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Fulltext Development of parallel scales to measure HIV related stigma in Sabah

Ei KS, Shoesmith WD

Borneo Journal of Medical Sciences, 2016;10(1):19-29.
MyJurnal

In this study parallel scales were constructed to use to measure the levels of HIV-related stigma towards people living with HIV (PLHIV) in populations with different backgrounds in Sabah. The study also explored the components of stigma within the population. We found that there were three principle components of HIV related stigma: “Interpersonal distancing,” “Shame and blame,” and “Positive opinions about PLHIV”. The scales constructed showed adequate internal consistency (Cronbach’s Alpha of 0.69 to 0.85) in all samples. The medical students and people with more knowledge about HIV had significantly lower levels of all three factors of personal stigma. Regarding HIV-related knowledge, the non-medical university students and the rural community group were found to have poor knowledge of HIV transmission and prevention. This scale can be used by researchers or public health officials who wish to study HIV related stigma or to evaluate the impact of stigma interventions in the local context.
Study site: Universiti Malaysia Sabah; Rural Medical Education Centre, Sikuati, Kudat, Sabah, Malaysia

Matched MeSH terms: Social Stigma*
Fulltext Faktor perbezaan tahap pengetahuan HIV/AIDS dan stigma pelajar GMI dan UKM mengikut tahap pendidikan

Muhammad Ajib bin Abd R, Nasrudin S

Jurnal Psikologi Malaysia, 2016;30:61-68.

HIV /AIDS is a global epidemic problem that is faced by many countries. There is a drastic increase of infection cases in children, youths, adults and elderly. Among students, there is a low level of knowledge that affects the comprehension elasticity based on the educational level which contributes to the increasing stigma among students. The focus of this study is to examine the differences of HIV/AIDS knowledge levels and students' stigma according to their levels of education. This study used HIV Knowledge Questionnaires (HIV-K-Q) version of 45 items and The Berger HIV Stigma Scale version of 40 items. 130 students from UKM and GMI participated in the study. Results showed that there were significant differences in the knowledge levels and stigma of HIV/AIDS between students' educational levels (Diploma level, Bachelor and Masters). The findings can assist educational institutions to develop the awareness of HIV/AIDS knowledge by targeting all levels of students' education. The implementation of various campaigns, talks, and interventions of reducing the stigma should be refined and planned as an annual program.

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
Fulltext Barriers faced by healthcare professionals when managing falls in older people in Kuala Lumpur, Malaysia: a qualitative study

Loganathan A, Ng CJ, Tan MP, Low WY

BMJ Open, 2015 Nov 05;5(11):e008460.
PMID: 26546140 DOI: 10.1136/bmjopen-2015-008460

OBJECTIVE: To explore the barriers faced by healthcare professionals (HCPs) in managing falls among older people (aged above 60 years) who have a high risk of falling.
RESEARCH DESIGN: The study used a qualitative methodology, comprising 10 in-depth interviews and two focus group discussions. A semistructured topic guide was used to facilitate the interviews, which were audio recorded, transcribed verbatim and checked for accuracy. Data were analysed thematically using WeftQDA software.
PARTICIPANTS: 20 HCPs who managed falls in older people.
SETTING: This study was conducted at the Primary Care Clinic in the University Malaya Medical Centre (UMMC), Malaysia.
RESULTS: Four categories of barriers emerged-these were related to perceived barriers for older people, HCPs' barriers, lack of caregiver support and healthcare system barriers. HCPs perceived that older people normalised falls, felt stigmatised, were fatalistic, as well as in denial regarding falls-related advice. HCPs themselves trivialised falls and lacked the skills to manage falls. Rehabilitation was impeded by premature decisions to admit older people to nursing homes. Lastly, there was a lack of healthcare providers as well as a dearth of fall education and training on fall prevention for HCPs.
CONCLUSIONS: This study identified barriers that explain poor fall management in older people with a high risk of falls. The lack of structured fall prevention guidelines and insufficient training in fall management made HCPs unable to advise patients on how to prevent falls. The findings of this study warrant evidence-based structured fall prevention intervention targeted to patients as well as to HCPs.

