Changing Sources of Stigma against Patients with HIV/AIDS in the Rapid Expansion of Antiretroviral Treatment Services in Vietnam

Bach Xuan Tran; Phung Quoc Tat Than; Tung Thanh Tran; Cuong Tat Nguyen; Carl A Latkin

doi:10.1155/2019/4208638

Changing Sources of Stigma against Patients with HIV/AIDS in the Rapid Expansion of Antiretroviral Treatment Services in Vietnam

Biomed Res Int. 2019 Jan 21:2019:4208638. doi: 10.1155/2019/4208638. eCollection 2019.

Authors

Bach Xuan Tran^{1

2}, Phung Quoc Tat Than^{3

4}, Tung Thanh Tran⁵, Cuong Tat Nguyen³, Carl A Latkin²

Affiliations

¹ Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam.
² Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
³ Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam.
⁴ California State University, Northridge, Northridge, CA, USA.
⁵ Center of Excellence in Evidence-Based Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam.

Abstract

Stigmatization against HIV/AIDS greatly hinders efforts to increase the accessibility and utilization of HIV/AIDS services to meet the 90-90-90 goal. This study assessed the stigmatization and discrimination experienced by people living with HIV (PLWH) across multiple social settings such as family, community, and healthcare facilities in Vietnam. A total of 1,016 patients (63.8% males, mean age = 35.4) participated in a cross-sectional study using a culturally tailored HIV stigma measure in three HIV-epidemic-concentrated cities in Vietnam. Zero-inflated Poisson models were used to examine factors associated with the number of types of stigma that patients experienced. 86.2% PLWH reported experiencing stigma against HIV/AIDS, more frequently from their community (62.8%) and family (30.2%) than from health care facilities (8%). The level of stigma from community reported by PLWH is associated with socioeconomic status (e.g., income, occupation). The poor and middle economic classes and unemployed patients reported more stigmatization and discrimination from the community. Across all settings, PLWH experienced fewer stigmatization over the course of ART indicating the benefits of rapidly expanded ART programs. PLWH reported more stigmatization and discrimination at the provincial level of the health administration. Those with the history of drug injection reported significantly less stigmatization from healthcare setting. More culturally tailored interventions to reduce stigmatization overall to improve the quality of life and health outcomes of PLWH should be warranted to achieve the 90-90-90 goal. Improving HIV-related knowledge of the general population and providing opportunities for PLWH to be reintegrated into should be considered. Using mass media with positive messages and images would also foster positive attitudes towards HIV/AIDS among the population and could potentially change social values. Continuous training of health staffs' attitude could minimize the occurrence of stigmatization and discrimination at healthcare facilities.

MeSH terms

Acquired Immunodeficiency Syndrome / drug therapy*
Acquired Immunodeficiency Syndrome / psychology*
Adult
Anti-Retroviral Agents / therapeutic use*
Attitude
Cross-Sectional Studies
Female
HIV / drug effects*
HIV Infections / drug therapy*
HIV Infections / psychology*
Humans
Male
Quality of Life
Social Class
Social Stigma
Socioeconomic Factors
Stereotyping
Surveys and Questionnaires
Vietnam

Substances

Anti-Retroviral Agents