Stigma and discrimination: coping behaviours of people living with HIV and AIDS in an urban community of Mabvuku and Tafara, Harare, Zimbabwe.

OBJECTIVES To assess how people living with HIV and AIDS reacted to the knowledge of the infection and how they are coping with stigma and discrimination. SETTINGS The study was conducted in the two high density urban suburbs of Mabvuku and Tafara in Harare, Zimbabwe. DESIGN The study was a descriptive cross sectional survey. SUBJECTS A total of 600 participants (160 men and 440 women) who had received their HIV results after Voluntary Counselling and Testing for HIV at the Zimbabwe AIDS Prevention and Support Organization (ZAPSO) Mabvuku/Tafara Voluntary Counselling and Testing Centre were interviewed. MAIN OUTCOME MEASURES Reactions to the diagnosis of HIV, disclosure of sero-status, experiences of self, family and community induced stigma and discrimination, coping mechanisms and desired interventions to reduce stigma. RESULTS The majority, 61.7%, had been diagnosed HIV positive less than two years at the time of the study. While 33.3% felt hurt, 41% were immediately depressed when they discovered they were HIV positive. Eighty five percent had not disclosed their sero-status to anyone. While 55% experience self induced stigma, 56.7% experienced family induced and 38.3% experienced community induced stigma. People living with HIV and AIDS were coping with stigma through withdrawal (60%); joining support groups (83.3%); seeking counselling (95%) and praying (86.7%). Encouraging community counselling and HIV testing with disclosure of status was perceived by 98.3% of the respondents as an effective method to reduce HIV and AIDS related stigma and discrimination. CONCLUSION While non disclosure of sero status is still high, self, family and community induced stigma pose a big challenge. Withdrawal (used mostly by men), seeking counselling and joining support groups (used mostly by older women) are the common coping behaviours being used by HIV positive clients. There is need to improve counselling capacities so as to meet the demands from a stigma reduction perspective as well as from a coping perspective.