekanem EE, Gbadeqesin A. Voluntary Counselling and Testing (VCT) for Human Immunodeficiency Virus: A study on acceptability by Nigerian women attending antenatal clinics, Afr J Reprod. Health, 2004; 8: 91-100.

Thorne C, Newell ML. Mother-to-Child transmission of HIV infection and its prevention. Curr. HIV Res. 2003; 1: 447-462

Shapiro RL, Lockman S, Thior, I, Sticking L, Kebaabetswe P et al. Low adherence to recommended infant feeding stategies among HIV-infected women: Results from the pilot phase of a randomized trial to prevent Mother-to-Child transmission in Botswana. AIDS Education Prev, 2003; 15: 221-230.

Rankin WW, Brennans S, Schell E, Laviwa J, Rankin SH. The stigma of being HIV positive in Africa. PloS Med. 2005; 2(8): e247.

UNAIDS. Towards universal access to prevention, treatment and care: experiences and challenges from the Mbeya Region in Tanzania- a case study. Best Practices Collection. UNAIDS 2007 accessed from www.unaids.org.

Ehiri JE, Anyanwu EC, Donath E, Kanu I,

Jolly, PE. AIDS-Related stigma in subSaharan Africa: Its context and potential intervention strategies. AIDS public policy J. 2005; 20: 25-39

Essien EJ, Ross MW, Ezedinachi EN, Meremikwu M. Cross-national HIV infection control practices and fear of AIDS: A comparison between Nigeria and the USA. International J. STD & AIDS. 1997; 8(12): 764-771

Utulu SN, Lawoyin TO. Epidemiological features of HIV Infection among pregnant women in Markurdi, Benue State, Nigeria. Journal of Biological Science, 2007; 39(3): 397-408

Otolok-Tanga E, Atuyambe L, Murphy CK, Ringheim KE, Woldehanna S. Examining the actions of faith-based organizations and their influence on HIV/AIDS related stigma: a

case study of Uganda. Afr. Health. Science, 2007; 7(1): 55-60.

Fawole,IO, Asuzu, MC, Oduntan,SO, Brieger,WR. A school-based AIDS education program for secondary school students in Nigeria: a review of effectiveness. Health Edu, Res. 1999; 14(5): 675-683

Uwakwe, CB. Systematized HIV/AIDS education for student nurses at the University of Ibadan, Nigeria: Impact on Knowledge, attitudes and compliance with universal precautions. Journal of Advanced Nursing, 2000; 32(2): 416-424.

Alubo, O, Zwandor A, Jolayemi,T Omudu,E. Aceptance and Stigmatization of PLWA in Nigeria. AIDS Care. 2002; 14(1): 117-120.

Oyediran, K Oladipo O, Anyanti J. HIV/AIDS Stigma and Discrimination in Nigeria Paper presented at XXV

International Population Conference, International Union for the Scientific Study of Population (IUSSP), Tours, France, July

-23, 2005, accessed from

http://www.iussp2005.princeton.edu/downloa d.aspx/submissionID=51685.

Odimeqwu, CO. Prevalence and predictors of HIV-related stigma and Knowledge in Nigeria: Implications for HIV/AIDS prevention initiatives. Takemi Research Report 210, 2003, Harvard school of public health, Boston. Acessed from:

http://www.hsph.harvard.edu/takemi/working _papers.htm.

Ezedinachi EW, Ross, MW, Meremikwu, M, Essien,EJ, Edem CO, Ekure E, Ita,O.The impact of an intervention to change health workers HIV/AIDS attitudes and Knowledge in Nigeria: a controlled trial. Public Health, 2002; 116(2): 106-112.

Oyelese AO. Stigma, Discrimination and ostracization: HIV/AIDS infection in Nigeria. Int. Quarterly of Comm. Health Edu. 2004; 22(1-2):125-129

Babalola, S. Readiness for HIV Testing among Young People in Northern Nigeria:

The Roles of social norm and perceived stigma. AIDS Behav. 2007; 11: 759-769.

Reis C, Heisler M, Amowitz LL, Moreland RS, Mafeni JO, Anyamele C, Lacopino V. Discriminatory attitudes and practices by Health workers towards patients with HIV/AIDS in Nigeria. PLoS Med. 2005;

(8):e246.

Sadob AE, Fawole A O, Sadoh WE, Oladimeji AO, Sotiloye OS. Attitudes of health-care workers to HIV/AIDS. Afr. J Reproduc. Health. 2006; 10(1): 39-46.

Adelekan ML, Jolayemi SO, Ndom RJ, Adegboye J, Babatunde S, Tunde-Ayimode, M, Yusuff, O. Makanjuola, AB. Caring for people with AIDS in a Nigerian teaching hospital: staff attitudes and knowledge. AIDS Care. 1995; 7 Suppl 1: S63-72.

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