Stigma and discrimination associated with HIV/AIDS in health care settings: a comparative study in two hospitals of different categories in Douala-Cameroon

Abstract

The response to the human immunodeficiency virus epidemic faces many challenges with stigma and discrimination being two of them. The aim of this study is to determine the extent of effects of stigmatization and discrimination against people living with HIV-AIDS, and the influence of the type of hospital structure, in the manifestations of stigma and discrimination. A prospective cross sectional study was conducted among a total of 400 patients, using a pre-tested questionnaire. An observation form was also filled to evaluate attitudes and behaviour of health care providers towards patients. Chi-Square test and Fisher test were used to test association between two variables, then multi logistic regression tests were done to check predictive factors of discrimination. The level of significance was chosen at p<0.05. Among the participants, 104 (26%) patients reported having been victims of discrimination. Laquintinie hospital of Douala has a risk factor for blames and maltreatment (p = 0.0060) and (p= 0.0091) respectively. Also 152 (76.1%) patients of Laquintinie vs 103 (51.5%) of Nylon have been victims of stigmatization. The stigmatizing elements were: the name of the treatment center (p<0.0001) and the unconfidential manner of handling medical files (p=0.0527). Among the 400 patients, fifty nine (14.8%) avoided going to the hospital because of past experience of stigma and discrimination. Patients encounter several difficulties and those related to stigma and discrimination experienced in a hospital milieu can particularly constitute obstacles to better health seeking and therapeutic adherence. The human immunodeficiency virus infection response strategy should address stigma and discrimination by reviewing the management of treatment centers, elaborating relevant public health policies and training of healthcare practitioner.

Keywords: HIV/AIDS; Stigma; Discrimination; Laquintinie; Nylon; Douala