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. 2018 Jun 5;14(1):56.
doi: 10.1186/s12992-018-0374-5.

Quantification and factors associated with HIV-related stigma among persons living with HIV/AIDS on antiretroviral therapy at the HIV-day care unit of the Bamenda Regional Hospital, North West Region of Cameroon

Atem Bethel Ajong  1 , Philip Nana Njotang  2   3 , Ngholapeh Emmanuel Nghoniji  4 , Marie José Essi  5 , Martin Ndinakie Yakum  6 , Valirie Ndip Agbor  7 , Bruno Kenfack  8
Affiliations

Quantification and factors associated with HIV-related stigma among persons living with HIV/AIDS on antiretroviral therapy at the HIV-day care unit of the Bamenda Regional Hospital, North West Region of Cameroon

Atem Bethel Ajong et al. Global Health. .

Abstract

Background: The Human Immunodeficiency Virus /Acquired Immune Deficiency Syndrome (HIV/AIDS) is not just a medical problem but its social impact is increasingly affecting its effective management. The fear of HIV-stigma constitutes a major barrier to HIV testing, prevention, uptake and adherence to antiretroviral therapy (ART). We aimed to quantify HIV-related stigma, and identify the factors associated with high HIV-related stigma among persons living with HIV and AIDS (PLHIVA) and on ART.

Methods: A hospital-based cross sectional analytic survey targeting PLHIVA on ART at the HIV-day care unit of the Bamenda Regional Hospital of Cameroon was conducted from February to April 2016. A total of 308 eligible and willing participants were consecutively included in the survey. Data were collected using a pretested questionnaire designed from the Berger HIV stigma scale and analyzed using Epi info 3.5.4.

Results: The mean age of the 308 participants was 40.1±10.2 years. The mean overall HIV/AIDS related stigma score was 88.3 ± 18.80 which corresponds to a moderate level of stigma according to the Berger stigma scale. Further analysis revealed that most participants suffered from moderate forms of the different subtypes of stigma including: personalized (49.8%), disclosure (66.4%), negative self-image (50.0%) and public attitude (52.1%) stigmatization. It was estimated that 62.7% (95% confidence interval [CI] = 57.8-68.9%) of the participants lived with high levels of HIV-related stigma. After controlling for gender, religion, age and occupation, level of education below tertiary (Adjusted Odds Ratio [AOR] = 0.70 [95% CI = 0.44-0.91]; p = 0.036) and a duration from diagnosis below 5 years (AOR = 1.74 [95% CI = 1.01-3.00]; p = 0.046) were significantly associated with high HIV-related stigma.

Conclusion: About three out of every five PLHIVA receiving ART in Bamenda Regional Hospital still experience high levels of HIV-related stigma. This occurs more frequently in participants with low educational status, and who may have known their HIV status for less than 5 years. Anti-HIV-stigma programs in the North West Region need strengthening with intensified psychosocial follow-up of newly diagnosed cases.

Keywords: Acquired immunodeficiency syndrome; Antiretroviral therapy; Cameroon; Human immunodeficiency virus; Stigma.

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Conflict of interest statement

Authors’ information

ABA: Doctor in Medicine, Kekem District Hospital, West Region, Cameroon.

PNN: Associate professor of Obstetrics and Gynecology, Head of service of the Principal Maternity of the Yaoundé Central Hospital, Cameroon. Senior lecturer of Obstetrics/Gynecology, department of Obstetrics/Gynecology, Faculty of Medicine and Biomedical Sciences of the University of Yaoundé I, Cameroon.

NEN: Doctor in Medicine, Bamenda Regional Hospital, North-west Region, Cameroon.

MJE: Senior Lecturer of Medical Anthropology and Public Health in the Faculty of Medicine and Biomedical Sciences of the University of Yaoundé I, Cameroon, In charge of the Library of the University of Yaoundé I.

MNY: Masters of Epidemiology and Public Health working as the M&E officer at M.A.SANTE (Meilleur Accès aux Soins de Santé), Yaoundé-Cameroon.

VNA: Doctor in Medicine, Ibal sub-divisional Hospital, Oku, North-west Region, Cameroon.

KB: Lecturer of Obstetrics and Gynecology, Department of Biomedical Sciences, Faculty of Science, University of Dschang, Cameroon. Obstetrician/Gynecologist in the Dschang District Hospital, Cameroon.

Ethics approval and consent to participate

Ethical clearance for this study was obtained from the ethical review board of the Faculty of Medicine and Biomedical Sciences of the University of Yaoundé I, and administrative authorization obtained from the Director of the Bamenda Regional Hospital. Only consenting participants were included in the study and for participants who were aged less than 18 years, consent was obtained from their legal representatives. The interviewers were well trained on the consenting and data collection procedure and participants who were mentally incapacitated and critically ill were not included in the survey.

Competing interests

The authors declare that they have no competing interest.

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