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P4.41 Effect of hiv related stigma on utilisation of skilled birth attendants by hiv positive women in nigeria; a systematic review
  1. Foluso Ishola
  1. Japan International Cooperation Agency, Lagos, Nigeria

Abstract

Introduction HIV/AIDS-related stigma is recognised as a major barrier to utilisation of health facilities for delivery by pregnant women living with HIV/AIDs and an impediment to prevention of mother to child (PMTCT) of HIV. Greater comprehension of contextual factors that specifically reduce HIV-positive women’s access to maternity care is essential. This paper reviews the existing research literature on AIDS stigma experienced by HIV positive pregnant women in Nigeria with the objective of documenting the current status of research, highlighting major findings and identifying key gaps remaining.

Methods Fifteen publications were identified after a structured search of six electronic databases for published literature between 2000 and 2016 that potentially contained data on HIV-related stigma, utilisation of skilled birth attendants and delivery outcomes. We used the method of meta-synthesis to summarise the findings from the qualitative studies.

Results Stigmatisation experienced includes exclusion from maternity services,termination of appointment, abuse, disrespect, maltreatment, negative attitudes and hostility amongst others. There is increasing concern about health care workers reluctance to care for and treat HIV positive pregnant women. This is further exacerbated by weak health systems and poor legal and ethical framework. HIV positive pregnant women are reluctant to deliver their babies in a health facility with a skilled attendant due to the risk being labelled HIV positive. This avoidance could contribute to obstetric complications and avoidable maternal deaths.

Conclusion Interventions should be introduced to reduce HIV-related stigma. Training health workers on the elements of psychosocial care and avoiding stigmatising behaviour is important. Research exploring linkages between HIV related stigma and maternity services uptake are largely missing and need to be prioritised. In addition, more research is needed to advance conceptual understanding of stigma within the cultural context of Nigeria.

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