Examining the effect of peer-support on self-stigma among persons living with HIV/AIDS

INTRODUCTION: Contrary to assertions that stigma may no longer be experienced due to substantial advancement in antiretroviral access and treatment, self-stigma still exists among people living with HIV/AIDS (PLWHA) in Nigeria. The use of peer health workers to improve care in underserviced settings has been implemented by a number of programs, but its effect has not been extensively assessed. This study compared the level of self-stigma among PLWHA in peer support and non-support groups in Enugu State Nigeria. METHODS: A cross-sectional study using quantitative and qualitative instruments was conducted among PLWHA attending ARV clinics. Quantitative data was assessed using pre-tested structured interviewer-administered questionnaires. Chi-square test of statistical significance was used in the analysis. Four focus group discussions and eight key informant interviews were conducted among PLWHA and healthcare workers respectively. Manual content analysis was used to analyse the qualitative data. RESULTS: Comparable proportions of respondents in peer support (31.4%) and non-peer support groups (30.2%) had self-stigma (p=0.709). Disclosure was higher among respondents in non-peer support groups (96%) against 94.5% in peer support groups (p=0.331). Health workers interviewed were of the opinion that self-stigma cuts across members of both groups. Participants in the FGD reported that the media and economic empowerment have helped reduce self-stigma among PLWHA. CONCLUSION: Though peer support groups may be a starting place for the development of social support interventions for PLWHA, it might not be sufficient to combat self-stigma. Interventions aimed at economic empowerment of PLWHA and public enlightenment are essential for effective mitigation against self-stigma.