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*
Fulltext HIV-related stigma and discriminatory attitudes among a semi-urban population

Lugova H, Mon AA, Daher AM, Suleiman A

Malays J Med Sci, 2015 Sep;22(5):64-69.
PMID: 28239270

BACKGROUND: Stigma and discriminatory attitudes (SDAs) have a negative impact on human immunodeficiency virus (HIV) prevention, testing, and treatment as well as on family and social networks. There is a lack of understanding about HIV-related SDAs among people living outside large cities. This study is aimed to determine the level of HIV-related SDAs among a semi-urban population in Malaysia and to compare the SDA results among people with different sociodemographic characteristics.

METHODS: A sample of 106 respondents was generated by convenience sampling during the screening campaign in Alor Gajah, Malaysia. Data collection was carried out based on a pre-tested questionnaire via face-to-face interviews.

RESULTS: More than half of the respondents (62.3%) thought that an HIV-positive teacher should not be allowed to continue teaching at school; 81.1% were unsure or were unwilling to care for their family member with AIDS at home; 81.2% thought children with HIV/AIDS should not continue to be raised in families; and 77.3% thought they would not reveal if a family member had HIV/AIDS.

CONCLUSION: Priority should be given to evidence-based interventions to reduce HIV-related SDAs. This study did not reveal any significant relationship between sociodemographic profiles and HIV-related SDAs. Therefore, further research with a larger sample size is needed to investigate the underlying causes of HIV-related SDAs.

Matched MeSH terms: Social Stigma
Development and Psychometric Properties of a Tuberculosis-Specific Multidimensional Health-Related Quality-of-Life Measure for Patients with Pulmonary Tuberculosis

Abdulelah J, Sulaiman SAS, Hassali MA, Blebil AQ, Awaisu A, Bredle JM

Value Health Reg Issues, 2015 May;6:53-59.
PMID: 29698193 DOI: 10.1016/j.vhri.2015.03.006

BACKGROUND: Various generic instruments exist to assess health-related quality of life (HRQOL) in patients with tuberculosis (TB), but a psychometrically sound disease-specific instrument is lacking.

OBJECTIVES: The present study aimed to develop and psychometrically validate a multidimensional TB-specific HRQOL instrument relevant to the value of patients with pulmonary TB in Iraq with an eye toward cross-cultural application.

METHODS: The core general HRQOL questionnaire is composed of the Functional Assessment of Cancer Therapy-General items. A modular approach was followed for the development of the Functional Assessment of Chronic Illness Therapy-Tuberculosis (FACIT-TB) questionnaire in which a set of items assessing quality-of-life (QOL) issues not sufficiently covered by the core Functional Assessment of Cancer Therapy-General items, but considered to be relevant to the target population, was added. Moreover, principal-component analysis was used to determine the new subscale structure of the questionnaire.

RESULTS: In addition to the 27 items of the core questionnaire, a set of 20 items referring to disease symptoms related to the site of infection, adverse effects, and additional QOL dimensions such as fatigue, social stigma, and economic burden of the illness was included. Factor analysis demonstrated that the FACIT-TB construct comprised five domains.

CONCLUSIONS: A rigorous method was applied in the development of the FACIT-TB measure to fully understand the impact of TB on patients' QOL. The instrument is psychometrically sound and portrays multiple important dimensions of HRQOL. FACIT-TB is relatively brief, is easy to administer and score, and is appropriate for use in clinical trials and practice.

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
Fulltext HIV/AIDS Related Stigma and Discrimination against PLWHA in Nigerian Population

Dahlui M, Azahar N, Bulgiba A, Zaki R, Oche OM, Adekunjo FO, et al.

