Online Program

Nature of HIV stigma & discrimination in northern Thailand: Public health & human rights implications

Wednesday, November 6, 2013 : 8:30 a.m. - 8:50 a.m.

G. Pamela-Renée Crawford, MPhil, SM, MS, PhD, International Health Department, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
David D. Celentano, ScD, MHS, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Nancy K. Roderer, MLS, Division of Health Science Informatics, Johns Hopkins University School of Medicine, Baltimore, MD
Robert S. Lawrence, MD, Center for a Livable Future Professor, Johns Hopkins University, Baltimore, MD
Objective: To obtain a deeper understanding of the nature of perceived and enacted HIV stigma and discrimination in Northern Thailand. Background: HIV stigma and discrimination, as described by Thai and ethnic minority participants, was elicited using Thailand's Project Accept qualitative data. Methods: Qualitative research methods (open and focused coding, theme development, memoing and integrative-memoing, conceptual framework construction) were applied to semi-structured in-depth interview transcripts using Atlast.ti and Microsoft Office software. Study sample (n=117, aged 18-32 years) included Thai (n=81) and ethnic minorities (n=36) representing Chinese, Pakistani, Thai-Yai, Black/Red Lahu, Lisu, Hmong, Akha, Karen, Zam and Kon-Muang ethnicities. Results: HIV stigma and discrimination was prevalent in study communities. Examples of perceived stigma included: fears of associating with a person living with HIV (PLHIV) and being perceived as a PLHIV. (Perceived stigma was so intense many participants stated they would commit suicide if ever diagnosed HIV positive, regardless of access to HIV care). Enacted stigma/discrimination included PLHIV isolation by family/friends/communities (even unto death), inability to participate in community activities, including purchasing or eating in the market. HIV stigma overlapped with stigmas and prejudices toward traditionally marginalized groups (LGBT persons, sex workers, substance users and ethnic minorities) and further perpetuated blame of PLHIV. Intense fear of stigma and discrimination can affect uptake of HIV testing, seeking antiretroviral therapy when needed, and human rights. Conclusion: HIV-related stigma and discrimination in Northern Thailand affects both PLHIV (and those perceived to be PLHIV), resulting in serious public health and human rights consequences which must be addressed.

Learning Areas:

Advocacy for health and health education
Assessment of individual and community needs for health education
Planning of health education strategies, interventions, and programs
Public health or related research

Learning Objectives:
Describe the nature of HIV-related stigma and discrimination among Thai and ethnic minorities in northern Thailand Identify how HIV stigma and discrimination affects human rights Discuss challenges and obstacles facing health programmers and health care providers in increasing uptake of HIV care and services in the presence of widespread and intense HIV stigma and discrimination

Keyword(s): HIV/AIDS, Human Rights

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal investigator of this research project on HIV health information and health behaviors in Northern Thailand for my PhD dissertation research. Among my scientific interests have been human rights issues, health information gaps associated with continued high risk HIV behaviors and obstructing the access to HIV related care.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.