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Assessment of discriminatory clinician attitudes and practices toward patients with HIV/AIDS in Nigeria

Chen Reis, JD MPH1, Lynn L Amowitz, MD, MSPH, MSc2, Michele Heisler, MD MPA3, R. Scott Moreland, PhD4, Jerome O. Mafeni, MPH, MDSc, FMCDS4, Chukwuemeka Anyamele, MBBS5, and Vincent Iacopino, MD1. (1) Physicians for Human Rights, 100 Boylston St, Suite 702, Boston, MA 02116, 617 695 0041 x208, creis@phrusa.org, (2) Senior Medical Researcher and Director, Initiative in Global Women's Health, Physicians for Human Rights, Harvard Medical School, 100 Boylston St, Suite 702, Boston, MA 02116, (3) University of Michigan, 100 Boylston St, Suite 702, Boston, MA 02116, (4) Policy Project, The Futures Group, 4309 Emperor Blvd., Suite 350, Winchester Place, Durham, NC 27703-5500, (5) Centre for the Right to Health, 3, Obanle-Aro Avenue, Off Coker Road Roundabout, Ilupeju, Lagos, Nigeria

Context: Little is known about the nature and extent of discrimination against patients with HIV/AIDS in Nigeria. Objective: To characterize the nature and extent of discriminatory practices and attitudes in the health sector and identify possible contributing factors and intervention strategies. Design & Setting: A cross-sectional survey of 1021 Nigerian healthcare professionals in 111 healthcare facilities in 4 Nigerian states. Participants: 324 physicians, 541 nurses, and 133 midwives. Results: 9% reported refusing to care for an HIV/AIDS patient, and 9% indicated that they had refused an HIV/AIDS patient admission to a hospital. 59% agreed that people with HIV/AIDS should be on a separate ward, and 40% believed a person's HIV status could be determined by his or her appearance. 91% agreed that staff should be informed when a patient is HIV positive so they can protect themselves. 20% agreed that many with HIV/AIDS behaved immorally and deserve the disease. Basic materials needed for treatment and prevention of HIV were not adequately available. 12% agreed that treatment of opportunistic infections in HIV/AIDS patients wastes resources and 8% indicated that treating someone with HIV/AIDS is a waste of precious resources. Conclusions: While most health care professionals surveyed reported being in compliance with their ethical obligations despite the lack of resources, discriminatory behavior and attitudes toward HIV/AIDS patients exist among a proportion of health care professionals in the surveyed states. Fear of infection, inadequate education about HIV/AIDS and a lack of protective and treatment materials likely contribute to these practices and attitudes.

Learning Objectives:

Keywords: HIV/AIDS, Health Care Workers

Related Web page: www.phrusa.org

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

HIV/AIDS Health Care Delivery, Services, and Providers

The 132nd Annual Meeting (November 6-10, 2004) of APHA