Perspectives of HIV-related stigma in a community in Vietnam: a qualitative study.

BACKGROUND: While HIV/AIDS is increasing in Vietnam, very few published studies focus on HIV-related stigma in Vietnam. This study reports on findings from a community development project to reduce HIV-related stigma within one community in Vietnam. OBJECTIVES AND DESIGN: The purpose of this qualitative study is to describe HIV-related stigma from the perspective of three groups within one community in Vietnam: people living with HIV, their family members, and community members and leaders, including health care professionals. SETTING, PARTICIPANTS AND METHODS: Fifty-eight individuals from a poor, industrial district on the outskirts of a large city participated in the study and were asked to describe HIV-related stigma. Interviews were conducted with 10 people living with HIV, 10 family members of a person living with HIV, and 10 community members and 5 community leaders including health care professionals. We also conducted three focus groups, one with people living with HIV (n=8), one with family members of people living with HIV (n=8), and one with community leaders including health care professionals (n=7). FINDINGS: Stigma across the three groups is characterized by four dimensions of HIV-related stigma: feeling shamed and scorned, behaving differently, stigma due to association, and fear of transmission. The manifestation of these dimensions differs for each group. Four themes of HIV-related stigma as described by people living with HIV are: being avoided, experiencing anger and rejection, being viewed as a social ill, and hiding the illness. Seven themes of HIV-related stigma as described by family members are: shunned by neighbors, viewed as poor parents, discriminated by health professionals, overhearing discussions about people with HIV, maintaining the secret, financial hardship for family, and fear of contracting HIV. Four themes of HIV-related stigma as described by community members and leaders including health professionals are: stigma as a fair reward, avoidance and shunning by neighbors, ruined family reputation, and fear of contracting HIV. CONCLUSIONS: HIV-related stigma is experienced in a different manner by each of these groups, a finding that should help in developing culturally sensitive strategies to reduce HIV-related stigma in Vietnam.

Developing culturally sensitive interventions for Vietnamese health issues: an action research approach.

This article describes an action research approach to community development in Vietnam. An advisory committee worked with the researchers and identified the stigma of HIV/AIDS as a health issue of importance to it. The advisory committee consisted of representatives from the community. The selected issue was then explored in greater depth by individually interviewing infected persons, their family members, community members, and leaders. At the same time, focus groups were conducted for additional members of each of the above three cohorts. Through open-ended questions, the participants described the impacts of the stigma on their life, the possible causes of the stigma, and the relevant strategies to reduce these causes. Based on the findings, the advisory committee suggested interventions to reduce the stigma. This project demonstrated an effective way in which nurses can work with communities to help them to identify local solutions to their identified health issues.