University of California
Type of paper: Thesis/Dissertation Chapter
Imperative Analysis of HIV Stigmatization in Vietnamese and London
Indeed, HIV is a deadly scourge that affects a wide population across the globe; in essence it’s a virus responsible for weakening the human immune system thus making the human body vulnerable to disease CITATION Alt07 l 1033 (Altman, 2007). Considering its incurable capabilities, a great deal of investment has gone into creating awareness on the same but still, not all and sundry have joined into the initiative of fighting the war against the disease but rather some are discriminative towards the people living with HIV (PLHIV). These discriminative tendencies have negative impacts on an individual and in return lead to stigmatization where individuals feel psychologically different from the rest because of a condition they are suffering.
Many at times, the stigmatization is fueled by the fact that many people are guided by myths of how the disease is spread from one person to the other, PLHIV are considered as having wild sex lives. Despite the massive steps being made in the fight against HIV in the world, the cost of managing the disease is high specifically for people living in third world countries CITATION Ste05 l 1033 (Stephenson, 2005). Acquisition of antiretroviral (ARVs) treatment drugs used for prolonging the lives of PLHIV is difficult for people in these nations but some of the governments like Kenya and Uganda have taken up the initiative of supplying their citizens with free ARVs through the support of western nations and non-governmental organizations. Statistics from the Canadian Aids Humanity Organization suggest that out of 3070 infections in the country, the government spends 7% of its expenditure in the management of the scourge CITATION Che09 l 1033 (Chesney, 2009). Arguably, it is not only the governments that feel the financial pinch but also the families of the PLHIV for they have to invest heavily in proper dieting for the infected people in their family.
With regards to the aforementioned details on HIV, this paper analyzes two articles that expound on the stigmatization problem in Vietnam and London. Firstly there is the research article “Persisting stigma reduces the utilization of HIV-related care and support services in Viet Nam” penned down by multiple authors; Duong Cong Thanh, Karen Marie Moland and Knut Fylkesnes. Basically, the article is a research finding arrived at through multiple interviews carried out on Vietnamese nationals from six districts with an emphasis of stigmatization exhibited by the people living with the HIV epidemic; the commercial sex workers and the people involved with them and drug users in the country CITATION Gre98 l 1033 (Green, 1998). On the other hand, the second article “HIV-related discrimination reported by people living with HIV in London” is the work of Jonathan Elford, Fowzia Ibrahim, Cecilia Bukutu and Jane Anderson that expounds on the stigmatization experience for people living with HIV in London in the United Kingdom. In their study, questionnaires were used as the primary data collection means with the respondents being accessed through hospitals. The respondents in this case comprise gay people, heterosexual women and heterosexual men of Black origin. The outcome of the second study demonstrates that a majority of the people accessed had experienced events of discrimination because of their conditions CITATION Ham01 l 1033 (Hammet, 2001).
The article “Persisting stigma reduces the utilization of HIV-related care and support services in Viet Nam” delves mainly on individual experiences of Vietnamese people who are living with HIV in a society that is yet to completely come to terms with what is firstly infecting their irresponsible population and also affecting those connected to people of this category. Main focus of the article was on exploring and getting an in-depth understanding of the treatment, care and support of the PLHIV in Vietnam specifically for drug users and sex workers who are the population at a greatest risk of already having the disease. From the data obtained in the study, the people living with HIV in Vietnam reported instances of discrimination and stigmatization because of their condition CITATION Ngu06 l 1033 (Nguyen, 2006). Essentially because of the stigmatization and discrimination, they were unwilling to go out and seek HIV-related services. The stigmatization was as a result of poor awareness campaign drives by the government which was inclined more on painting the PLHIV as social evils of the society. As a result, the lives of those infected were totally ruined because of the stigmatization as a majority of them missed on job opportunities and were isolated. An integral part of the fighting the disease in Vietnam came from the support that victims received from their families; this support acted as a pillar of hope that they still belonged somewhere irrespective of their condition.
Great professionalism was exhibited in the compilation of this article; Duong Cong Thanh was the principal contributor who prepared drafts of the study with the other two authors Karen Marie Moland and Knut Fylkesnes took up the job of reviewing and finalizing the manuscripts. The authors have in previous year’s undertaken extensive research on HIV management and the principal author, Duong Cong Thanh is a member of the Faculty of Health and Social Sciences at the Bergen University College in Norway. This is clear evidence that a great deal of professionalism went into undertaking this research thus warranting easy public acceptance of the findings. Funding for the qualitative research study was conceptualized through the Norwegian Ministry of Education and Research through the Quota Programme that receives full support from the Norwegian government CITATION Kno05 l 1033 (Knowlton & Latkin, 2005). The research study was also made possible through the support Hai Phong Service Health of Vietnam. The aim authorship of this article was to outline a solution to the stigmatization problem that the population of Vietnam faces and point the stakeholders involved in HIV management in the country towards the need to adopt a comprehensive care and support programme for the people living with HIV. Moreover, the article suggests that the stigmatization problem is plunged in the government’s scare tactic campaign that needs to be replaced with one that is accommodative legally and in inclined to the worldwide HIV policy CITATION Kap09 l 1033 (Kaplan & Golin, 2009).
The sample groups under investigation are people living with HIV from the Hai Phong region between the months of August and September selectively from three urban districts and three suburban districts. The interviews were carried out by Duong Cong Thanh with forty five participants being included; 33 males and 12 females between the ages of 18 to 46 years. Out of the 45 participants only eight were under antiretroviral treatment. The analysis of data and its management was undertaken through coding of units of the interview with variables such as; perceived causes of stigmatization and the effect of stigma and discrimination on self-esteem being accessed. The interview sessions were carried out in secluded consultation rooms so as to maintain high standards of privacy as earlier on agreed by the study respondents.
