**5. Limitations of the study**

A major weakness of this study is that the data cannot be generalized. We can also conclude that these results are not representative of Port Harcourt city or the community, but the study aims to gather a broad perspective on stigma and societal reactions to PLWHA. The study was carried out in the city where people from different tribes live and reflects only the ideas or culture of the people interviewed.

Another weakness of the present study relied on verbal reports of participants. It was difficult for participants to admit to stigmatizing HIV persons because of social desirability, but when indirectly asked about others or spontaneously describing other's reactions, many of them expressed the view that stigmatization is still strong in society. Despite these limitations, this study illustrates the importance of not only knowing that stigma is still very much present, but also calls for more research in this area.

#### **6. Conclusion and recommendations**

The findings of our study may be valuable for developing interventions on stigma. The societal image of PLWHA can fuel the spread of HIV/AIDS because people continue to have unprotected sex based on their personal judgment on physical features associated with HIV/AIDS, because they believe a person with HIV/AIDS is supposed to be emaciated, without knowing that a well-cared-for person with HIV/AIDS can have a normal weight. Sometimes, the long-term nature of illness of someone can fuel suspicion from people, especially when the person is moved from one hospital to another or from the hospital in the city to the village. Participants placed great emphasis on faith-healing power when the pastor prays, which may influence the way they care for PLWHA. At the same time, some other participants felt the church should use their position to teach people how to care for sufferers of HIV/AIDS. The church should also use their position to protect the rights of PLWHA. Almost all the participants were of the opinion that care givers of people with HIV/AIDS should continue to care for them, mainly because they felt that they may find themselves in that position, as can anyone. Government should play a more active role in supporting PLWHA financially especially the vulnerable ones, such as women and children, to help cover the basic needs and accessing HIV/AIDS programmes. When people are knowledgeable about HIV/AIDS they know the steps they may take to protect themselves. Government should also create policies that protect PLWHA in important areas, such as the workplace. HIV/AIDS is likely to stay for many years, and so society may benefit from learning to live with it and not discriminating against PLWHA. Emphasis on the proactive role by media and faith-based institutions should be encouraged by government.

Problems associated with HIV/AIDS are very real in society. The government needs to educate the entire population through radio, television, markets, churches and everywhere there is a possibility of people listening. Continuous education of people about HIV/AIDS, modes of transmission, and how people can protect themselves when caring for HIV/AIDS is important. People should fully be aware that caring for a person with HIV/AIDS can be done without necessarily running a risk of contracting HIV/AIDS. A significant proportion of people in society have heard about HIV/AIDS and the kind of aggression with which the media initially provided information on HIV/AIDS, which enhanced discrimination, should now be turned towards giving HIV/AIDS a human face.

### **7. Acknowledgments**

The authors wish to thank Dr Anja Krumeich for her help in the design of the questionnaires.

#### **8. References**

220 Social and Psychological Aspects of HIV/AIDS and Their Ramifications

news paper in October 19, 1987, HIV/AIDS was typified as "a self-inflicted scourge caused by reckless sexual extravaganza, and the person must be prepared to bear the consequence of their lustful discretion" (Lear, 1998). Such images in the media flourish and take time to

A major weakness of this study is that the data cannot be generalized. We can also conclude that these results are not representative of Port Harcourt city or the community, but the study aims to gather a broad perspective on stigma and societal reactions to PLWHA. The study was carried out in the city where people from different tribes live and reflects only the

Another weakness of the present study relied on verbal reports of participants. It was difficult for participants to admit to stigmatizing HIV persons because of social desirability, but when indirectly asked about others or spontaneously describing other's reactions, many of them expressed the view that stigmatization is still strong in society. Despite these limitations, this study illustrates the importance of not only knowing that stigma is still very

