Your daily Selection of IRIN Africa PlusNews reports, 10/24/2006

[Guest guest]

U N I T E D N A T I O N S

Office for the Coordination of Humanitarian Affairs

Integrated Regional Information Network (IRIN) -

[These reports do not necessarily reflect the views of the United Nations]

CONTENT:

1 - INDIA: New study reveals HIV/AIDS stigma in hospitals

1 - INDIA: New study reveals HIV/AIDS stigma in hospitals

NEW DELHI, 24 October (PLUSNEWS) - India's growing HIV/AIDS pandemic is putting

more pressure on hospitals to provide improved levels of care, but prejudice

among medical staff against HIV-positive people is keeping those most in need

away, according to a recent report.

'Reducing AIDS-related Stigma and Discrimination in Indian Hospitals', is being

viewed with interest by policy makers and practitioners in India, as stigma and

discrimination against people living with the virus threaten to derail official

efforts to contain the epidemic.

The study was conducted by HORIZONS, a global research programme affiliated with

the Population Council, a US-based reproductive health nongovernmental

organisation (NGO), in conjunction with SHARAN, an Indian NGO, and the

Delhi-based Institute of Economic Growth.

Researchers spoke to doctors, nurses, hospital administrators, managers and

people living with HIV and AIDS and their caregivers at one private and two

state-owned hospitals in the capital, New Delhi, between 2002 and 2004.

In one interview, a doctor is quoted as saying, " High-risk population means

lower class people - they live in slums, in unhygienic conditions; they sleep

with anybody and everybody, extramarital affairs are common, and also drug users

and sex workers come into this category. " Another doctor commented, " There is a

separate bed which is earmarked for an HIV-positive patient, and I see to it

that it is not used by any other patients. "

Several people living with HIV and AIDS who participated in the study said their

common experience was denial of care, delay in treatment and multiple referrals.

" The doctor refused to examine me for almost two months - he even stopped doing

my dressing. He just told me to continue with my medicines. He also referred me

to another hospital for an operation that he would not do, as it would be too

costly for me, " one HIV-positive respondent told the researchers.

There were mixed reactions among staff regarding counselling and testing

practices. Nurses at one hospital said mandatory testing was carried out,

especially for those requiring surgery or invasive procedures, but doctors did

not ask for consent and the patient was not provided with professional

counselling, as there was no trained HIV/AIDS counsellor in the hospital. They

commented that many patients would not have been able to understand the form, or

would have refused to be tested if they had been asked.

Much of the discrimination was due to inherent prejudices against those infected

with HIV, but the difference in treatment given to people living with the virus

also stemmed from a lack of knowledge and inadequate institutional support for

infection control.

Although the infection control committees in each of the hospitals had

guidelines, and the staff had undergone training, their knowledge was often

outdated.

" New knowledge about safeguarding staff was not always shared with all staff

members. For example, the staff interviewed had low awareness about

post-exposure prophylaxis (PEP) and its potential to reduce the risk of

infection following potential exposure to HIV. Most of the staff interviewed

were not aware if PEP was available in their hospital or how to access it, " the

report said.

The findings have raised concerns about patients being tested for the HI virus

without giving informed consent.

" Guidelines by NACO [National AIDS Control Organisation] are clear. Doctors have

to explain the issues to a person before he/she can be tested for HIV. Testing

cannot be done unless he/she agrees, " said Arti Malik, advocacy officer at the

Lawyer's Collective HIV/AIDS Unit, an Indian legal aid group.

Malik pointed out that fear prevented more instances of hospital discrimination

against HIV-positive people from coming to light. " We are willing to take up the

cases, but not too many HIV-positive people are willing to take a government

institution to court on grounds of stigma and discrimination. We have much

anecdotal evidence, such as a recent case of an HIV-positive pregnant woman who

was denied a bed in a government hospital in Delhi and who slept on the floor.

The child died but the woman did not file a case. Instead, she went back to her

village. "

The findings were also used in pilot approaches to motivating hospitals to

become more caring towards HIV-infected people. For example, a PLHA-friendly

Checklist' (people living with HIV and AIDS) was developed as a self-assessment

tool for hospital managers to identify institutional strengths and weaknesses in

services for HIV-positive people, and evaluate hospital policies and procedures

to protect staff from the risk of exposure to HIV. Hospitals were then assisted

to develop 'action plans' to improve the situation.

After the pilot intervention, " doctors were more likely to agree that patients

should not be tested for HIV without their consent. They also were more likely

to seek informed consent ... [when] they ordered an HIV test " the report noted.

After the pilot project a greater proportion of doctors and nurses said

HIV-positive individuals had the right to decide who should know their status,

but this was not the case among ward staff.

HORIZON's Vaishali Mahendra hoped the findings would have a significant impact

in public hospitals. India's National AIDS Control Organisation, for example,

has endorsed the PLHA-friendly Checklist to be used in all public hospitals, and

the report has been disseminated to all the State AIDS Control Societies in the

country.

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Subscriber: AIDS treatments

[Guest guest]

U N I T E D N A T I O N S

Office for the Coordination of Humanitarian Affairs

Integrated Regional Information Network (IRIN) -

[These reports do not necessarily reflect the views of the United Nations]

CONTENT:

1 - INDIA: New study reveals HIV/AIDS stigma in hospitals

1 - INDIA: New study reveals HIV/AIDS stigma in hospitals

NEW DELHI, 24 October (PLUSNEWS) - India's growing HIV/AIDS pandemic is putting

more pressure on hospitals to provide improved levels of care, but prejudice

among medical staff against HIV-positive people is keeping those most in need

away, according to a recent report.

