The Discriminatory Attitudes of Health Workers against People Living with HIV

A necdotal evidence suggests that health-care professionals in Nigeria may discriminate against and stigmatise people living with HIV/AIDS(PLWA). In a study in the August issue of PLoS Medicine, Reis and colleagues set out to characterise the nature and extent of discriminatory practices and attitudes in the health sector, and indicate possible contributing factors and intervention strategies [1]. The study was specifi cally designed to answer three research questions: (1) are there discriminatory practices in the health sector that affect the health and well-being of PLWA in Nigeria, (2) how receptive are health workers and institutions to treating PLWA, and (3) what underlying factors may contribute to any discriminatory practices? In order to answer these questions, a representative sample of 1,103 health-care professionals (doctors, nurses, and midwives) working directly with patients with HIV/AIDS were selected from four states in Nigeria and asked to participate in a study. The response rate was 93% (i.e., 1,021 surveyed professionals participated). A survey questionnaire was administered to respondents to collect information about their knowledge, attitudes, and behaviour. The study was reviewed and approved by an independent ethics review board of individuals with expertise in clinical medicine, public health, bioethics, and international HIV/AIDS and human rights research. The results suggest that some health-care professionals discriminate against and stigmatise PLWA. For instance, 9% of professionals reported refusing to care for a patient with HIV/AIDS, and 9% reported that they refused a patient with HIV/AIDS admission to hospital. Two-thirds reported observing other health professionals refusing to care for a patient with HIV/AIDS, and 43% observed others refusing a patient with HIV/AIDS admission to hospital. The study suggests that a signifi cant number of health-care professionals engage in discriminatory and unethical behaviour. Some professionals reported giving confi dential information to other people (family members and unrelated individuals) without the patient's consent. Despite these discriminatory attitudes, an optimistic fi nding is that most health-care professionals expressed an interest in additional information and suggested education and counselling as a way to address discriminatory behaviours by their colleagues. The study concludes that all clinical staff should be educated about HIV/ AIDS, modes of transmission of the virus, universal precautions, and the rights of PLWA. Such education is likely to reduce discriminatory practices towards PLWA and may improve these patients' care and access to health services. The study also asserts that a lack of protective materials and other materials needed to treat and …