ArticleBMJ open2019
Refused and referred-persistent stigma and discrimination against people living with HIV/AIDS in Bihar: a qualitative study from India.
Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 22 citations in OpenAlex.
- Reduction in Stigma Drivers Partially Mediates the Effect of a Stigma Reduction Intervention Among Nursing Students in India: The DriSti Cluster Randomized Controlled Trial.Journal of acquired immune deficiency syndromes (1999) · 2021Trial
- Breaking barriers: access to services among people living with HIV/AIDS (PLHIV) in Jharkhand - a convergent mixed methods study.BMC public health · 2026Article
- Assessing the current situation and the influencing factors affecting perceived stigma among older patients after leukemia diagnosis.World journal of psychiatry · 2024Article
- Development and validation of the perceived symptom manageability scale among people living with the human immunodeficiency virus.BMC psychology · 2024Article
- Sexually transmitted infection (STI) knowledge and perceptions among people in HIV-sero-different partnerships in rural southwestern Uganda.PLOS global public health · 2024Article
- Sociodemographic correlates of discrimination against PLHIV in High HIV prevalence states of India, NFHS 2016-21.Scientific reports · 2023Article
- Development of shortened HIV-related stigma scales for young people living with HIV and young people affected by HIV in India.Health and quality of life outcomes · 2022Article
- Article
- HIV-Related Stigma Reduction in the Era of Undetectable Equals Untransmittable: The South Korean Perspective.Infection & chemotherapy · 2021Review
- Improving public health service delivery response to address contraceptive needs of socio-economically disadvantaged HIV positive people in Maharashtra, India.Contraception and reproductive medicine · 2021Article
- Lived experiences of palliative care among people living with HIV/AIDS: a qualitative study from Bihar, India.BMJ open · 2020Article
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Authors and funding
7 authors at 2 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThis study aimed to explore barriers to accessing care, if any, among people living with HIV/AIDS (PLHA) in two districts of Bihar. We also aimed to assess attitudes towards PLHA among healthcare providers and community members.
designThis qualitative study used an exploratory study design through thematic analysis of semistructured, in-depth interviews.
settingTwo districts were purposively selected for the study, namely the capital Patna and a peripheral district located approximately 100 km from Patna, in order to glean insights from a diverse sample of respondents.
participantsOur team purposively selected 71 participants, including 35 PLHA, 10 community members and 26 healthcare providers.
resultsThe overarching theme that evolved from these data through thematic coding identified that enacted stigma and discrimination interfere with each step in the HIV care continuum for PLHA in Bihar, India, especially outside urban areas. The five themes that contributed to these results include: perception of HIV as a dirty illness at the community level; non-consensual disclosure of HIV status; reliance on identifying PLHA to guide procedures and resistance to universal precautions; refusal to treat identified PLHA and referrals to other health centres for treatment; and inadequate knowledge and fear among health providers with respect to HIV transmission.
conclusionsThe continued presence of discriminatory and stigmatising attitudes towards PLHA negatively impacts both disclosure of HIV status as well as access to care and treatment. We recognise a pressing need to improve the knowledge of HIV transmission, and implement universal precautions across all health facilities in the state, not just to reduce stigma and discrimination but also to ensure proper infection control. In order to improve treatment adherence and encourage optimal utilisation of services, it is imperative that the health system invest more in stigma reduction in Bihar and move beyond more ineffective, punitive approaches.
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