Perceived stigma among people living with HIV/AIDS in Pokhara, Nepal.

BACKGROUND: HIV-related stigma among people living with HIV/AIDS (PLWHA) is the foremost barrier to HIV prevention, treatment, care, and support. The aim of this study was to identify the perceived stigma level of PLWHA and its relation with selected demographic and situational factors in Pokhara, Nepal. METHODS: Cross-sectional descriptive study was conducted among 282 PLWHA after probability sampling from antiretroviral treatment center of Western Regional Hospital, Pokhara, Nepal. Face-to-face interview was taken by using Bunn standard HSS tool. Stigma was measured in terms of felt stigma (public attitude concern [PAC], disclosure concern [DC], negative self-image [NSI]), enacted stigma [ES], as well as overall stigma. RESULT: The mean score of PAC, DC, NSI, ES, and overall stigma was 3.09, 3.02, 2.79, 1.66, and 2.52, respectively, where mean score of all domains of felt stigma (PAC, DC, and NSI) was >2.5, thus reflecting a higher level of felt stigma. ANOVA and t-test revealed higher level of overall stigma among younger age group (P<0.001), highly educated group (P=0.007), unmarried group (P<0.001), and recently HIV-diagnosed group (P=0.003). CONCLUSION: The study suggests high level of felt stigma, which has devastating effects on PLWHA as well as leads to nondisclosure of sero-positive status. So considering the significant impact of felt stigma on control of HIV epidemic, it is important to have a broader comprehension of this phenomenon and its repercussions on PLWHA via timely intervention like better educational intervention and counseling to PLWHA, wide-scale societal awareness campaigns, and more focused local interventions.

Diffuse vascular malformation of large intestine clinically and radiologically misdiagnosed as ulcerative colitis.

Hemangiomas and vascular malformations of the gastrointestinal tract are rare clinical entities that usually present as overt or occult bleeding. They can be distributed throughout the gastrointestinal system, or present as a singular cavernous hemangioma. Overall, 80% of such malformations are of cavernous subtype and are misdiagnosed as hemorrhoids and ulcerative colitis. Mucosal edema, nodularity and vascular congestion can lead to the incorrect diagnosis of inflammatory bowel disease. We present a case of 26-year-old male who presented with pain abdomen, bleeding per rectum and was treated as a case of ulcerative colitis for past 12 years on the basis of clinical and radiological features. As the patient did not respond, subtotal colectomy was done which on histopathologically reported as cavernous vascular malformation-diffuse infiltrating (expansive type).