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Fulltext Knowledge of HIV/Aids and attitudes towards people living with HIV/Aids (PlWHA) among undergraduate students in University Malaysia Sabah

Zulkhairul Naimbin Sidek Ahmad, Siti Fatimah Sa’at, Farrah Ilyanibinti Che Jamalludin, Mazlinda Musa

Malaysian Journal of Medicine and Health Sciences, 2020;16(105):69-0.
MyJurnal

Introduction: Globally, HIV/AIDS has been a growing global threat and one of the major public health challenges. In Malaysia, the number of PLWH is continued to increase year by year. What is of alarming concern is that the prejudices related to HIV/AIDS still exist within the community. Stigma and discrimination towards people living with HIV have been widely documented. It has extended their impact into the workplace and this hinders HIV pre- vention efforts and indirectly affected the national developmentprocesses. The aim of this study was to determine the knowledge of HIV/AIDS and the attitude of PLWHA among students in Universiti Malaysia Sabah. Methods: This is a cross-sectional study with convenience sampling techniques used. Data were collected among the 300 medical students and non-medical students. Self-administered questionnaires were distributed and comprise of; socio-de- mographic characteristics, items assessing knowledge of HIV/AIDS and attitudes towards PLWHA. Results: The majority of respondents were female (74%) who had never encountered PLWH (76%). The mean score of knowl- edge and attitudes were 4.04±1.12 and 27.18±4.0, respectively. Year 1 male students were found to have more comprehensive knowledge of HIV/AIDS. They were also having a more positive attitude toward PLWH as compared to female students. Conclusion: Stigma and discrimination associated with HIV/AIDS are the most challenges issues- experienced by people suffering from the disease and it has been recognized. It is regarded as a serious threat to the fundamental rights of all infected people who are affected by or associated with this disease. This study highlights the need for better education programs on HIV/AIDS at the undergraduate level in order to increase knowledge of HIV/ AIDS andshape the positive attitude toward PLWH.

Matched MeSH terms: Social Stigma
Fulltext Isolated Bilateral Pinna Swelling: A Rare Initial Presentation of Leprosy

Yusuf SYM, Ismail IA, Hamid RA, Jamil NA, Yasin MM

Open Access Maced J Med Sci, 2019 Jun 15;7(11):1815-1817.
PMID: 31316665 DOI: 10.3889/oamjms.2019.481

BACKGROUND: Leprosy or Hansen disease is a chronic infectious disease that causes social stigma due to its deforming bodily appearance and physical disability. It has a wide spectrum of presentation affecting diagnosis.
CASE REPORT: A 21-year-old man who presented with chronic isolated bilateral pinna swelling as a result of leprosy is reported. The bilateral pinna swelling started as multiple shiny papules with an erythematous background and progressively became hyperpigmented and lobular over two years. This rare presentation of leprosy poses initial diagnostic difficulties, leading to misdiagnoses by various health care professionals. Diagnoses ascribed include eczema, insect bite and perichondritis. A suspicion of leprosy was raised when hyperaesthetic hypopigmentation of skin started to appear on the body after two years, with worsening of the pinna swellings. This was confirmed by identification of Mycobacterium leprae in slit skin smear test and skin biopsy.
CONCLUSION: Isolated involvement of pinna in a patient without lesions in other body parts is an unusual initial presentation of leprosy. However, leprosy should be kept as a rare differential diagnosis of isolated lesions on the ear in patients not responding to conventional treatment.