PLoS One, 2015;10(12):e0143749.
PMID: 26658767 DOI: 10.1371/journal.pone.0143749

HIV/AIDS remain a major public health concern in Nigeria. People living with HIV/AIDS (PLWHA) face not only personal medical problems but also social problems associated with the disease such as stigma and discriminatory attitudes. This study provides an insight into HIV/AIDS related stigma and discrimination against PLWHA in Nigeria.

Matched MeSH terms: Social Stigma
Fulltext Reducing stigma towards people with mental illness in Malaysia

Lim, Sheri

ASEAN Journal of Psychiatry, 2015;16(2):261-264.
MyJurnal

Mental illness accounts for 12% of the global burden of disease with a reported 1 in 5 Malaysians suffering from a psychological disorder. Sufferers have been long plagued by stigma, which results in social isolation, low-selfesteem, lower opportunities for employment, housing, and ability to achieve life goals. This essay aims to suggest strategies to overcome such stigma in the local setting. Methods: Literature search was conducted through PubMed (http://www.ncbi.nlm.nih.gov/pubmed) and Google Scholar (http://scholar.google.com.my). Data obtained was compiled as an opinion piece. Results: Thefactors contributing to stigma in Malaysia include a lack of public knowledge, language and cultural influences, inaccurate media portrayal, doctors’ attitudes towards the field of psychiatry, and psychiatrists themselves. Stigma can be tackled in four areas: society, media, medical education, and the field of psychiatry. Firstly, psychiatric terminology can be adapted to local languages and cultural beliefs in order to avoid misconceptions. Secondly, public education is more effective if focused to targeted key groups. The media is crucial in influencing the public mind-set, and needs to be creatively engaged. Thirdly, more positive medical practitioner attitudes to mental illness can be moulded through early psychiatric postings during medical school. Finally, psychiatrists play a role in correcting misconceptions, avoiding misdiagnosis and ineffective treatments. Cultural competency leads to better management of patients by awareness towards socio-cultural and religious influences. Conclusion: A multifaceted, united coalition of effort is needed in order to tackle stigma in different contexts, and will require concerted leadership from different parties.

Matched MeSH terms: Social Stigma
Public stigma towards patients with schizophrenia of ethnic Malay: a comparison between the general public and patients' relatives

Razali SM, Ismail Z

J Ment Health, 2014 Aug;23(4):176-80.
PMID: 24784779 DOI: 10.3109/09638237.2014.910644

The stigma attached to mental disorders has been recognized as a major concern in healthcare services across societies.

Matched MeSH terms: Social Stigma*
Fulltext Exploring intentions to discriminate against patients living with HIV/AIDS among future healthcare providers in Malaysia

Earnshaw VA, Jin H, Wickersham J, Kamarulzaman A, John J, Altice FL

Trop Med Int Health, 2014 Jun;19(6):672-679.
PMID: 24666546 DOI: 10.1111/tmi.12306

OBJECTIVES: Stigma towards people living with HIV/AIDS (PLWHA) is strong in Malaysia. Although stigma has been understudied, it may be a barrier to treating the approximately 81 000 Malaysian PLWHA. The current study explores correlates of intentions to discriminate against PLWHA among medical and dental students, the future healthcare providers of Malaysia.
METHODS: An online, cross-sectional survey of 1296 medical and dental students was conducted in 2012 at seven Malaysian universities; 1165 (89.9%) completed the survey and were analysed. Socio-demographic characteristics, stigma-related constructs and intentions to discriminate against PLWHA were measured. Linear mixed models were conducted, controlling for clustering by university.
RESULTS: The final multivariate model demonstrated that students who intended to discriminate more against PLWHA were female, less advanced in their training, and studying dentistry. They further endorsed more negative attitudes towards PLWHA, internalised greater HIV-related shame, reported more HIV-related fear and disagreed more strongly that PLWHA deserve good care. The final model accounted for 38% of the variance in discrimination intent, with 10% accounted for by socio-demographic characteristics and 28% accounted for by stigma-related constructs.
CONCLUSIONS: It is critical to reduce stigma among medical and dental students to eliminate intentions to discriminate and achieve equitable care for Malaysian PLWHA. Stigma-reduction interventions should be multipronged, addressing attitudes, internalised shame, fear and perceptions of deservingness of care.
KEYWORDS: HIV/AIDS; Malaisie; Malasia; Malaysia; VIH/SIDA; cuidados sanitarios profesionales; discriminación; discrimination; estigma; homosexuality; professional healthcare students; stigma; stigmatisation; substance abuse; étudiants en profession de soins de santé

