HIV stigma in the teaching hospitals, Yemen
Background: Stigma facing People Living with HIV undermines their health, wellbeing and quality of life, and threatens HIV control. HIV control funds and interventions in Yemen diminished gradually, especially after 2015 when donor assistance to emergency relief interventions in 2015. We assessed the level and drivers of HIV stigma in the teaching hospitals in Sana’a city, Yemen. Methods: This was a cross-sectional study that targeted 320 health professionals working in invasive-procedure departments in the three teaching hospitals in Sana'a city in 2017. Data were collected anonymously using a specially designed self-filled questionnaire, which covers providers' background, potential personal and professional drivers of stigma and the stigmatising practices. Data were entered and analysed using SPSS. Results: All participants were Yemeni and the majority were females (68%), 20-39 years old (85%), nurses (84%) and holding a nursing diploma (69%) or a bachelor degree (27%). None of the health professionals was aware of institutional policies against HIV stigma and only 7% believed that the current infection control measures were adequate. A minority of the participants encountered/ provided care for PLHV (%), received HIV training (33%), or were confident that their HIV knowledge was adequate (23%). The majority would test patients for HIV prior to surgical procedures (77%) and discloses a +ve HIV results to others (99%) without the person’s prior knowledge or consent. All the participants applied at least one act of stigma such as avoiding physical contact with PLHIV (87%) or wearing gloves all through the consultation (96.5%). Stigmatizing practices were significantly correlated with poor HIV knowledge and fear of infection (P< 0.05) Conclusions: PLHIV face an epidemic of HIV stigma in the teaching hospitals in Yemen supporting the reports of higher level of stigma in the low HIV prevalence countries and its links to the fear of infection, poor HIV knowledge and lower HIV control funding. Conflict increases vulnerability and exposure to HIV and it is important to maintain the HIV control efforts within this context. Humanitarian efforts should mainstream HIV control measures within the health interventions so as to achieve an equitable and effectively sustainable response.