Medical Students’ Statement Regarding Stigma and Discrimination towards PLWHA in health care settings

Medical Students’ Statement Regarding Stigma and Discrimination towards PLWHA in health care settings

Summary

UNAIDS defines HIV-related stigma and discrimination thus: “a process of devaluation of people either living with or associated with HIV and AIDS. Discrimination follows stigma and is the unfair and unjust treatment of an individual based on his or her real or perceived HIV status.” [1] In countries worldwide, stigma is a daily reality for people living with HIV and AIDS (PLWHA) and their families. It also affects groups closely associated with the disease, including sex workers, men who have sex with men, injecting drug users and prisoners. Stigma not only adds to their burden, but functions as a key barrier to effective prevention, treatment, care and support.

Introduction

The 2006 Political Declaration adopted at the U.N. High Level Meeting on AIDS notes that addressing stigma and discrimination is “…a critical element in combating the global HIV/AIDS pandemic.”[2] More specifically, stigma has been cited as a major barrier to achieving the goal of universal access to comprehensive HIV prevention programmes, treatment, care and support by 2010. Through the 2006 Political Declaration, U.N. member states committed to “eliminate all forms of discrimination against people living with HIV and members of vulnerable groups… and developing strategies to combat stigma and social exclusion connected with the epidemic.” [2] Despite the pervasiveness and centrality of stigma, it remains neglected in country responses to HIV and AIDS [3].
The three key actionable drivers of stigma are: lack of awareness and knowledge of stigma; fear of acquiring HIV through everyday contact with infected people; and values linking PLWHA with behaviour considered improper and immoral.
In terms of public health outcomes, stigma in health care settings is particularly damaging. Numerous studies document that health care providers discriminate against PLWHA [4].

Main text

We, the IFMSA, raise our voices against stigma and discrimination in health care settings against people living with HIV/AIDS. Evidence suggests that PLWHA experience discrimination in the health care facilities. [4] There are four major types of discrimination experienced: care refusal, suboptimal care, excessive precautions and humiliation. [5,6]
Nowadays, in many countries patients’ rights are protected by legal system and laws enforced by governments. Unfortunately the reality remains in conflict to these laws. In our everyday professional trainings we, as medical students all over the world, have witnessed people being tested without informed consent, PLWHA were stigmatized and discriminated against in means of postponing or even denying care; we have seen how human rights of PLWHA are being neglected and violated too many times.
Thus, we are making a call for governments, stakeholders and boards of medical faculties to: take immediate action in order to reverse the current situation; to start implementing existing legislation regulating the behaviour that violates the human rights of PLWHA; to empower PLWHA and to provide easy access to information and proper health care. We call for a non-discriminative treatment of PLWHA. We recognize that in order to achieve this providing the training on all aspects of HIV for health care students and professionals is crucial. This should include non-discrimination, informed consent, confidentiality, duty to treat, sexual and reproductive health and rights [7], and specific needs of key populations. Together, this will ensure that staff within health care settings provides care to all populations in a manner that is non-discriminatory and protective of their human rights.
Awareness must be raised, universal safety precautions must be taught and skills must be built and educated.
We commit to fighting against all forms of stigma and discrimination against PLWHA within IFMSA projects and externally. We, suggest the implementation of frameworks which protect the rights of PLWHA and call upon universities and ministries of health to respond adequately with changes in their medical curricula in order to implement a human rights-based approach to care – particularly when it comes to access to health and services for vulnerable and marginalized people, including PLWHA.

References

1. Michael Carter, Aidsmap: Health care providers must respond to HIV-related stigma. Available online on: http://www.aidsmap.com/page/1436562
2. United Nations, G.A., Political Declaration on HIV/AIDS. 60/262, 2006.
3. Parker, R. and P. Aggleton, HIV and AIDS related stigma and discrimination: a conceptual framework and implications for action. Social Science & Medicine, 2003. 57(1): p. 13-24.
4. Heijnders, M. and S. van der Meij, The fight against stigma: An overview of stigma-reduction strategies and interventions. Psychology, Health and Medicine, 2006. 11(3): p. 353-363.
5. Li Li, et al. HIV-Related Stigma in Health Care Settings: A Survey of Service Providers in China. AIDS Patient Care STDS. 2007 October; 21(10): 753–762.
6. Rahmati-Najarkolaei F, et al.: Experiences of stigma in healthcare settings among adults living with HIV in the Islamic Republic of Iran; J Int AIDS Soc. 2010 Jul 22;13(1):27.
7. IPPF Charter on Sexual and Reproductive Rights, available online on: http://www.ippf.org/en/Resources/

Adopted by the 59th IFMSA August Meeting General Assembly, 5th Aug. 2010