The findings of our study may be valuable for developing interventions on stigma. The societal image of PLWHA can fuel the spread of HIV/AIDS because people continue to have unprotected sex based on their personal judgment on physical features associated with HIV/AIDS, because they believe a person with HIV/AIDS is supposed to be emaciated, without knowing that a well-cared-for person with HIV/AIDS can have a normal weight. Sometimes, the long-term nature of illness of someone can fuel suspicion from people, especially when the person is moved from one hospital to another or from the hospital in the city to the village. Participants placed great emphasis on faith-healing power when the pastor prays, which may influence the way they care for PLWHA. At the same time, some other participants felt the church should use their position to teach people how to care for sufferers of HIV/AIDS. The church should also use their position to protect the rights of PLWHA. Almost all the participants were of the opinion that care givers of people with HIV/AIDS should continue to care for them, mainly because they felt that they may find themselves in that position, as can anyone. Government should play a more active role in supporting PLWHA financially especially the vulnerable ones, such as women and children, to help cover the basic needs and accessing HIV/AIDS programmes. When people are knowledgeable about HIV/AIDS they know the steps they may take to protect themselves. Government should also create policies that protect PLWHA in important areas, such as the workplace. HIV/AIDS is likely to stay for many years, and so society may benefit from learning to live with it and not discriminating against PLWHA. Emphasis on the proactive

role by media and faith-based institutions should be encouraged by government.

Problems associated with HIV/AIDS are very real in society. The government needs to educate the entire population through radio, television, markets, churches and everywhere there is a possibility of people listening. Continuous education of people about HIV/AIDS, modes of transmission, and how people can protect themselves when caring for HIV/AIDS is important. People should fully be aware that caring for a person with HIV/AIDS can be

be reversed.

**5. Limitations of the study** 

ideas or culture of the people interviewed.

**6. Conclusion and recommendations** 

much present, but also calls for more research in this area.


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**12** 

**Trends and Levels of HIV/AIDS-Related** 

For a very long time now, people living HIV and AIDS have been stigmatized and discriminated against and these negative attitudes have been observed to deter people from seeking health care services such as participating in voluntary counselling and testing and prevention of mother-to-child transmission (Nyblade and Field, 2002). UNAIDS (2007) argued that in many countries and communities, the stigma associated with HIV and the resulting discrimination can be as devastating as the illness itself: abandonment by spouse and/or family, social ostracism, job and property loss, school expulsion, denial of medical services, lack of care and support, and violence. It found that these consequences, or fear of them, mean that people are less likely to come in for HIV testing, disclose their HIV status to others, adopt HIV preventive behaviour, or access treatment, care and support. If they do, they could lose everything. Previous research (for example, Alonzo and Reynolds, 1995) has found that HIV-related stigma originates from several sources. First, HIV and AIDS are associated with the deviant behaviour that is suspected to have caused the HIV-positive status. Second, that the individual was irresponsible to have contracted HIV. Third, that it is the individual's immoral behaviour that caused HIV and AIDS. Finally, that HIV and AIDS

One of the major challenges for studying HIV/AIDS-related stigma discrimination is how to best measure the concept of "stigma". At the moment, as USAID (2006) rightly stated: "...measures that can both describe an existing environment, and evaluate and compare interventions, are lacking" (p.2). A wide range of questions are used to measure stigma. There is a need to correctly measure stigma for a variety of reasons. USAID (2006) has summarized why there is a need to measure stigma and the reasons are summarized below. One such reason is the fact that anti-stigma interventions that have been designed and implemented need to be evaluated to determine if the intervention is effective or not. Another equally important reason for measuring stigma is to identify effective models and take them to scale. Measurement of stigma allows researchers to test the hypothesis that stigma would decline if antiretroviral drugs were more widely available. These are some of

**1. Introduction** 

are contagious and threatening to the community.

the reasons for developing a tested and validated measure of stigma.

**Attitudes: Insights from Botswana** 

**Stigma and Discriminatory** 

**AIDS Impact Surveys** 

Gobopamang Letamo *University of Botswana* 

*Botswana* 

 www://data.unaids.org/pub/report/2008/jc1526\_epibriefs\_subsaharanafrica\_en. pdf.