Matched MeSH terms: Social Stigma*
Fulltext An assessment of health-care students' attitudes toward patients with or at high risk for HIV: implications for education and cultural competency

Jin H, Earnshaw VA, Wickersham JA, Kamarulzaman A, Desai MM, John J, et al.

AIDS Care, 2014;26(10):1223-8.
PMID: 24625279 DOI: 10.1080/09540121.2014.894616

Stigma perpetuated by health-care providers has been found to be a barrier to care for vulnerable populations, including HIV-infected, people who inject drugs (PWIDs), and men who have sex with men (MSM) in multiple clinical contexts and remains unexamined among professional health-care students in Malaysia. This cross-sectional, anonymous, and Internet-based survey assessed the attitudes of medical and dental students toward HIV-infected, PWID, and MSM patients. Survey invitation was emailed to 3191 students at 8 professional schools; 1296 (40.6%) responded and scored their attitudes toward these patient groups using a feeling thermometer, indicating their attitudes on a sliding scale from 0 (most negative) to 100 (most positive). Compared to general patients (mean = 76.50), the mean scores for HIV-infected (mean = 54.04; p < 0.001), PWID (mean = 37.50; p < 0.001), and MSM (mean = 32.13; p < 0.001) patients were significantly lower and significantly different between each group comparison. Within group differences, most notably religion, ethnicity, and personally knowing someone from these populations were associated with significant differences in attitudes. No differences were noted between pre-clinical and clinical year of training. Health-care students represent the next generation of clinicians who will be responsible for future HIV prevention and treatment efforts. Our findings suggest alarmingly negative attitudes toward these patients, especially MSM, necessitating prompt and effective interventions designed to ameliorate the negative attitudes of health-care students toward vulnerable populations, specifically HIV-infected, PWID, and MSM patients in Malaysia.
Site site: online surveys at seven universities: University of Malaya, National University of Malaysia, International Islamic University Malaysia, Universiti Malaysia Sarawak, Penang International Dental College, Universiti Teknologi MARA Malaysia, and Universiti Sains Malaysia.

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
Fulltext Epilepsy stigma in Asia: the meaning and impact of stigma

Lim, Kheng-Seang, Tan, Chong-Tin

Neurology Asia, 2014;19(1):1-10.
MyJurnal

Stigma is conceptually broad and culturally variable. Understanding stigma from the conceptual theories, culturally application based on the word stigma in other languages, the definition of stigma and its synonyms, as well as the medical implications in other stigmatized disease such as AIDS, will help us to understand the complexity of stigma in epilepsy. This review investigated the meaning and types of stigma from different perspectives, leading to staging stigma into 5 levels, i.e. social identity, stereotype, prejudice, discrimination and social disability. In addition to the conventional categorization of stigma into social, felt, self-perceived or internalized stigma, new categories of stigma i.e. personal and general attitudes towards epilepsy based on a newly developed Public Attitudes Toward Epilepsy (PATE) scale was introduced. Courtesy stigma was further elaborated in related to Asian culture. Based on well-established and recently developed theories, the causation and impact of epilepsy stigma was discussed in an Asian context, especially from the aspects of language and society values which are culturally specific. Integrating these theories of causation, illness and stereotype perceptions were proposed to be the mediating mechanism of stigma, which led to the development of a practical and multi-dimensional stigmatization model, aiming to guide, widen and deepen the scope of future stigma research in epilepsy. Using the established model, together with review of related studies, research priorities in epilepsy stigma research especially in Asia focusing on five aspects, i.e. expanding population studies especially on significant others, understanding stigma from personal attitude perspective, investigating the cultural and social causation of stigma, and the impacts of stigma on patients as well as the family members, were proposed.

