Research on HIV stigma and discrimination among health care workers in public and private health care sector in BIH
Bosnia and Herzegovina falls into the group of countries with the low HIV prevalence, lower than 1% among general population and lower than 5% among the population at risk. Till the end of 2010, 170 people infected with HIV were registered in Bosnia and Herzegovina, whereas AIDS developed in 109 people. Despite the existence of the programme for HIV prevention on the state level and the support of the Global Fund against AIDS, Tuberculosis and Malaria (GFATM), the number of HIV-tested people is extremely low, so it is likely that there are a considerably larger number of people living with HIV (PLHIV), than presented in the official data.
The most common way of transmitting HIV in the period from 1986, when the first case of HIV in Bosnia and Herzegovina was recorded, up to now, is heterosexual. The heterosexual way of transmitting HIV is followed by homo/bisexual ways and the transmission among injection drug users, while for a certain number of infected people, the way of transmission can’t be identified.
In Bosnia and Herzegovina there are 19 centers for voluntary and confidential counselling and testing, but the number of tested people is extremely low. In 2010 slightly more than 8000 people were tested in voluntary and confidential counselling and testing centers.
Poor socioeconomic state, insufficiently educated population, lack of a reliable evaluation of the size of the populations exposed to higher risks, migration of mobile populations, inadequate HIV and AIDS control system and the presence of HIV and AIDS-related stigma and discrimination, are of the utmost importance for HIV infection spread in Bosnia and Herzegovina.
With HIV outbreak all over the world, there is growing concern among health workers about the possibility of being infected while performing professional activities. One of the main causes of concern is the insufficient knowledge about the way HIV is transmitted and about preventative measures. According to unofficial information obtained from the interviews conducted with the staff from clinics for infectious diseases, where PLHIV patients are treated, and civil society organizations which deal with HIV prevention, PLHIV patients’ discrimination is often evident in the way that their medical records are marked or the patients are isolated during their treatment. Some cases where medical intervention was denied were also recorded.
Stigma is a social phenomenon of the marginalization of an individual or a population group which causes denying people living with AIDS full rights in the social environment. It is a dynamic process of underestimating a person, resulting in significant discrediting of an individual in the eyes of other people. When stigma occurs, the result is discrimination, either in the form of a particular activity or negligence.
There are several levels on which HIV and AIDS-related discrimination can be manifested – on general social level, local community level, in the workplace, during professional engagement, on the health care level, in the family and among friends.
In order to cope with the problem of stigma and discrimination, it is necessary to examine all the causes and, based on the results obtained, create quality