Matched MeSH terms: Social Stigma
Fulltext Validation of the malay version of the Affiliate Stigma Scale among caregivers of patients with mental illness

Yun YS, Jaapar SZS, Fadzil NA, Cheng KY

Malays J Med Sci, 2018 Nov;25(6):127-136.
PMID: 30914886 MyJurnal DOI: 10.21315/mjms2018.25.6.13

Background: Caregivers of patients with mental illness are exposed to stigma. The internalisation of this stigma among caregivers is known as affiliate stigma and can be measured by the Affiliate Stigma Scale (ASS). The aim of this study was to validate the Malay version of the ASS.
Methods: A cross-sectional study was performed from May to December 2017 with 372 caregivers of patients with mental illness. The ASS was first translated into Malay using standard forward and backward translation procedures. The final version of the ASS-Malay (ASS-M) was completed by participants. The data analyses involved assessment of construct validity by exploratory factor analysis, confirmatory factor analysis and construct reliability.
Results: The final model of the ASS-M consists of four factors with 21 items, as compared to the original version, which has three factors with 22 items. The results showed that the final model has good model fit based on RMSEA (0.065) and SRMR (0.055) and a satisfactory composite reliability (affective = 0.827, cognitive = 0.857, behaviour = 0.764, self-esteem = 0.861).
Conclusion: The study showed that the four-factor, 21-item ASS-M model has good psychometric properties. The scale is valid and reliable for measuring affiliate stigma among caregivers of patients with mental illness in Malaysia.

Matched MeSH terms: Social Stigma
Validation of the Chinese version of public attitudes toward epilepsy scale in Mainland China

Yue Z, Ma C, Lim KS, Xiao B, Wu Q, Shu Y, et al.

Epilepsy Behav, 2017 07;72:150-155.
PMID: 28582727 DOI: 10.1016/j.yebeh.2017.04.028

PURPOSE: Epilepsy is a significant yet seriously underappreciated public health issue in Mainland China. The stigma and discrimination toward people with epilepsy (PWE) and their families are especially severe in China based on cultural misconceptions which cause tremendous psychological, economic and social burdens. It is imperative to formulate a targeted public intervention to eliminate knowledge gaps and correct these misconceptions of epilepsy. However, to date, the essential tools that may drive such an intervention by measuring the public perspective on PWEs is lacking in China. The goal of this study is to test the reliability and validity of a Simplified Chinese version of the "Public Attitude Toward Epilepsy" scale (PATE) in Mainland China which can be used to understand the content and identify the possible sources of stigma to better inform the design and focus of future stigma reduction interventions.

METHODS: The standard procedure of cross-cultural adaptation was used in the translation process. Subjects from different economic and social backgrounds were enrolled by convenience sampling in central China. Exploratory factor analysis and confirmatory factor analysis were used to check the underlying factor structure of the items. Furthermore, Cronbach's alpha was utilized to assess internal consistency.

RESULTS: 199 respondents were included in the final analysis. Content validity of this Chinese PATE was assessed to be adequate for assessing public attitudes toward epilepsy among the mainland Chinese. Two factors were extracted from the data by exploratory factor analysis; confirmatory factor analysis further confirmed good consistency of theoretical constructs between the original Public Attitudes Toward Epilepsy scale and our Chinese PATE. Our Chinese PATE presented excellent internal consistency (α=0.853-0.909).

CONCLUSION: This version of the Chinese PATE showed acceptable psychometric properties, indicating that it can be implemented in surveying public attitudes toward epilepsy in Mainland China.

Matched MeSH terms: Social Stigma
Fulltext Self-perception of stigma among epilepsy patients in Malaysia

Yousuf, R.M., Shahar, M.A., Marzuki, O.A., Azarisman, S.M.S., Rosle, C., Tin, M.H.

