Background Stigmatization of persons living with HIV/AIDS (PLWHA) is a major reason for low uptake of HIV screening and treatment services. This paper describes the impact of integration of health services on stigma reduction in Nigeria.
Methods In order to reduce stigmatisation and increase uptake of HIV screening and treatment services at three clinics in Northern Nigeria, the MSH PrO-ACT project implemented the following interventions
Amalgamation of clinic space to ensure that HIV positive clients are attended to at the same clinic as other patients.
Training of health care providers on patient confidentiality protection.
Ensured that the same doctor attends to all patients irrespective of their HIV status.
Blood samples for all patients visiting the laboratory are collected at the same phlebotomy point irrespective of their HIV status.
Initiated focus group discussions on stigmatisation within the community and health facilities to promote a change in attitude towards PLWHA.
Initiated support group meetings for PLWHA in order to encourage open discussions on stigma and partner disclosure.
Results At the end of twelve months, 12,436 (Male- 3,616, Female- 8,820) clients were counselled and tested for HIV and the number who accessed laboratory services for CD4 count monitoring increased from 53.8% to 93.3%. The number of partner testing also increased from 35% to 68%. In addition, health worker attitude towards PLWHA improved significantly as workers now report a stronger belief in patient confidentiality protection.
Conclusion Integration of HIV related services into existing health systems has helped reduce stigmatisation of PLWHA. However, a lot more still needs to be done in enlightening and equipping health care providers in the fight against stigma in rural communities.
- HIV screening
- Structural interventions and services
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