Friday, 15 March 2013

Ways to Really Help: HIV and Stigma by Kayla Strickland

         Human immunodeficiency virus (HIV) is an infectious disease that is transmitted through bodily fluids such as blood, semen and vaginal secretions (Harrowing, 2010). HIV is caused by a retrovirus that attacks essential cells needed for the body’s immune function and, over time, destroys the infected person’s immune system. The decline in immune function puts the person at greater risk for infections and other complications (Harrowing, 2010). There is no cure for HIV therefore treatment is aimed at symptom management and slowing the progression of the disease. While the use of anti-retroviral therapy (ARV) can dramatically improve the quality of life for those living with HIV, prevention is the optimal goal.
An essential element necessary for the prevention and detection of HIV infection is awareness. In Ghana, efforts have been made to increase public awareness regarding the transmission of the disease. In 2003, 98% of women and 99% of men reported that they were aware of HIV (Boateng, Kwapong, and Agyei- Baffour, 2013). The reported prevalence rate of HIV in Ghana declined from 3.6% in 2003 to 2.9% in 2009 (United Nations, n.d). For all African countries the true prevalence is difficult to estimate because of undiagnosed and unreported cases. Comprehensive knowledge about HIV, prevention, and non-stigmatizing behaviour still remains an issue (Boateng, Kwapong, and Agyei- Baffour, 2013).
A major barrier to achieving widespread knowledge and prevention of HIV is stigma. Many people who are not familiar with the disease have a negative attitude surrounding the infection resulting in shunning behaviours, and negative experiences for those living with HIV (Barker et al., 2012). The distorted understanding of HIV deters people from seeking medical services such as screening and reduces compliance to the treatment regimen due to fear of being associated with HIV positive test results (Barker et al., 2012). Much of the stigma surrounding HIV stems from the belief that infection only occurs among homosexual men, injection drug users or people who engage in promiscuous sexual behavior. While these lifestyle choices do place individuals at a greater risk for HIV infection it does not mean that they must always go hand in hand.
Research conducted by Barker et al. (2012) discussed how the use of youth intervention programs can help increase participants knowledge on HIV and reduce stigma. The study utilized knowledge and skill based programs that were designed to help youth identify HIV risk exposure in their communities, anticipate and prepare for risky situations, and reduce the incidence of risky lifestyle choices. The program engaged the youth in group discussions, arts and crafts, role plays, storytelling, and videos that addressed HIV preventative behaviors. The intervention also provided skill based instruction around condom use, decision making and communication. The results of the study showed that the intervention helped to reduce stigma among youth by increasing knowledge about HIV. This increased knowledge would then help in the reduction and prevention of the spread of HIV. The investigator recommended that programs designed to reduce HIV stigma should include skills on how to interact with people living with HIV, live testimonials, and visualizing living with HIV (Barker et al., 2012).
            HIV is a global problem that must be addressed in countries all over the world including both Canada and Ghana. It is important for nurses as well as the general public to continue to raise awareness about HIV and work to reduce the stigma attached to the disease. Working to reduce the stigma would make it less stressful for individuals to seek the required screening tests needed to prevent the spread of HIV. It would also greatly improve the quality of life for individuals living with HIV. Knowledge is the key to reducing HIV related stigma. As nurses we should ensure that we are advocating for increased education on the disease starting at adolescence and ensuring that prevention mechanisms are put in place. Nurses and the general public can also work together to get involved with awareness campaigns in their area if they are eager to get involved to truely help in the prevention of HIV.

Barker, D., Swenson, R., Brown, L., Stanton, B., Vanable, P., Carey, M., & ... Romer, D. (2012). Blocking the Benefit of Group-Based HIV-Prevention Efforts during Adolescence: The Problem of HIV-Related Stigma. AIDS & Behavior, 16(3), 571-577. doi:
Boateng, D., Kwapong, G., and Agyei- Baffour, P. (2013). Knowledge, perception about antiretroviral therapy (ART) and prevention of mother-to-child transmission (PMTCT) and adherence to ART among HIV positive women in the Ashanti Region, Ghana: a cross-sectional study. BMC Women’s Health, 13(2), 1-8.
Harrowing, J.N. (2010). Management of patients with HIV disease and AIDS. In A. Day, P. Paul, B. Williams, S. Smeltzer, & B. Bare (Eds.), Textbook of Canadian Medical – Surgical Nursing 2nd Edition (pp. 1716-1729). Philadelphia: Lippincott.
United Nations (n.d.) United Nations Development Programme: MDG Progress in Ghana. Retrieved on February 28, 2013 from Progress

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