International Medical Journal Malaysia, 2018;17(1):113-120.
MyJurnal

Introduction: Epilepsy remains a stigmatised disease across geographical and temporal boundaries. Very little is known about epileptic stigma (ES) in cross-cultural settings. The aim of this study was to assess the prevalence of perceived stigma and factors associated with it, among patients with epilepsy (PWE) at a tertiary care referral hospital in East Coast of Malaysia. Methods: A cross sectional survey among 132 consenting PWE using pre-tested, semi-structured questionnaire in Malay/English language to assess their knowledge, attitude and practices (KAPs). Results: Among 132 respondents, 51.5% were male and 48.5 % were female. Their age ranged from 14 to 70 years (mean=31.6±13.41). Majority (53.8%) of them were aged 30 years or younger. The median number of years they had epilepsy was 8.0 (IQR 4.0-18.8) years and average duration of seizure prior to seeking medical attention was 1.0 (IQR 0.3 - 4.5) year. Most of them (90.9%) did not know the cause of epilepsy; however nearly all (91.7%) believed that it was a disease of the
brain. Higher education level respondents possessed significantly higher KAP scores compared to lower education level respondents (p

Matched MeSH terms: Social Stigma
Fulltext Poor adherence to antiretroviral therapy and associated factors among people living with HIV in Omdurman City, Sudan

Yassin Ibrahim, Rosnah Sutan, Khalib Bin Abdul Latif, Al - Abed A. Al - Abed, Amara, Ahmed, Adam, Ishag

Malaysian Journal of Public Health Medicine, 2014;14(1):90-101.
MyJurnal

Adherence to antiretroviral therapy (ART) plays an important role in the treatment outcomes of human immunodeficiency virus (HIV) infection. Poor adherence would result in failure to prevent viral replication as well as an increased risk of developing drug resistance. Adherence to a life long treatment such as antiretroviral therapy is usually a complicated issue that requires careful and continuous collaboration of patient, family and healthcare provider. The objective of this study was to assess adherence to antiretroviral therapy and its associated factors among people living with HIV. This is a health facility-based cross sectional study conducted among adults’ people living with HIV in Omdurman HIV/AIDS centre, Sudan. Data was collected through direct interview using semi-structured questionnaire. There were only 144/846 (17.02%) who adhered to antiretroviral therapy as prescribed by their doctors. The remaining 51.18% were taking the therapy but not regularly, 31.21% were taking it but currently not and 0.59% stated that they have never taken any antiretroviral therapy. Factors associated with poor adherence that have been identified include female gender (Adj. OR = 3.46 (95%CI: 1.46-8.21), P = 0.005), younger age (Adj. OR = 1.14 (95%CI: 1.02-1.28), P = 0.022), being unemployed (Adj. OR = 5.94 (95%CI: 1.51-23.40), P = 0.011), those who were divorced, separated or widowed (Adj. OR = 11.35 (95%CI: 1.74-73.96), P = 0.011) and respondents who perceived that their health status is poor (Adj. OR = 5.21 (95%CI: 1.44-18.81), P = 0.012) or very poor (Adj. OR = 4.04 (95%CI: 1.27-12.81), P = 0.018). Educational level and social support against HIV-related stigma and discrimination were not significantly associated with adherence. Adherence to antiretroviral therapy among the respondents is very poor. Urgent interventions based on modifiable factors and mainly targeting females and younger age group are needed to improve adherence to antiretroviral therapy among people living with HIV.

Matched MeSH terms: Social Stigma
Prevalence and factors associated with HIV/AIDS-related stigma and discriminatory attitudes: a cross-sectional nationwide study

