HIV patients fear accessing care due to stigma, new study reveals
Boda bodas in Lodwar during a HIV/Aids awareness drive. A study has shown HIV individuals fear accessing treatment and care from public hospitals for fear of being exposed by healthworkers. It recommends more training for healthcare employees.
HIV patients want health care providers to identify them using a unique method in a bid to reduce stigma and discrimination.
According to a research by the Kenya Legal and Ethical Issues Network on HIV/Aids (KELIN), HIV clinics are in separate locations at public hospitals, thus hindering the uptake of the key services.
Many patients complain that health care providers call them by their names when giving them drugs.
The research conducted in the four constituencies of Kisumu county involved 102 females aged 16 to 34.
It reveals that healthcare employees are not adequately trained to maintain the privacy of patients’ data and other information.
Some of the women interviewed said hospital workers openly discuss their HIV/Aids status with their relatives, friends and colleagues.
They also mentioned a breach of confidentiality by the workers who call them by name when delivering their HIV/Aids status results.
“I and many others were once at a government hospital. We were counselled and tested as a group,” one of the participants is quoted as saying in the study.
“After testing, the nurse came and called names. She directed people where to go. The nurse then told three of us to follow her. One could easily tell that the HIV/Aids results of those who were asked to follow the nurse were positive.”
The participants said being called by name to receive their drugs and the manner they were being treated when the results were out were some of the issues hindering them from going to the clinics.
“Hospitals should follow the example of researchers. Rather than using real names, researchers assign individuals pseudo names. By writing real names, almost everyone will know that you have HIV,” the study says.
In the case of index testing, patients give consent to healthcare providers to disclose their status to selected persons. However, this is not always adhered to.
Index testing, also knowns as assisted partner notification services, is the process of reaching out to undiagnosed sexual partners of people with HIV/Aids to inform them of their possible exposure to the virus. It offers to test and link them to care.
Status concealed
During index testing, the client voluntarily consents to the contact of their partners by healthcare workers or counsellors.
Unfortunately, their status is on many occasions shared with the people to whom they did not consent.
“Disclosure of one’s HIV/Aids status plays a significant role in the prevention of transmission and in accessing treatment programmes. The benefits generally outweigh the risks,” the study continues.
“Even so, if the right to privacy is not safeguarded through practices such as informed consent and confidentiality, there is a likelihood that this will influence their decision to disclose their HIV status and negatively impact the uptake of health services.”
Breach of confidentiality has been determined as a major cause of low health-seeking behaviour and poor treatment adherence for people with HIV/Aids.
The study also shows that HIV clinic locations in most public hospitals hinder access to sexual reproductive health services for young women and girls.
Participants in the study were concerned about the open and standalone locations of some clinics, thus not guaranteeing privacy while accessing HIV care and treatment
They often fear that other people might see them entering or leaving the clinics and suspect them of having the virus.
“HIV patients prefer to access services in privacy to avoid being identified by others, leading to stigma, discrimination and other negative consequences,” the study says.
“Accessing private services enables clients to conceal their status. Information gathered from patients must be kept away from other people.”
According to the study, it is necessary that the location of testing, counselling and treatment centres or rooms be merged with others so that people with HIV do not face discrimination.
A total of 11 focused group discussions and 24 in-depth interviews were conducted to highlight the impact of HIV index testing on access to sexual and reproductive health services among young women and girls with HIV/Aids.
The majority of respondents attained formal schooling, with 15 per cent having been to university, 36 per cent attaining college-level education and 33 per cent having completed secondary school.
The participants were predominantly heterosexual. However, about 13 per cent were identified as bisexual, five per cent homosexual (lesbian) while three per cent said they were transgender.
Accessing private services enables clients to conceal their status, the study says.
Information gathered from patients must be managed in such a way as to keep it from other people so that access to services is not compromised.
To improve the privacy and confidentiality of patients’ records, the study recommends that hospitals and clinics have specific individuals who can access the data to help reduce the risk of breaches.
“Hospitals and clinics should have HIV counselling and treatment rooms not labelled and with privacy,” the study concludes.
