Key Findings and Recommendations

Findings-1:

The dominant sources of information on HIV and AIDS among non-PLHIV are radio (88.3%) and TV (72.3%). Books/magazines/posters were less likely to be used by respondents as their source of HIV and AIDS information.

Recommendation-1

These channels (radio and TV) could be used as preferred media for the dissemination of stigma and discrimination reduction messages by the project especially the radio. This is most opportune given the proliferation of community radio facilities across the country. Management would be spot on if these facilities are extensively used as the probability of reaching a wider audience is high.

Findings-2:

Knowledge around HIV and AIDS is superficial and limited among the public in many respects. It was further observed from the study that the lack of in-depth knowledge around HIV and AIDS among the study population gave rise to misconceptions and myths about the pandemic.

Recommendation-2

The program should aim at providing a comprehensive knowledge about HIV and AIDS. This will help cut down considerably the misconception levels among the public since misconceptions and insufficient knowledge are noted to be at the heart of stigma and discrimination with its ramifications. A lot more education is needed to provide the public with correct information about HIV and AIDS

Findings-3:

Though risk perception of HIV infection was high among the larger population (70.0%), the 15-20 age group was less apprehensive about the menace of HIV. Females were also more likely to have a high sense of risk to HIV infection. Meanwhile, reasons provided by majority of those who claimed not to be at risk of HIV infection appeared to be mainly flimsy and frivolous – that is to say they did not have any tangible reason for their claim.

Recommendation-3:

The youth constitutes a critical mass of the country’s population. It would be a tragedy if this segment of the population is allowed to proceed along non-risk perception in the face of HIV and AIDS scare. There is the need to work on their psyche to bring them to the point where they would fully appreciate the menace of HIV and AIDS and the susceptibility of all to its infectious attributes. The same goes for the males – and it will also be appropriate to impress upon them not to take HIV and AIDS for granted as no one is insulated from the pandemic for the simple reason that there are multiple transmission routes.

Findings-4:

About three out of every five respondents had never tested for HIV. Testing was rather common among seemingly rural settings with Accra recording the least test cases. It appears the more rural the setting, the higher the percentage of those who got tested.

Recommendation-4:

The level of efforts that will go into getting the messages across to the urban dwellers and getting them to accept those messages and internalise them for the eventual behaviour and attitudinal changes to be effected could be high. It may well be easier to reach the rural folks with information than those in the urban settings. The sub-recipients working in the urban certain particularly Accra should be prepared to face these challenges. The situation might not be different with respect to gender – females appeared to be more receptive to messages and acting on them than their male counterparts. Males should therefore be given more attention with more consistent and sustained messages emphasising on the benefits of counselling and testing.

Findings-5:

Stigma in all its forms- social, physical, verbal, institutionalized, secondary, etc. was observed among the study population at times in alarming proportions. It appeared as though the base of the prevailing stigma among the respondents was instrumental stigma driven by fear of casual transmission which in itself is a product of inadequate knowledge about HIV and AIDS.

Recommendation-5:

It was evident from the study that in most cases, the stigmatizing attitudes of the population was fuelled mainly by lack of adequate knowledge around HIV and AIDS- a situation which gives birth to myths and misconceptions which in turn generate the stigma and discrimination sentiments. It is believed that should the general population be given accurate information about HIV and AIDS, the erroneous impressions about HIV and AIDS which is extended to PLHIV would be dispelled thereby reducing to the barest minimum the level of stigma as it prevails among the study population.

Findings-6:

Though high altruistic values were purportedly displayed by the general population towards PLHIV, it did appear though that these values or concerns were not genuine and could be described at best as cosmetic. Findings from PLHIV suggested massive stigma and discrimination against them.

Recommendation-6:

Since one of the major consequences of stigma is low patronage and uptake of HIV and AIDS prevention and treatment services, it would be advisable to step up measures to ensure that the general population is committed not only by word of mouth but by deed to show love and compassion towards PLHIV. This would encourage them to come in the open to access services that are available for them.

