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Discriminatory Attitudes and Practices by Health Workers toward Patients with HIV/AIDS in Nigeria

BACKGROUND: Nigeria has an estimated 3.6 million people with HIV/AIDS and is home to one out of every 11 people with HIV/AIDS worldwide. This study is the first population-based assessment of discrimination against people living with HIV/AIDS in the health sector of a country. The purpose of this st...

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Autores principales: Reis, Chen, Heisler, Michele, Amowitz, Lynn L, Moreland, R. Scott, Mafeni, Jerome O, Anyamele, Chukwuemeka, Iacopino, Vincent
Formato: Texto
Lenguaje:English
Publicado: Public Library of Science 2005
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1176239/
https://www.ncbi.nlm.nih.gov/pubmed/16022564
http://dx.doi.org/10.1371/journal.pmed.0020246
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author Reis, Chen
Heisler, Michele
Amowitz, Lynn L
Moreland, R. Scott
Mafeni, Jerome O
Anyamele, Chukwuemeka
Iacopino, Vincent
author_facet Reis, Chen
Heisler, Michele
Amowitz, Lynn L
Moreland, R. Scott
Mafeni, Jerome O
Anyamele, Chukwuemeka
Iacopino, Vincent
author_sort Reis, Chen
collection PubMed
description BACKGROUND: Nigeria has an estimated 3.6 million people with HIV/AIDS and is home to one out of every 11 people with HIV/AIDS worldwide. This study is the first population-based assessment of discrimination against people living with HIV/AIDS in the health sector of a country. The purpose of this study was to characterize the nature and extent of discriminatory practices and attitudes in the health sector and indicate possible contributing factors and intervention strategies. The study involved a cross-sectional survey of 1,021 Nigerian health-care professionals (including 324 physicians, 541 nurses, and 133 midwives identified by profession) in 111 health-care facilities in four Nigerian states. METHODS AND FINDINGS: Fifty-four percent of the health-care professionals (550/1,021) were sampled from public tertiary care facilities. Nine percent of professionals reported refusing to care for an HIV/AIDS patient, and 9% indicated that they had refused an HIV/AIDS patient admission to a hospital. Fifty-nine percent agreed that people with HIV/AIDS should be on a separate ward, and 40% believed a person's HIV status could be determined by his or her appearance. Ninety-one percent agreed that staff and health-care professionals should be informed when a patient is HIV-positive so they can protect themselves. Forty percent believed that health-care professionals with HIV/AIDS should not be allowed to work in any area of health-care that requires patient contact. Twenty percent agreed that many with HIV/AIDS behaved immorally and deserve the disease. Basic materials needed for treatment and prevention of HIV were not adequately available. Twelve percent agreed that treatment of opportunistic infections in HIV/AIDS patients wastes resources, and 8% indicated that treating someone with HIV/AIDS is a waste of precious resources. Providers who reported working in facilities that did not always practice universal precautions were more likely to favor restrictive policies toward people with HIV/AIDS. Providers who reported less adequate training in HIV treatment and ethics were also more likely to report negative attitudes toward patients with HIV/AIDS. There was no consistent pattern of differences in negative attitudes and practices across the different health specialties surveyed. CONCLUSION: While most health-care professionals surveyed reported being in compliance with their ethical obligations despite the lack of resources, discriminatory behavior and attitudes toward patients with HIV/AIDS exist among a significant proportion of health-care professionals in the surveyed states. Inadequate education about HIV/AIDS and a lack of protective and treatment materials appear to contribute to these practices and attitudes.
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spelling pubmed-11762392005-07-19 Discriminatory Attitudes and Practices by Health Workers toward Patients with HIV/AIDS in Nigeria Reis, Chen Heisler, Michele Amowitz, Lynn L Moreland, R. Scott Mafeni, Jerome O Anyamele, Chukwuemeka Iacopino, Vincent PLoS Med Research Article BACKGROUND: Nigeria has an estimated 3.6 million people with HIV/AIDS and is home to one out of every 11 people with HIV/AIDS worldwide. This study is the first population-based assessment of discrimination against people living with HIV/AIDS in the health sector of a country. The purpose of this study was to characterize the nature and extent of discriminatory practices and attitudes in the health sector and indicate possible contributing factors and intervention strategies. The study involved a cross-sectional survey of 1,021 Nigerian health-care professionals (including 324 physicians, 541 nurses, and 133 midwives identified by profession) in 111 health-care facilities in four Nigerian states. METHODS AND FINDINGS: Fifty-four percent of the health-care professionals (550/1,021) were sampled from public tertiary care facilities. Nine percent of professionals reported refusing to care for an HIV/AIDS patient, and 9% indicated that they had refused an HIV/AIDS patient admission to a hospital. Fifty-nine percent agreed that people with HIV/AIDS should be on a separate ward, and 40% believed a person's HIV status could be determined by his or her appearance. Ninety-one percent agreed that staff and health-care professionals should be informed when a patient is HIV-positive so they can protect themselves. Forty percent believed that health-care professionals with HIV/AIDS should not be allowed to work in any area of health-care that requires patient contact. Twenty percent agreed that many with HIV/AIDS behaved immorally and deserve the disease. Basic materials needed for treatment and prevention of HIV were not adequately available. Twelve percent agreed that treatment of opportunistic infections in HIV/AIDS patients wastes resources, and 8% indicated that treating someone with HIV/AIDS is a waste of precious resources. Providers who reported working in facilities that did not always practice universal precautions were more likely to favor restrictive policies toward people with HIV/AIDS. Providers who reported less adequate training in HIV treatment and ethics were also more likely to report negative attitudes toward patients with HIV/AIDS. There was no consistent pattern of differences in negative attitudes and practices across the different health specialties surveyed. CONCLUSION: While most health-care professionals surveyed reported being in compliance with their ethical obligations despite the lack of resources, discriminatory behavior and attitudes toward patients with HIV/AIDS exist among a significant proportion of health-care professionals in the surveyed states. Inadequate education about HIV/AIDS and a lack of protective and treatment materials appear to contribute to these practices and attitudes. Public Library of Science 2005-08 2005-07-19 /pmc/articles/PMC1176239/ /pubmed/16022564 http://dx.doi.org/10.1371/journal.pmed.0020246 Text en Copyright: © 2005 Reis et al. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Reis, Chen
Heisler, Michele
Amowitz, Lynn L
Moreland, R. Scott
Mafeni, Jerome O
Anyamele, Chukwuemeka
Iacopino, Vincent
Discriminatory Attitudes and Practices by Health Workers toward Patients with HIV/AIDS in Nigeria
title Discriminatory Attitudes and Practices by Health Workers toward Patients with HIV/AIDS in Nigeria
title_full Discriminatory Attitudes and Practices by Health Workers toward Patients with HIV/AIDS in Nigeria
title_fullStr Discriminatory Attitudes and Practices by Health Workers toward Patients with HIV/AIDS in Nigeria
title_full_unstemmed Discriminatory Attitudes and Practices by Health Workers toward Patients with HIV/AIDS in Nigeria
title_short Discriminatory Attitudes and Practices by Health Workers toward Patients with HIV/AIDS in Nigeria
title_sort discriminatory attitudes and practices by health workers toward patients with hiv/aids in nigeria
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1176239/
https://www.ncbi.nlm.nih.gov/pubmed/16022564
http://dx.doi.org/10.1371/journal.pmed.0020246
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