Wong LP

Prev Med, 2013;57 Suppl:S60-3.
PMID: 23583477 DOI: 10.1016/j.ypmed.2013.03.013

OBJECTIVE: The prime purpose of this study is to assess HIV/AIDS-related self-stigma and discrimination (S&D) attitudes and associated factors using multivariate analysis of data from the 2010-11 National Survey of Understanding the Root of HIV/AIDS Related Stigma and Discrimination.
METHOD: A national telephone survey was carried out with 2271 of the Malaysian public aged 18-60 years. The sample was contacted by random digit dialing covering the whole of Peninsular Malaysia from December 2010 to May 2011. The HIV-transmission knowledge, HIV-related self-stigma, and public stigma were investigated.
RESULTS: Despite high level of HIV-transmission knowledge [mean (SD)=10.56 (2.42), mean score at 70th percentile] the respondents in this study had moderate levels (mean scores near midpoints) of self-stigma and public stigma attitudes. HIV-transmission knowledge score was not significantly correlated with self-stigma score, but showed a significantly small positive effect (r<0.2) for public stigma scores. Ethnicity is the strongest correlate of HIV-transmission knowledge, self-stigma, and public stigma attitudes in the multivariate analyses. Other significant correlates were age, socioeconomic group, and urban-rural setting.
CONCLUSIONS: The root causes of HIV stigma and discriminatory attitudes were not associated with knowledge deficiency. Interventions should be oriented towards promoting de-stigmatization of HIV/AIDS, and tailored socio-culturally.
KEYWORDS: Discriminatory; HIV/AIDS; Knowledge; Stigma

Matched MeSH terms: Social Stigma
Stigmatization and discrimination towards people living with or affected by HIV/AIDS by the general public in Malaysia

Wong LP, Syuhada AR

Southeast Asian J. Trop. Med. Public Health, 2011 Sep;42(5):1119-29.
PMID: 22299438

Globally, HIV/AIDS-related stigma and discriminatory attitudes deter the effectiveness of HIV prevention and care programs. This study investigated the general public's perceptions about HIV/AIDS-related stigma and discrimination towards people living with or affected by HIV/AIDS in order to understand the root of HIV/AIDS-related stigma and discriminatory attitudes. Study was carried out using qualitative focus group discussions (FGD). An interview guide with semi-structured questions was used. Participants were members of the public in Malaysia. Purposive sampling was adopted for recruitment of participants. A total 14 focus group discussions (n = 74) was carried out between March and July 2008. HIV/AIDS-related stigma and discrimination towards people living with HIV/AIDS (PLWHA) was profound. Key factors affecting discriminatory attitudes included high-risk taking behavior, individuals related to stigmatized identities, sources of HIV infection, stage of the disease, and relationship with an infected person. Other factors that influence attitudes toward PLWHA include ethnicity and urban-rural locality. Malay participants were less likely than other ethnic groups to perceive no stigmatization if their spouses were HIV positive. HIV/AIDS-related stigma and discrimination were stronger among participants in rural settings. The differences indicate attitudes toward PLWHA are influenced by cultural differences.

Matched MeSH terms: Social Stigma*
Fulltext Multi-ethnic perspective of uptake of HIV testing and HIV-related stigma: a cross-sectional population-based study

Wong LP

AIDS Care, 2013;25(11):1356-69.
PMID: 23406514 DOI: 10.1080/09540121.2013.766302

The objective of this study was to identify demographic characteristics and correlates of the uptake of HIV testing, willingness to be tested and perceived HIV-related stigma of Malaysian lay public. A cross-sectional computer-assisted telephone interview survey of a representative sample of multiracial Malaysians aged 18 years and above was conducted between December and July 2011. The survey collected information on demographics, knowledge about HIV transmission and religious beliefs on attitudes to HIV/AIDS. A total of 2271 households were successfully interviewed. The response rate was 48.65%. The HIV transmission knowledge score ranged from 0 to 15 (mean =10.56; SD±2.42). Three of the most common misconceptions about HIV transmission were mosquito bite (42.8%), eating in a restaurant where the cook is HIV positive (20.4%) and using a public toilet (20.1%). Only 20.6% reported ever having been tested for HIV, 49.1% reported a willingness to be tested for HIV and 30.3% had no intention of getting an HIV test. Low-risk perception (63.7%) constitutes a major barrier to HIV testing. Being Malay and Chinese (relative to Indian) were the strongest predictors of low-risk perception. Other significant predictors of low-risk perception were being male, being married and living in an urban locality. Perceived self-stigma if tested positive for HIV was prevalent (78.8%). Multivariate findings showed that being female, Malay, low income, living in rural localities and public stigma were significant correlates of self-stigma. These findings warrant interventions to reduce the disproportionate HIV transmission misconception, barriers to HIV testing and stigma and discriminative attitudes to involve considerations of sociocultural economic and demographic characteristics.

