Stigma still a major hinderance to getting HIV care and treatment

By Aisha Naava & Lilian Nuwabaine Luyima

Several HIV newly diagnosed clients are discovered on a daily, irrespective of the preventive measures, care and treatment that are being provided all over the world. This is an eye-opener that we still have a high number of HIV-positive individuals that do not know their status which leads to continuous transmission of HIV/AIDS within the community. On the other hand, some people are aware of their HIV status but have lots of fear of seeking medical support because they believe it is a mark of disgrace in society. 

There is no cure for HIV infection, however, with access to effective HIV prevention, diagnosis, treatment and care, including for opportunistic infections, HIV infection has become a manageable chronic health condition, enabling people living with HIV to lead long and healthy lives.

HIV stigma refers to irrational or negative attitudes, behaviors, and judgments towards people living with or at risk of HIV. It is the prejudice that comes with labelling an individual as part of a group that is believed to be socially unacceptable. It can negatively affect the health and well-being of people living with HIV by discouraging some individuals from learning their HIV status, accessing treatment, or staying in care.

Additionally, HIV self-stigma happens when a person takes in the negative ideas and stereotypes about people living with HIV and starts to apply them to themselves. HIV internalized stigma can lead to feelings of shame, fear of disclosure, isolation, and despair. In this regard, on the reception of the HIV-positive results, some people end up having negative feelings about themselves in relation to HIV diagnosis due to stigma and discrimination. This has been shown to affect a person’s ability to live positively, adhere to treatment or access to health services, and to diminish quality of life in general.

People living with HIV often internalize the stigma they experience and begin to develop a negative self-image. They may fear they will be discriminated against or judged negatively if their HIV status is revealed.

Currently, many people still have misconceptions about how HIV is transmitted, and false beliefs and some people still think that HIV only affects a certain group of people. This is mainly due to lack of information and has greatly contributed to stigma and discrimination thus the increasing number of HIV-positive individuals staying in the community without seeking care and treatment.  This promotes continuous transmission of HIV which hinders achievement of the goal to end HIV by 2030.

To promote ART initiation, we, therefore, recommend the need for comprehensive interventions to fight stigma, encourage couple HIV counselling, address gender inequalities, and strengthen health education and counselling programs. We recommend the need to implement more patient-friendly and flexible clinic working hours. In regard to this, embrace community refill pharmacy drug distribution points as this has benefited so many recipients of care to minimize stigma. The Community Retail Pharmacy acts as an alternative ARV pick-up point for selected recipients of care. Stable clients on treatment with suppressed viral loads are educated and encouraged to get their ARVs from the community pharmacies like they are picking other drugs and come back to the facility once a year for viral load monitoring or in case they are unwell. Finally, more emphasis should be put on creating more awareness about HIV/AIDS among the community members.

The authors are; Aisha Naava; a Nursing Officer at Kawolo General Hospital and
Ms Lilian Nuwabaine Luyima; BSc Nurse & MSN-Midwife & Women’s’ Health Specialist