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The association between ethnicity, stigma, beliefs about medicines and adherence in people living with HIV in a rural area in Indonesia.

ABSTRACT: BACKGROUND:Indonesia is one of Asia's countries with the fastest growing rate of human immunodeficiency virus (HIV) infections according to the World Health Organization (WHO). The prevalence of HIV infections in the province of Papua is 2.4% which is 24 times higher than the national rate in Indonesia. This study aimed to investigate the association between stigma, beliefs about medicines, sociodemographic characteristics including ethnicity and adherence in People living with HIV (PLHIV) in Papua, Indonesia. METHODS:We conducted a cross-sectional study using questionnaires. We included participants from two hospital-outpatient clinics who were on antiretroviral treatment (ART) for more than 6 months, were at least 18?years old, and signed informed consent. Participants completed the Medication Adherence Rating Scale (MARS), Beliefs about Medicines Questionnaire (BMQ), an HIV stigma scale and questions on demographic information. Data on antiretroviral medications were collected from medical records. The outcome was self-reported adherence as measured by the MARS using an 80% cut-off score. Multivariate logistic regression was used to analyse the data. RESULTS:Overall, 331 out of 363 eligible participants were included with a mean age of 33.3 (± 9.4) years, 61.6% were female, 67.1% were Papuan. A total of 65.9% of participants were adherent. Being Papuan decreased the likelihood of adherence (odds ratio (OR)?=?0.53; 95% confidence interval (CI)?=?0.32-0.89). Feeling more distant, a stigma type, also decreased the likelihood of adherence (OR?=?0.93; 95% CI?=?0.88-0.99). CONCLUSION:The ethnicity of being Papuan and taking a distance to others were associated with non-adherence. Targeted interventions should be developed to improve adherence in this group.

SUBMITTER: Sianturi EI

PROVIDER: S-EPMC6330480 | biostudies-literature | 2019 Jan

REPOSITORIES: biostudies-literature

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The association between ethnicity, stigma, beliefs about medicines and adherence in people living with HIV in a rural area in Indonesia.

Sianturi E I EI Perwitasari D A DA Islam Md A MA Taxis K K

BMC public health 20190111 1

<h4>Background</h4>Indonesia is one of Asia's countries with the fastest growing rate of human immunodeficiency virus (HIV) infections according to the World Health Organization (WHO). The prevalence of HIV infections in the province of Papua is 2.4% which is 24 times higher than the national rate in Indonesia. This study aimed to investigate the association between stigma, beliefs about medicines, sociodemographic characteristics including ethnicity and adherence in People living with HIV (PLHI ...[more]

PMID: 30634953

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Project description:BackgroundHealth-related stigma is a complex phenomenon, the experience of which intersects with those of other adversities arising from a diversity of social inequalities and oppressive identities like gender, sexuality, and poverty - a concept called "intersectionality". Understanding this intersectionality between health-related stigma and other forms of social marginalization can provide a fuller and more comprehensive picture of stigma associated with health conditions. The main objective of this paper is to build upon the concept of intersectionality in health-related stigma by exploring the convergence of experiences of stigma and other adversities across the intersections of health and other forms of social oppressions among people living with stigmatized health conditions in Indonesia.MethodsThis qualitative study interviewed 40 people affected by either of four stigmatizing health conditions (HIV, leprosy, schizophrenia, and diabetes) in Jakarta and West Java, Indonesia between March and June 2018. Data was analyzed thematically using an integrative inductive-deductive framework approach.ResultsThe main intersectional inequalities identified by the participants were gender and socioeconomic status (n = 21), followed by religion (n = 13), age (n = 11), co-morbidity (n = 9), disability (n = 6), and sexuality (n = 4). Based on these inequalities/identities, the participants reported of experiencing oppression because of prevailing social norms, systems, and policies (macro-level), exclusion and discrimination from societal actors (meso-level), and self-shame and stigma (micro-level). While religion and age posed adversities that negatively affected participants in macro and meso levels, they helped mitigate the negative experiences of stigma in micro level by improving self-acceptance and self-confidence.ConclusionThis study uncovered how the experience of health-related stigma intersects with other oppressions originating from the various social inequalities in an individual's life. The findings highlight the importance of acknowledging and understanding the multi-dimensional aspect of lives of people living with stigmatized health conditions, and warrant integrated multi-level and cross-cutting stigma reduction interventions to address the intersectional oppressions they experience.

Dataset Information

The association between ethnicity, stigma, beliefs about medicines and adherence in people living with HIV in a rural area in Indonesia.

Publications

The association between ethnicity, stigma, beliefs about medicines and adherence in people living with HIV in a rural area in Indonesia.

Similar Datasets

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