Matched MeSH terms: Social Stigma*
Employability among people with uncontrolled seizures: An interpretative phenomenological approach

Wo MC, Lim KS, Choo WY, Tan CT

Epilepsy Behav, 2015 Apr;45:21-30.
PMID: 25794681 DOI: 10.1016/j.yebeh.2015.02.016

This study aimed to explore positive and negative factors affecting the employability in patients with uncontrolled seizures.

Matched MeSH terms: Social Stigma
Employability in people with epilepsy: A systematic review

Wo MC, Lim KS, Choo WY, Tan CT

Epilepsy Res, 2015 Oct;116:67-78.
PMID: 26354169 DOI: 10.1016/j.eplepsyres.2015.06.016

People with epilepsy were (PWE) reported to have poorer employment rate. However, the methodologies used differ greatly from one study to another, making global comparison difficult. We aimed to determine the employment rate of PWE globally using a unified definition of employment rate and to summarize the reported positive and negative factors affecting employability in PWE, using a systematic review.

Matched MeSH terms: Social Stigma*
Factors affecting the employability in people with epilepsy

Wo MC, Lim KS, Choo WY, Tan CT

Epilepsy Res, 2016 Dec;128:6-11.
PMID: 27792885 DOI: 10.1016/j.eplepsyres.2016.10.003

PURPOSE: People with epilepsy (PWE) are negatively prejudiced in their ability to work. This study aimed to examine demographic, clinical and psychological factors associated with employability in PWE.

METHODS: This study recruited epilepsy patients from a neurology clinic in Malaysia. Employability was measured using employment ratio, with a ratio ≥90% (ER90) classified as high employability. Basic demographic data such as age, gender, marital status, religion, education level and household income was collected. Clinical measures consisted of age of seizure onset, seizure frequency, type of epilepsy, aura, polytherapy, nocturnal seizures and seizure control. Psychological measures included Work Self-Determination Index (WSDI), Rosenberg Self-Esteem Scale (SES), and Multidimensional Scale of Perceived Social Support (MSPSS).

RESULTS: Of 146 PWE, 64.4% had high employability. The participants were predominantly female (52%), Chinese (50.7%), single (50%), having tertiary education (55.5%) and focal epilepsy (72.6%). Clinically, only type of epilepsy was significantly correlated to employability of PWE. Employability of PWE was associated with ability to work (indicated by education level, work performance affected by seizures, ability to travel independently and ability to cope with stress at work) and family overprotection. The high employability group was found to have lower self-perceived stigma (ESS), higher self-determined motivation (WSDI), self-esteem (SES) and perceived social support (MSPSS), than the low employability group. Logistic regression analysis showed that tertiary education level (AOR 3.42, CI: 1.46-8.00), higher self-determination (WSDI, AOR 1.09, CI: 1.012-1.17), lower family overprotection (AOR 0.76, CI: 0.61-0.95), and generalised epilepsy (AOR 4.17, CI: 1.37-12.70) were significant predictors for higher employability in PWE.

CONCLUSION: Ability to work (education level), clinical factor (type of epilepsy) and psychological factor (self-determined motivation and family overprotection) were important factors affecting employability in PWE.

