Docstoc

HIV Stigma Index 2009 Rwanda

Document Sample
HIV Stigma Index 2009  Rwanda Powered By Docstoc
					     HIV Stigma Index 2009
       Rwanda
AVVAIS, RBC/IHDPC, RRP +, UNAIDS



      SAHARA CONFERENCE


      Port-Elisabeth, South Africa
    November 28 to December 2, 2011
     Presentation Outline

• Introduction: Why focusing on stigma and
  Discrimination?
• Objectives of the study
• Methods
• Key findings




                                             2
               Introduction:
  Why focusing on stigma & discrimination?

• Stigma & discrimination are a health and human rights
  issue

• Stigma & Discrimination constitute a barrier to AIDS
  response 
 Limit universal access to:
      Prevention services, counseling & testing
      Treatment (seek services outside own community
        out of fear)
      Care and support (postponing or rejecting care)
                                                     3
     Why focusing on S & D (cont’d…)

 Stigma & Discrimination affect more women and
  girls, MARPs in general and vulnerable people e.g.
  sex workers, widows, prisoners and TB patients




                                                  4
 Situation of stigma & discrimination issues
                  in Rwanda


• The Government of Rwanda has classified PLHA
  as a priority group for prevention, care, treatment,
  and support (NSP, 2009-2012).
• 46% males & 51% females had accepting attitudes
  towards stigma & discrimination (DHS, 2005)




                                                    5
          Objectives of the study

To collect info on Stigma & Discrimination (S&D)
   against members of the Network of PLHA that
   will help to understand & reduce S&D in the
   country. Specifically:
  – To document the various experiences of PLHA

  – To provide an evidence base for advocacy,
    policy change and programme interventions to
    address S&D related to HIV.


                                                  6
                     Methods
• Used Stigma Index questionnaire (quantitative &
  Qualitative)
Selection Criteria:
• Members of PLHA Network aged 18 years & older,
• Association with at least 50 members and with 2+
  years old; member of the Network

• Sample size:
– There were about 1,500 associations of PLHA with +/-
  1000 members of the Rwanda Network of PLHA
– 38 Associations in total were surveyed
– Random selection of 2 districts per Province
                                                   7
               Methods (Cont’d…)
  – Estimated sample size: 1640 individuals
  – Purposively included all HIV+ males into sample
    since women formed 90% of members

• Interviewed up to 1560 PLHIV individuals located in 10
  districts across Rwanda
• Self-reporting was the most applied approach during
  interviews




                                                     8
                    Ethics

• Study approved by RBC/IHDPC & NISR Ethics
  Committees
• Used information sheet and informed consent
  forms in Kinyarwanda before starting an
  interview
• Emphasized respondent rights to freely
  participate in and withdraw from study
• Protected identify of respondents
• Interviewed participants of 18 years and older

                                                   9
            Key findings outline

• Demographic characteristics of PLHA

• Experience   of   HIV-related   stigma   and
  discrimination (12 months preceding the survey)

• Experience of Testing, Disclosure, Treatment
  and having children (12 months preceding the
  survey)


                                                    10
Current relationship status




                              11
                     Duration of living with HIV

                      




               • Sixty-four (64%) reported to have
                 lived with HIV within five years
                 preceding the survey.               12
    Perceived experience with HIV related
         stigma and discrimination

• HIV was perceived as the main reason (69%) for
  discrimination in terms of exclusion from family
  activities, being gossiped about and physical
  harassment
• Of those who experienced exclusion, 65%
  respondents reported exclusion from religious and
  family activities;
• 72% of females and 70% males respectively
  reported exclusion from family activities and being
  gossiped about
                                                   13
   Access to social services during 12
      months preceding the study


• 39% thought they lost jobs because of their HIV+
  status

• 66% felt obliged to stop working due to poor
  health




                                                     14
         Internal stigma and fears

• Women:
          Anticipation of fear of being gossiped,
       verbally insulted, harassed and/or
       threatened was higher (44%) for females
       than males (38%),
• Men:
         More men (47%) than females (41%)
       feared that someone would not want to be
       sexually intimate with them because of HIV
       infection.
                                                    15
   Internal stigma and fears (cont’d…)

• 45% of respondents in total reported they felt
  ashamed because of their HIV+ status

• The main forms of internal stigma were feelings
  of guilt (27%), self-blame (25%) and low self
  esteem (22%)




                                                    16
        Rights, Laws And Policies


• About 50% of respondents were aware of the
 Declaration of Commitment on HIV to protect
 rights of PLHIV

• 10% thought to have been denied health
 insurance due to their HIV+ status




                                               17
               Effecting change

• 80% said they supported other PLHA emotionally
  and physically
• There was low knowledge (25%) of organizations
  that help care for PLHIV, except the network of
  PLHIV
• about ¼ of respondents reported they had influence
  in policy and programmes locally & wider




                                                  18
          Testing and diagnosis

• 22% tested for HIV because of pregnancy

• Only 4% tested to prepare for marriage/sexual
    relationship.

• Of those who tested, 79% made a decision to
    test on their own and had both pre and post HIV
    test counselling.
•
                                                      19
        Disclosure & Confidentiality

• 88% of men disclosed to partners while 84% of
    females to their children.

• 60% of respondents reported “felt” pressure to
    disclose their HIV status from other individuals
    not living with HIV

• ¾ reported they felt confident medical records
    are kept confidential
•                                                      20
                      Treatment


• 75% had access to ARVs and treatment for
    opportunistic infections.

• 75% discussed with a health care professional
    subject of HIV-related treatment options in the
    12 months preceding the survey
•


                                                      21
 Self-reported health status associated with
    economic and quality of health care


• 75% had access to ARVs and treatment for
  opportunistic infections.

• 75% discussed with a health care professional
  subject of HIV-related treatment options in 12
  months preceding the survey



                                                   22
Self-reported health status associated with
economic status and quality of health care




                                              23
         Experience of having children


• 88% of respondents said they had children

• 77% said were advised not to have children.

• Over 50% of female respondents had received
  ARV for PMTCT.




                                                24
                  Conclusion


The Stigma & Discrimination findings suggest
 unmet needs in terms of interventions towards
 empowering    PLWA     and   increased   HIV
 prevention, care and treatment




                                                 25
   END




THANK YOU




            26

				
DOCUMENT INFO
Shared By:
Categories:
Tags:
Stats:
views:36
posted:11/19/2013
language:
pages:26