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  5. Stigma and Discrimination against PHAs: Some Cases

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FOCUS December 2006 Volume 46

Stigma and Discrimination against PHAs: Some Cases

Centre for Policy Alternatives

The Centre for Policy Alternatives (CPA) profiled the stigma and discrimination faced by people living with HIV/AIDS (PHAs) and their family members in Sri Lanka. It interviewed a limited number of people for the study. The Asia Pacific Leadership Forum (APLF) commissioned the 2005 report. Below is an edited excerpt of the report.

Health Care

The findings indicate that many cases of discrimination have occurred in the health sector. However, despite this, many interviewees still had faith in the public health care system. They believed that the services in the Infectious Diseases Hospital (IDH) and Ward 33 of the General Hospital were good, and that they were treated well. A few agreed that free health care provided by government hospitals gave people who could not afford private health care access to treatment they would otherwise be denied. However, there was much consensus that awareness among health staff, in public and private hospitals, must be addressed. They brought up several instances where health staff (including doctors, nurses, attendants and minor staff) had discriminated against people living with HIV/AIDS and their families.

Breach of Confidentiality

According to the interviewees, there were several cases in which confidentiality regarding a patient's HIV status was not respected. A few interviewees mentioned that they lost their jobs as a result of their status being made public. In one case, the lab technician was shocked by test results, it being the first time that such a test turned out positive for HIV. He shared the information with his colleagues at the lab and the rest of the hospital. In the case of a patient who has since passed away due to complications resulting from AIDS, the interviewee was diagnosed with HIV at the General Hospital. A person working in the hospital found out his HIV status and spread this information around their village. This resulted in the stigmatization of both the patient and the family by members of the community.

Unprofessional/Unkind Treatment by Health Staff

Health staff should be educated on, and sensitized towards HIV/AIDS so that they will be able to take proper precautions and treat the patients in a non-discriminatory manner. It is also important that health staff is knowledgeable about the disease, so that they can educate the public and give them accurate information, thereby dispelling fear and misconceptions. At a government hospital, hospital staff operated a patient on without any testing or consultation with the patient's family. After the operation, the patient's mother informed the doctor that the patient was HIV+. Though the doctor behaved respectfully towards the patient and family, the attendants and minor staff treated both the patient and family badly. The mother of the HIV+ person, when interviewed, stated that the health staff was ignorant of HIV/AIDS and this resulted in stigmatization and discrimination. She went on to mention that the hospital staff had even refused to touch the sheets on the patient's bed.

Lack of Informed Consent/Counseling

The majority of the people interviewed stated that they consented to being tested. At the same time, nobody informed them about HIV/AIDS. Many had very little knowledge on what HIV/AIDS is, and some had misconceptions on how it could be transmitted. The majority of interviewees claimed that the doctor present explained HIV/AIDS only after the results came back positive. The doctors then directed the people to institutions such as Salvation Army and Lanka+ to get assistance and support. There were no cases in the study where pre-test counseling was conducted.

For further information, please contact: Dr. Paikiasothy Saravanamuttu, Executive Director, Centre for Policy Alternatives (CPA), 24/2, 28th Lane, Off Flower Road, Colombo 7, Sri Lanka; ph(94-11 ) 2301634 / 2565304-6,5552746/8, ext. 102; fax: 4714460;,;