Study site: neurology clinic Universiti Malaya Medical Centre (UMMC)

Matched MeSH terms: Social Stigma
Fulltext Innovative Self-Confidence Webinar Intervention for Depression in the Workplace: A Focus Group Study and Systematic Development

Wan Mohd Yunus WMA, Musiat P, Brown JSL

Behav Sci (Basel), 2020 Dec 16;10(12).
PMID: 33339086 DOI: 10.3390/bs10120193

Brief face-to-face self-confidence workshops were effective in reducing depression among the public. Technological advances have enabled traditional face-to-face interventions to be adapted using unique technology-mediated platforms. This article details the formative development of a self-confidence web-based seminar (webinar) intervention for workplace depression. The first section discusses a qualitative study that explores the feasibility and acceptability of adapting the self-confidence workshops into a webinar platform on employees in the workplace. The second section describes the systematic development of this new webinar intervention informed by the qualitative study findings, a published systematic review, and previous face-to-face self-confidence workshops. The qualitative study involves three focus groups (n = 10) conducted in a small organization. Three themes were identified relevant to the running of the new self-confidence webinars in the workplace: personal (content, time and duration preference, features of the webinar, individual participation, personalization), interpersonal (stigma from others, engagement with participants/presenter, moderated interaction), and organizational (endorsement from management, work demand). For the intervention development, the format, structure, features, and content of the self-confidence webinar intervention are described. Features such as file sharing, virtual whiteboard, live chat, and poll are explained with the intervention primarily based on cognitive behavior therapy and coping flexibility concepts.

Matched MeSH terms: Social Stigma
Fulltext Barriers and Facilitators to Implementing Project ECHO in Malaysia During the COVID-19 Pandemic

Walters SM, Li WP, Saifi R, Azwa I, Syed Omar SF, Collier ZK, et al.

J Int Assoc Provid AIDS Care, 2022;21:23259582221128512.
PMID: 36177542 DOI: 10.1177/23259582221128512

Objective: In Malaysia, HIV is concentrated among key populations who experience barriers to care due to stigma and healthcare discrimination. The COVID-19 pandemic has increased barriers to healthcare. Project ECHO (Extension for Community Healthcare Outcomes) is a transformative tele-education strategy that could improve HIV prevention and treatment. Methods: Practicing physicians who were aged 18 years or older and had internet access participated in asynchronous online focus groups. Results: Barriers to Project ECHO were conflicting priorities, time constraints, and technology. Facilitators included content and format, dedicated time, asynchronized flexible programming, incentives, and ensuring technology was available. Conclusion: Project ECHO is a promising intervention that can increase physicians' knowledge and skill set in specialty medicine during the COVID-19 pandemic. Interventionists in Malaysia in particular, but also in general, should consider these barriers and facilitators when developing Project ECHO as they may aid in developing a more robust program and increase participation.

Matched MeSH terms: Social Stigma
Fulltext Factors Associated with Medical Doctors' Intentions to Discriminate Against Transgender Patients in Kuala Lumpur, Malaysia

Vijay A, Earnshaw VA, Tee YC, Pillai V, White Hughto JM, Clark K, et al.

LGBT Health, 2018 01;5(1):61-68.
PMID: 29227183 DOI: 10.1089/lgbt.2017.0092

PURPOSE: Transgender people are frequent targets of discrimination. Discrimination against transgender people in the context of healthcare can lead to poor health outcomes and facilitate the growth of health disparities. This study explores factors associated with medical doctors' intentions to discriminate against transgender people in Malaysia.
METHODS: A total of 436 physicians at two major university medical centers in Kuala Lumpur, Malaysia, completed an online survey. Sociodemographic characteristics, stigma-related constructs, and intentions to discriminate against transgender people were measured. Bivariate and multivariate linear regression were used to evaluate independent covariates of discrimination intent.
RESULTS: Medical doctors who felt more fearful of transgender people and more personal shame associated with transgender people expressed greater intention to discriminate against transgender people, whereas doctors who endorsed the belief that transgender people deserve good care reported lower discrimination intent. Stigma-related constructs accounted for 42% of the variance and 8% was accounted for by sociodemographic characteristics.
CONCLUSIONS: Constructs associated with transgender stigma play an important role in medical doctors' intentions to discriminate against transgender patients. Development of interventions to improve medical doctors' knowledge about and attitudes toward transgender people are necessary to reduce discriminatory intent in healthcare settings.