Matched MeSH terms: Social Stigma
Fulltext Physical and psychosocial impacts of pregnancy on adolescents and their coping strategies: a descriptive study in Kuala Lumpur, Malaysia

Su XV, Muhammad NA, Tan PS, Tan KTM, Tohid H, Omar K

Malaysian Journal of Public Health Medicine, 2014;14(3):0-0.
MyJurnal

Teenage pregnancy carries serious impacts on adolescent health. This study aimed to examine the effects of pregnancy on adolescents and to explore how they cope with the problems they faced during the pregnancy. It involved 26 adolescents residing in a government shelter home in Kuala Lumpur. A self-administered questionnaire containing a mixture of open- and closed-ended questions was used. Among physical (sleeping problem and self-care problem), psychological (emotional difficulties and low self-efficacy) and social (stigma and discrimination, financial difficulty, friendship problem and school dropout) problems, emotional difficulties were the most common problems, whereas stigma and discrimination was the least common. Young adolescents aged less than 16 years old were significantly associated with poor self-care (p=0.01). To cope with their problems, the adolescents generally used avoidance, withdrawal, and social support, particularly from parents and peers. Doctors were the least popular among all. In conclusion, holistic and individualised care is needed. Strategies to reduce emotional problem experienced by pregnant adolescents should be implemented. The available healthcare services for teenage pregnancy should also be promoted.

Matched MeSH terms: Social Stigma
Fulltext The experiences and challenges in caring for HIV/AIDS patients: a qualitative exploration among Muslim family caregivers in Terengganu, Malaysia

Pei, Lin Lua, Norhayati Mustapha, Ramle Abdullah, Ahmad Kashfi Abdul Rahman

ASEAN Journal of Psychiatry, 2014;15(2):120-130.
MyJurnal

Objective: The family caregiver has a pivotal role in the management of HIV/AIDS patients and their well-being is consequently crucial as it could impact negatively on the quality of caregiving. This preliminary qualitative investigation intended to explore and describe the challenges and experiences of HIV/AIDS family caregivers in Terengganu, Malaysia. Methods: A convenient sample of family caregivers of HIV/AIDS patients who were aware of the diagnosis was enrolled. Recruitment was conducted in Hospital Sultanah Nur Zahirah, Kuala Terengganu, Malaysia and semi-structured interviews were used. Results: Results were transcribed into verbatim before being subjected to analysis. Twelve Muslim caregivers consented participation (age range = 18.0 - 81.0; female = 75.0%, mother/wife = 50.0%; married = 83.3%; ≤ primary school
= 50.0%; and self-employed = 66.7%). The four major themes that emerged were challenges of caregiving, financial issues, stigma and discrimination, and support for caregivers. Additionally, caregivers did mention several positive aspects of their caregiving role including satisfaction from helping family member and improved family relationships. Conclusion: A variety of life aspects were negatively affected by caring for HIV patients, thus requiring a multidisciplinary approach to address such issues. ASEAN Journal of Psychiatry, Vol. 15 (2): July - December 2014: 120-130.