The privacy statement agreed upon stipulated that the participants medical information would not be divulged in any whatsoever way to any other third party and will be specifically utilized for the purposes of the study only. Furthermore, participation was on a voluntary basis where respondents had the option of bowing out of the study at any particular point of the research. Approval for the research was attained from the National Institute of Hygiene and Epidemiology, Hanoi. Reliability on the study by respondents was guaranteed since no individual identifiers were collected CITATION Rot11 l 1033 (Rotheram, 2011). Validity of collected data was also guaranteed considering that the respondents were tested for HIV before their engagement in the study.
Findings and results demonstrated that the experiences of the respondents in relation to discrimination and stigmatization varied with regards to the relationships and emotional distance the PLHIV had with their families. Generally, the Vietnamese population that was affected victimized PLHIV and the government helped fuel these perceptions of fear by promotion of the social evils campaign that focused on anti-prostitution and drug abuse as vices in society. In some situations some respondents reported that neighbor were terrified of them simply because they were terrified a HIV positive individual was contagious thus leading to their isolation. Looking at such perceptions, it is evident that majority of the Vietnam population were ignorant and not knowledgeable about the basic facts of the disease. From the study findings, it is evident through discrimination and stigmatization, PLHIV are unwilling to go out and seek necessary healthcare and support services CITATION Sur03 l 1033 (Surlis, 2003). Discrimination against PLHIV goes to the extent of being exhibited by the people meant to offer healthcare and support services in healthcare facilities; in the offset, this makes it impossible for people to turn to healthcare services for they are afraid they will be vilified.
In making their closing arguments, the researchers link the high stigmatization and discrimination levels to administrative regulations of the Vietnam government and misconceptions by the general public on the contraction of the HIV virus. Use of negative images in media in the creation of awareness is to blame for the high prevalence of stigmatization which creates a wide gap of social indifference. The article closes with the authors suggesting for a complete overhaul of the existing HIV awareness campaign in Vietnam, the defensive panic approach should be dropped immediately.
The second article, “HIV-related discrimination reported by people living with HIV in London,” focuses its study on the levels of stigmatization in London. The aims and objectives of the second article are categorical about the result of stigmatization and aspects of fright among the uninfected population of London which tends to explain the discrimination problem. Further reflections on stigmatization and discrimination in the United Kingdom is expressed through personal experiences of PLHIV through situations where there only last resolution is resorting to denial of having contracted the virus and wanting to be isolated from the rest of the society thus resulting to solitude in most cases.
The authors Jonathan Elford, Fowzia Ibrahim, Cecilia Bukutu and Jane Anderson are Faculty members to the City University of London. Funding for this study was conceptualized through the support of St Bartholomew’s and The Royal London Charitable Foundation and the research Advisory Board plus the aid of additional support from City University London, Institute of Health Sciences. The respondents of the study were reached through the National Hospital Service (NHS) which offered outpatient services to HIV related individuals CITATION Kan06 l 1033 (Kandifeldn, 2006). The recruitment for respondents was on a voluntary basis where they were signed up a consent form for participation. After consent approval, the patients were given questionnaires to fill at the facilities they were enrolled at or allowed to go with the questionnaires at home and drop the same on a later date. However, the research excluded people and considered those who were not well versed in the English language ineligible.
Analyses of data were carried out through STATA where gay men and black African heterosexual data were combined CITATION Pet01 l 1033 (Petrak, 2001). An association between HIV discrimination and stigmatization were the demographics being accessed in this case coupled up with clinical variables of patients to develop a univariate logistic model. Through these analyses, it was possible to deduce evidence suggesting that stigmatization for people living with HIV in London was highly rampant. Data further suggests that a majority of those infected by the HIV virus are gay men; also heterosexual Blacks had a high prevalence to the disease. Critical analyzes of the article illustrates that a huge number of the PLHIV in London are being discriminated against because of their condition to the extent that they do not have the right to comfortably access some of the public services in the city comfortably.
Respondents in this study comprised of people who were tested positive for the HIV virus and were eighteen years old and over. Additionally, the study participants must have been in the healthcare system getting HIV care treatment plus they were in the NHS (National Health Service) out-patients database. Selection was a random basis with the only outlying qualification being of adult age and proficient in the English language CITATION Gre98 l 1033 (Green, 1998). A total 1,687 respondents filled out the questionnaires and returned them but only 1,385 respondents were drafted for analyses. Out of the 1,385 respondents 727 were gay males, 448 heterosexual females and 210 heterosexual black African males; of the 727 gay males, 621 were white and 106 were of ethnic minority.
Questionnaire use was the dominant means of data collection where respondents were provided with a sheet containing questions where they were to mark or tick against the questions being asked. An example of such question is “when were you knowledgeable of your HIV status?” The questionnaire administration method was most appropriate for patient had no direct contact with their researchers. From the study the results and findings were able to establish that there was no direct stigmatization with regards to gay people’s HIV status. Furthermore, the result findings of the study suggest that the stigmatization menace is fuelled by health providers who do not fulfil their counselling duties but rather chide their patients thereby causing psychological torture to them that in return leads to stigmatization.
One third of the respondents’ population that was accessed had at one point or more than once been discriminated against in London because of their medical status. Despite the existence of regulations that have been by the United Kingdom government to prevent discriminative tendencies and inequality against PLHIV, the problem still continues to be prevalent in healthcare institutions and facilities. Lastly, the authors of this article close their study by suggesting there is a need for further policy revisions so that people living with HIV; in this case the gay people (men) and the heterosexual male and females in the UK are not discriminated against.
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