Matched MeSH terms: Social Stigma*
Fulltext Relationship and career challenges faced by people infected with HIV in Malaysia

Tuan Abdullah TN, Mat Min R, Hossain M, Abdullah SS

F1000Res, 2019;8:1994.
PMID: 33214871 DOI: 10.12688/f1000research.21079.3

Background: In Malaysia, there are still lack of studies related to the challenges of people infected with HIV (PIWH). Therefore, this study was conducted to explore the experiences of PIWH and how they cope with HIV. Methods: This qualitative study was based on a social constructivist and grounded theory approach. A total of 12 PIWH were selected by purposive sampling, all of whom participated in semi-structured and audio-recorded interviews, which were supported with non-participant observations and diary entries on three occasions for each participant. The interviews and diaries were transcribed and analysed using the grounded theory approach, which was assisted by utilizing NVIVO-8 to identify the themes related to the experiences of the participants. Results: PIWH experienced challenges related to their career and relationships with family and others. These challenges led to difficulties in gaining employment and career development, as well as feelings of denial, being uncomfortable, rejection, and labelling. They found that their lives were totally and dramatically changed after being tested positive for HIV. Conclusions: Among PIWH, HIV impacted relationships with significant others and career development. The absence of support and acceptance from significant others affected the ability of PIWH to cope with their daily challenges. The results of this study have implications for policymakers in terms of gaining sufficient knowledge and awareness to provide prevention programmes for HIV/AIDS.

Matched MeSH terms: Social Stigma
Engaging with people living with HIV: challenges experienced by Malaysian counsellors

Tuan Abdullah TN, Mat Min R

AIDS Care, 2021 06;33(6):795-800.
PMID: 32338043 DOI: 10.1080/09540121.2020.1757024

People living with HIV (PLHIV) suffer from mental issues and need emotional support. Counselling is a part of HIV and AIDS care and management, and provides emotional support to PLHIV. Knowledge about HIV and AIDS care and management is not part of the counselling training curriculum in Malaysia. This study aims to explore the challenges experienced by registered counsellors who engage in counselling sessions with PLHIV. A total of five counsellors participated in this qualitative research. Data were gathered through a series of semi-structured interviews, and each of the interviews was conducted within one and half hours. Each of the participants was interviewed three times. The interviews were audio-recorded with the consent of the participants. The emergent themes were further explored in subsequent interviews until thematic saturation was reached, and data were analysed based on the grounded theory approach. The findings showed that lack of knowledge, limited training, and stigma among the registered counsellors contributed to resistance and poor trust among the PLHIV. Knowledge concerning the care and management of HIV and AIDS can be incorporated in a counselling training programme, and ongoing training related to HIV and AIDS are required.

Matched MeSH terms: Social Stigma
Fulltext Evaluating Physicians' Intention to Discriminate Against Patients Living with HIV in Malaysia

Tee YC, Earnshaw VA, Altice FL, Jin H, Kamarulzaman A, Wickersham JA

AIDS Behav, 2019 Apr;23(4):1039-1047.
PMID: 30560483 DOI: 10.1007/s10461-018-2362-4

People with HIV (PWH) in Malaysia experience high levels of stigma, which may act as a barrier to accessing healthcare. Stigma against PWH in medical settings is understudied in Malaysia. In the present study, we examine factors associated with physicians' intention to discriminate against PWH in Malaysia. A cross-sectional online survey was emailed to all 1431 physicians at two major university hospitals in Malaysia; 568 (39.6%) participants completed the survey and were included in this analysis. Measures included intention to discriminate against PWH, stigma-related constructs, and socio-demographic characteristics. Multivariate linear regression was used to identify factors associated with intention to discriminate against PWH. Participants were comprised of women (53.5%), Malays (43.1%), and Chinese (35.0%) with nearly 10 years of clinical experience. Most participants were from non-surgical specialties (77.6%). The final multivariate linear regression showed that physicians who expressed greater discriminatory intent against PWH also expressed more negative feelings toward PWH, more HIV-related shame, were more fearful of HIV, and believed that PWH do not deserve good care. Physicians from surgical-based specialties were also significantly more likely to endorse discriminatory intent toward PWH. Stigma and intentions to discriminate against a class of patients, including PWH, can undermine engagement in care, which is central to international HIV prevention and treatment strategies. Interventions that reduce stigma toward PWH among physicians are crucial to ensuring equitable and stigma-free healthcare.