Findings-7:

In almost all the stigma issues investigated, Eastern Region emerged as the most stigmatizing region or the region where PLHIV were most stigmatised; on the contrary, Brong Ahafo appeared to be the least stigmatizing region.

Recommendation-7:

It might be worth the effort to do further investigation to establish the cause of high stigma in the Eastern Region. The issue of stigma needs to be tackled more frontally particularly in the Eastern Region if prevention, care and support services are to reach PLHIV. This is because it is feared the hostile social environment has the potential of sending the PLHIV into concealment as they would not be willing to disclose their sero-status or even if their status is known, they may not be willing to come out to access the needed services.

Findings-8:

Given the heavily stigmatizing environment the PLHIV live in, majority are compelled to indulge in self-stigmatization leading to lowered self-esteem and confidence levels. PLHIV in Eastern Region are more likely to self-stigmatise themselves than PLHIV from the other regions.

Recommendation-8:

Health messages emphasizing the continued relevance and value as well as the fundamental rights of PLHIV irrespective of their sero-status not only to themselves but to their families, communities and society at large should be developed and churned out to enable the PLHIV regain their self-confidence.

Findings-9:

Secondary or courtesy stigma has also been identified among the study populations and threatens the possibility of close associates and professional caregivers to willingly provide the needed services to PLHIV. The study revealed that 62.3% of PLHIV reportedly admitted suffering abandonment from people close to them because they (the close relatives) were afraid they would be rejected by the larger society if they associate themselves with them (the PLHIV).

Recommendation-9:

Since stigma in whatever form has the potential to deny PLHIV support and care services they so much need, it would be appropriate to tackle the entire gamut of stigma from a holistic standpoint with more focus on the primary objects of stigma - PLHIV. And since secondary stigma comes about as a result of association with PLHIV, it is believed that once the stigma directed towards the PLHIV is reduced, then the secondary stigma would also be addressed as a matter of course or in a more effortless manner

Findings-10:

The average PLHIV has the propensity to conceal rather than disclose his or her sero-status given the opportunity; hence would employ all kinds of means including selective disclosures, complete non-disclosure, conditional disclosures, etc.

At least, close to eight out of every ten PLHIV who participated in the study stated that they consciously made efforts to keep their sero-status a secret. Understandably, PLHIV from the Eastern Region, where the stigma situation appeared to be very high, were more prone to concealing their sero-status.

  Recommendation-10:

Since research shows that the instincts of stigma are reinforced or heightened when conscious efforts are made to conceal the sero-status of an individual (WHO, 2004), the family members and the PLHIV alike would be better off if they come open on their status rather than trying to hide it from the public through false pretences only for the public to get to know of it through the rumour mill.

 

Conclusion:

Stigmatization and discrimination in all their forms against PLHIV were noticed among the study populations. This was at times in high proportions. It was observed that most of the stigmatizing sentiments were based on lack of adequate knowledge about HIV and AIDS in terms of how it is transmitted, how one could prevent him/herself from getting infected whilst living positively with infected persons, etc. Lack of or inadequate knowledge of HIV and AIDS was noted to also fuel various kinds of misconceptions which culminated in the level of stigmatizing attitudes and behaviours found among the public. The good news however is that, equally accepting and compassionate behaviours and attitudes (such as willingness of majority of respondents leaving their children in the same school where HIV+ person was; and respondents resolving to go extra mile to help colleagues diagnosed positive) were found among segments of the respondents across geographic locations, gender and age groups. This constitutes a window of opportunity which could be exploited by the Global Fund Round 8 Program to ensure that stigma is reduced to manageable levels.

The fear of being stigmatized and discriminated against appeared to be rife among both PLHIV and non-PLHIV. It might be worth considering the factors that made PLHIV from Brong Ahafo Region to stand tall among others in terms of their resilience and resolve to the threats of a stigmatizing society. Several other recommendations have been made in response to the key findings of this study. It is hoped that when these recommendations are taken on board by the Management of this Program, a lot more stride would be made in reducing stigma and discrimination in the beneficiary regions.

 

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