Matched MeSH terms: Social Stigma
Fulltext Factors influencing insulin acceptance among type 2 diabetes mellitus patients in a primary care clinic: a qualitative exploration

Abu Hassan H, Tohid H, Mohd Amin R, Long Bidin MB, Muthupalaniappen L, Omar K

BMC Fam Pract, 2013;14:164.
PMID: 24164794 DOI: 10.1186/1471-2296-14-164

BACKGROUND: Many Type 2 Diabetes Mellitus (T2DM) patients refuse insulin therapy even when they require this modality of treatment. However, some eventually accept insulin. This study aimed to explore the T2DM patients' reasons for accepting insulin therapy and their initial barriers to use insulin.
METHODS: This qualitative study interviewed twenty-one T2DM patients at a primary care clinic who had been on insulin for more than a year through three in-depth interviews and three focus group discussions. A semi structured interview protocol was used and the sessions were audio-recorded. Subsequently, thematic analysis was conducted to identify major themes.
RESULTS: The participants' acceptance of insulin was influenced by their concerns and beliefs about diabetes and insulin. Concerns about complications of poorly controlled diabetes and side effects of other treatment regime had resulted in insulin acceptance among the participants. They also had a strong belief in insulin benefits and effectiveness. These concerns and beliefs were the results of having good knowledge about the diabetes and insulin, experiential learning, as well as doctors' practical and emotional support that helped them to accept insulin therapy and become efficient in self-care management. These factors also allayed their negative concerns and beliefs towards diabetes and insulin, which were their barriers for insulin acceptance as it caused fear to use insulin. These negative concerns were related to injection (self-injection, needle phobia, injection pain), and insulin use (inconvenience, embarrassment, lifestyle restriction, negative social stigma, and poor self-efficacy), whereas the negative beliefs were 'insulin could cause organ damage', 'their diabetes was not serious enough', 'insulin is for life-long', and 'insulin is for more severe disease only'.
CONCLUSIONS: Exploring patients' concerns and beliefs about diabetes and insulin is crucial to assist physicians in delivering patient-centered care. By understanding this, physicians could address their concerns with aim to modify their patients' misconceptions towards insulin therapy. In addition, continuous educations as well as practical and emotional support from others were found to be valuable for insulin acceptance.
TRIAL REGISTRATION: Universiti Kebangsaan Malaysia FF-214-2009.
Study site: Primary Care clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia

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
Fulltext Assessing HIV/AIDS knowledge and stigmatizing attitudes among medical students in Universiti Putra Malaysia

Chew BH, Cheong AT

Med J Malaysia, 2013;68(1):24-9.
PMID: 23466762 MyJurnal

OBJECTIVE: Medical students are future doctors who are trained to treat all kind of diseases including people living with HIV/AIDS (PLWHA) without prejudice. This study was to determine the factors associated with knowledge on HIV/AIDS and stigma towards PLWHA among medical students.
METHODS: This was a cross sectional study with stratified random sampling conducted in a public university, Malaysia. The participants were preclinical-year (year 1 and year 2) and clinical-year (year 3 and year 4) medical students. Simple randomisation was carried out after stratification of medical students into preclinical and clinical-year. The self-administered questionnaires were consisted of socio-demographic data, items assessing HIV/AIDS knowledge and items assessing stigmatisation attitudes towards PLWHA.
RESULTS: We had 100% response rate of 340 participants. Pre-clinical and clinical year medical students each contributed 170 (50%). Majority was female (64.1%). About two-thirds (60.6%) was Malay, followed by Chinese (31.2%) and Indian (7.1%). Pre-clinical students were significantly more stigmatizing in subscale of "attitudes towards imposed measures" (t=3.917, p<0.001), even with adjustment for previous encounter and ethnicity (B= 1.2, 95% CI 0.48 to 1.83, p=0.001). On the other hand, clinical students were found to be significantly less comfortable in handling HIV/AIDS cases (t=0.039, p=0.039), even after controlled for previous encounter and ethnicity (B=0.6, 95% CI 0.29 to 0.98, p< 0.001).
CONCLUSION: Clinical encounter with PLWHA was associated with higher knowledge in HIV/AIDS. Medical students in preclinical years were having stigmatizing attitude towards imposed measures compared to the clinical years who had more stigmatizing attitude in being less comfortable with PLWHA.

Matched MeSH terms: Social Stigma

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