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Table of Contents   
EDITORIAL COMMENTARY  
Year : 2017  |  Volume : 10  |  Issue : 4  |  Page : 795-796
Offering integrated package of services to counter stigma associated with HIV


Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Chennai, Tamil Nadu, India

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Date of Web Publication5-Oct-2017
 

How to cite this article:
Shrivastava SR, Shrivastava PS, Ramasamy J. Offering integrated package of services to counter stigma associated with HIV. Ann Trop Med Public Health 2017;10:795-6

How to cite this URL:
Shrivastava SR, Shrivastava PS, Ramasamy J. Offering integrated package of services to counter stigma associated with HIV. Ann Trop Med Public Health [serial online] 2017 [cited 2019 Sep 19];10:795-6. Available from: http://www.atmph.org/text.asp?2017/10/4/795/196503
HIV continues to persist as one of the major global public health concerns accounting for the lives of millions of people each year worldwide.[1] Even though it is a good sign that the incidence of the disease has started to decline owing to the consistent and targeted efforts, a lot has to be done to ensure that it no longer remains a public health concern.[1] The infection has been stigmatized since the inception of the epidemic, especially because of the chance of acquiring the infection through an immoral behavior, and even remains as one of the major barriers to prevent people from accessing HIV prevention and care-related services.[1],[2]

It is important to understand that with the availability of free and more effective drugs and better reach of the services, the life expectancy of the infected people has increased; nevertheless, for that to happen, people will have to initiate or continue their therapy, and that attitude is seriously challenged by the stigma associated with the disease.[2],[3] Further, by continuing therapy, the risk of acquiring opportunistic infections or even their management can be accomplished timely.[2] HIV stigma can present as experiencing discrimination because of HIV-positive status, anticipating discrimination in the community, and having a feeling of shame because of HIV status.[2],[3] Owing to any one of the above, people living with HIV do not access care and support services.[3] Further, it has even been observed that in some of the communities, people who are not infected with HIV are reluctant to use those healthcare establishments in which HIV-positive people are treated.[4]

In order to deal with the situation of stigma, different approaches have been tried in heterogeneous settings to target different sets of people (local communities, health workers, HIV-positive women, HIV-positive children, etc.).[3],[4],[5] Further, the outcome to eventually minimize the stigma can be achieved only when context-specific and culturally appropriate measures are taken to minimize the associated stigma and discrimination.[2],[4] Often, the planned interventions can be one of the four types, namely information-based strategies, skill building, counseling strategy, and improving the prospects of contact with the affected group.[4],[5]

At the same time, there is immense need to ensure that any discrimination strategy from the health sector perspective has to be neutralized.[6] This was observed in one of the districts of Malawi, where HIV-related services were earlier offered only on a specific day and thus anyone seen entering the health facility on that day was labelled as HIV positive and hence subjected to stigma and discrimination by the community.[6] In fact, the affected people were sending their relatives or kids to collect the drugs and even they were stigmatized in the community.[6] Thus, many people living with HIV dropped out of care to avoid discrimination.[6] Similar sort of discrimination was even faced by women who wanted to use contraception on the day allotted for family planning-related services, and wanted to keep it confidential.[6]

In order to respond to the challenge of stigma, the United Nation Population Fund launched an integrated package of sexual and reproductive services and HIV services in the same healthcare establishment on all days of the week.[6] In fact, by means of this integrated approach, the existing services are offered in a more user-friendly manner, and thus people in their single visit can avail all the desired services.[6] Such an approach is playing a crucial role in even reducing the risk of mother-to-child transmission of the infection.[1],[6]

Further, the approach has been extended in other six nations and gives special focus to adolescent girls.[6]

To conclude, millions of people have been victims of HIV-related stigma, and thus there is an indispensable need to offer need-based and culturally acceptable approach to minimize the stigma and hence ensure patient's retention in care.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
World Health Organization HIV/AIDS-Fact sheet No. 360; 2015. Available from: http://who.int/mediacentre/factsheets/fs360/en/. [Last Accessed on 2016 July 2].  Back to cited text no. 1
    
2.
Valenzuela C, Ugarte-Gil C, Paz J, Echevarria J, Gotuzzo E, Vermund SH. et al. HIV stigma as a barrier to retention in HIV care at a general hospital in Lima, Peru: a case-control study. AIDS Behav 2015;19:235-45.  Back to cited text no. 2
    
3.
Lohiniva AL, Benkirane M, Numair T, Mahdy A, Saleh H, Zahran A. et al. HIV stigma intervention in a low-HIV prevalence setting: a pilot study in an Egyptian healthcare facility. AIDS Care 2016;28:644-52.  Back to cited text no. 3
    
4.
Li L, Liang LJ, Lin C, Wu Z. Addressing HIV stigma in protected medical settings. AIDS Care 2015;27:1439-42.  Back to cited text no. 4
[PUBMED]    
5.
French H, Greeff M, Watson MJ. Experiences of people living with HIV and people living close to them of a comprehensive HIV stigma reduction community intervention in an urban and a rural setting. SAHARA J 2014;11:105-15.  Back to cited text no. 5
[PUBMED]    
6.
UNFPAEnding AIDS through integrated care: combining sexual and reproductive health and HIV services in Malawi; 2016. Available from: http://www.unfpa.org/news/ending-aids-through-integrated-care-combining-sexual-and-reproductive-health-and-hiv-services. [Last Accessed on 2016 July 2].  Back to cited text no. 6
    

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Correspondence Address:
Saurabh R Shrivastava
3rd Floor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai Village, Thiruporur, Guduvancherry Main Road, Sembakkam Post, Kancheepuram, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1755-6783.196503

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