'Reducing AIDS-related Stigma and Discrimination in Indian Hospitals', is being

viewed with interest by policy makers and practitioners in India, as stigma and

discrimination against people living with the virus threaten to derail official

efforts to contain the epidemic.

The study was conducted by HORIZONS, a global research programme affiliated with

the Population Council, a US-based reproductive health nongovernmental

organisation (NGO), in conjunction with SHARAN, an Indian NGO, and the

Delhi-based Institute of Economic Growth.

Researchers spoke to doctors, nurses, hospital administrators, managers and

people living with HIV and AIDS and their caregivers at one private and two

state-owned hospitals in the capital, New Delhi, between 2002 and 2004.

In one interview, a doctor is quoted as saying, " High-risk population means

lower class people - they live in slums, in unhygienic conditions; they sleep

with anybody and everybody, extramarital affairs are common, and also drug users

and sex workers come into this category. " Another doctor commented, " There is a

separate bed which is earmarked for an HIV-positive patient, and I see to it

that it is not used by any other patients. "

Several people living with HIV and AIDS who participated in the study said their

common experience was denial of care, delay in treatment and multiple referrals.

" The doctor refused to examine me for almost two months - he even stopped doing

my dressing. He just told me to continue with my medicines. He also referred me

to another hospital for an operation that he would not do, as it would be too

costly for me, " one HIV-positive respondent told the researchers.

There were mixed reactions among staff regarding counselling and testing

practices. Nurses at one hospital said mandatory testing was carried out,

especially for those requiring surgery or invasive procedures, but doctors did

not ask for consent and the patient was not provided with professional

counselling, as there was no trained HIV/AIDS counsellor in the hospital. They

commented that many patients would not have been able to understand the form, or

would have refused to be tested if they had been asked.

Much of the discrimination was due to inherent prejudices against those infected

with HIV, but the difference in treatment given to people living with the virus

also stemmed from a lack of knowledge and inadequate institutional support for

infection control.

Although the infection control committees in each of the hospitals had

guidelines, and the staff had undergone training, their knowledge was often

outdated.

" New knowledge about safeguarding staff was not always shared with all staff

members. For example, the staff interviewed had low awareness about

post-exposure prophylaxis (PEP) and its potential to reduce the risk of

infection following potential exposure to HIV. Most of the staff interviewed

were not aware if PEP was available in their hospital or how to access it, " the

report said.

The findings have raised concerns about patients being tested for the HI virus

without giving informed consent.

" Guidelines by NACO [National AIDS Control Organisation] are clear. Doctors have

to explain the issues to a person before he/she can be tested for HIV. Testing

cannot be done unless he/she agrees, " said Arti Malik, advocacy officer at the

Lawyer's Collective HIV/AIDS Unit, an Indian legal aid group.

Malik pointed out that fear prevented more instances of hospital discrimination

against HIV-positive people from coming to light. " We are willing to take up the

cases, but not too many HIV-positive people are willing to take a government

institution to court on grounds of stigma and discrimination. We have much

anecdotal evidence, such as a recent case of an HIV-positive pregnant woman who

was denied a bed in a government hospital in Delhi and who slept on the floor.

The child died but the woman did not file a case. Instead, she went back to her

village. "

The findings were also used in pilot approaches to motivating hospitals to

become more caring towards HIV-infected people. For example, a PLHA-friendly

Checklist' (people living with HIV and AIDS) was developed as a self-assessment

tool for hospital managers to identify institutional strengths and weaknesses in

services for HIV-positive people, and evaluate hospital policies and procedures

to protect staff from the risk of exposure to HIV. Hospitals were then assisted

to develop 'action plans' to improve the situation.

After the pilot intervention, " doctors were more likely to agree that patients

should not be tested for HIV without their consent. They also were more likely

to seek informed consent ... [when] they ordered an HIV test " the report noted.

After the pilot project a greater proportion of doctors and nurses said

HIV-positive individuals had the right to decide who should know their status,

but this was not the case among ward staff.

HORIZON's Vaishali Mahendra hoped the findings would have a significant impact

in public hospitals. India's National AIDS Control Organisation, for example,

has endorsed the PLHA-friendly Checklist to be used in all public hospitals, and

the report has been disseminated to all the State AIDS Control Societies in the

country.

[ENDS]

This is non-reply e-mail. Please do not hesitate to contact us at

Mail@....

Principal donors: IRIN is generously supported by Australia, Canada, Denmark,

ECHO, Japan, Netherlands, Norway, Sweden, Switzerland, the United Kingdom and

the United States of America. For more information, go to:

http://www.IRINnews.org/donors

[This item comes to you via IRIN, a UN humanitarian news and information

service, but may not necessarily reflect the views of the United Nations or its

agencies. All IRIN material may be reposted or reprinted free-of-charge; refer

to the copyright page (Http://www.irinnews.org/copyright ) for conditions of

use. IRIN is a project of the UN Office for the Coordination of Humanitarian

Affairs.]

PLUSNEWS

Tel: +27 11 895-1900

Fax: +27 11 784-6759

Email: Mail@...

To make changes to or cancel your subscription visit:

http://www.irinnews.org/subscriptions

Subscriber: AIDS treatments