Matched MeSH terms: Social Stigma*
Correlates of stigma for patients with breast cancer: a systematic review and meta-analysis

Tang WZ, Yusuf A, Jia K, Iskandar YHP, Mangantig E, Mo XS, et al.

Support Care Cancer, 2022 Dec 17;31(1):55.
PMID: 36526859 DOI: 10.1007/s00520-022-07506-4

OBJECTIVE: This study was conducted to examine the factors associated with stigma in breast cancer women.
METHODS: PubMed, Embase, the Cochrane Library, Web of Science, and two Chinese electronic databases were electronically searched to identify eligible studies that reported the correlates of stigma for patients with breast cancer from inception to July 2022. Two researchers independently performed literature screening, data extraction, and risk of bias assessment. R4.1.1 software was used for statistical analysis.
RESULTS: Twenty articles including 4161 patients were included in the systematic review and meta-analysis. Results showed that breast cancer stigma was positively correlated with working status, type of surgery, resignation coping, depression, ambivalence over emotional expression, and delayed help-seeking behavior and negatively correlated with age, education, income, quality of life, social support, confrontation coping, psychological adaptation, self-efficacy, and self-esteem. Descriptive analysis showed that breast cancer stigma was positively correlated with intrusive thoughts, body image, anxiety, and self-perceived burden but negatively correlated with a sense of coherence, personal acceptance of the disease, sleep quality, cancer screening attendance and doctor's empathy.
CONCLUSION: Many demographic, disease-related, and psychosocial variables are related to breast cancer stigma. Our view can serve as a basis for health care professionals to develop health promotion and prevention strategies for patients with breast cancer.

Matched MeSH terms: Social Stigma
Fulltext A qualitative insight of HIV/AIDS patients' perspective on disease and disclosure

Syed IA, Syed Sulaiman SA, Hassali MA, Thiruchelvum K, Lee CK

Health Expect, 2015 Dec;18(6):2841-52.
PMID: 25228140 DOI: 10.1111/hex.12268

BACKGROUND: Understanding patients' knowledge and belief towards disease could play a vital role from an outcome perspective of disease management and HIV/AIDS patients are not exception to that.

METHODS: Qualitative methodology was used to explore Malaysian HIV/AIDS patients' perspectives on disease and status disclosure. A semi structured interview guide was used to interview the patients and a saturation point was reached after the 13th interview. All interviews were audio-recorded and subjected to a standard content analysis framework.

RESULTS: Understandings and beliefs towards HIV/AIDS and Perspective on disease disclosures were two main themes derived from patients' data. Beliefs towards causes and cure emerged as sub-themes under disease understandings while reasons for disclosure and non-disclosure were resulted as main sub-themes under disease disclosure. Majority of patients apprehended HIV/AIDS and its causes to acceptable extent, there were elements of spirituality and lack of education involved with such understandings. Though beliefs existed that knowing status is better than being ignorant, fear of stigma and discrimination, social consequences and family emotions were found important elements linked to disease non-disclosure.

CONCLUSIONS: The outcomes provided basic information about patients' perceptions towards disease and status disclosure among HIV/AIDS patients which can help in the designing and improvising existing strategies to enhance disease awareness and acceptance and will also serve as baseline data for future research further focusing on this subject.

Matched MeSH terms: Social Stigma

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