ABSTRACT
The HIV/AIDS stigma, fear and discrimination have been linked with poor participation in Voluntary Counselling and Testing (VCT) programs. Cultural factors, attitudes and behaviours strongly influence the spread of HIV/AIDS and these have been extensively studied in several sub-Sahara African countries. Similar studies in Papua New Guinea are scanty. This study investigates the extents of HIV/AIDS-Stigma, fear, discrimination and other psychological factors as barriers to the access of VCT and other services in four suburban villages in the National Capital District, Papua New Guinea. The study sites were Baruni, Hanuabada, Pari and Kilakila villages. A semi-structured questionnaire comprising of closed and open ended questions was administered to respondents selected randomly. Groups were selected for focus group discussions. Gender stratification was used to ensure that views of both men and women were equally represented. A total of 333 respondents comprising of 166 (49.8%) males, and 167 (50.2 %) females participated in the survey. Self-stigmatization as a major barrier to VCT was indicated by 90.7% of all the respondents. Gender based differences were not statistically significant. Discrimination by relatives and friends was indicated by 74.8% respondents; 79.0% of respondents would discriminate HIV/AIDS-infected people. A total of 42.0% respondents indicated the possibility of rejection from close relationships. The likelihood of dismissal from workplace was indicated by 68.5% of respondents. Lack of support from health providers (67.0%) and fear of HIV test result (61.6%) were other barriers to VCT indicated by respondents. This study recommends the need to heighten awareness of VCT and to eliminate stigma and fear in order to control the HIV/AIDS pandemic.
ABSTRACT
A number of research findings have linked stigma, discrimination and fear with poor participation in Voluntary Counseling and Testing (VCT) programs. Cultural factors, attitudes and behaviours strongly influence the spread of HIV/AIDS and these have been extensively studied in several sub-Sahara African countries. Treppe and Wambua believed that stigma, silence, discrimination, denial and lack of confidentiality would contribute to an environment of fear that undermines the prevention and treatment efforts, thereby increasing the impact of the HIV pandemic in Papua New Guinea. The objective of this study was to investigate the Impact of HIV/AIDS-Stigma and discrimination on the access to VCT and related services in selected areas of the National Capital District, Papua New Guinea. A semi-structured questionnaire survey comprising of closed and open ended questions was carried out among youths respondents (15-24 years) selected at random, but gender stratified, from two sub-urban areas of the National Capital District, Papua New Guinea. The areas studied were Elevala and Morata 1. Important questions included in the questionnaire aimed at exposing the existence of stigma, fear and discrimination that would occur when close relatives or/and people of the immediate community know about the HIV/AIDS status of individuals, and linked these to impacts on access to VCT and related services. In-depth focus group discussions were also carried out to confirm issues encountered in the quantitative surveys and to disclose other concerns of the community inherent to HIV/AIDS stigma and discrimination. Out of a total of 380 respondents from the areas surveyed, 364 (95.8%) indicated existence of self stigmatization, while 335 (88.2%) showed perceived stigma. The notion of perceived discrimination and discriminating others occurred among 322 (84.7%) and 349 (91.8%) respondents respectively. Both stigma and discrimination were found to impact negatively on VCT and other services; with 255 (67.1%) respondents expressing fear of what to do with HIV positive results, 209 (55%) indicating self withdrawal from normal duties and 15 (3.9%) exhibiting suicidal tendencies in the event where HIV test would reveal positive results. Despite the negative impacts of stigma and discrimination it was reassuring however, to see the majority of respondents; n=347 or 91.3 %) indicating willingness to utilize VCT services, and readiness for HIV testing; n= 266 (70.0%). Focus group discussions showed consistencies in the above findings, but also revealed a strong attitude of abandonment and rejection of an HIV positive person by family members, relatives, friends and workmates. Scepticism whether service providers and caregivers would attend to HIV positive clients politely as they would do with other clients was also highlighted. These results which had little or no significant gender based differences, tended to agree with patterns of studies carried out elsewhere mostly in sub-Saharan African countries. HIV/AIDS - Stigma and discrimination create fear and discouragement as reported by the individuals surveyed, and collectively forms a great barrier in the access to VCT and other related services. Due to the wide diversity in cultural norms in Papua New Guinea, the study should be quickly tested in other areas including rural populations, such that outcomes may be used to complement and strengthen the ongoing government awareness on VCT in the country.