Challenges to ART scale-up in a rural district in Tanzania: Stigma and distrust among Tanzanian health care workers, people living with HIV and community members

Tropical Medicine and International Health

Volumn 15, Issue 9, 2010, Pages 1000-1007

  Agnarson, Abela Mpobela ^a   Masanja, Honorati ^b   Ekström, Anna Mia ^a   Eriksen, Jaran ^a   Tomson, Göran ^a   Thorson, Anna ^a  

^a KAROLINSKA INSTITUTE   (Sweden)

^b IFAKARA HEALTH INSTITUTE   (Tanzania)

Author keywords

ART related stigma; attitudes towards ART patients; health care workers; people living with HIV; sexual behaviour; sub Saharan Africa

Indexed keywords

DISEASE TREATMENT; HEALTH CARE; HEALTH WORKER; HUMAN IMMUNODEFICIENCY VIRUS; PERCEPTION; RURAL AREA; SEXUAL BEHAVIOR; SOCIAL CONFLICT; SUSTAINABILITY;

ADOLESCENT; ADULT; ARTICLE; ATTITUDE TO HEALTH; FEMALE; HEALTH BEHAVIOR; HEALTH CARE AVAILABILITY; HEALTH CARE PERSONNEL; HEALTH PERSONNEL ATTITUDE; HIGH RISK BEHAVIOR; HIGHLY ACTIVE ANTIRETROVIRAL THERAPY; HUMAN; HUMAN IMMUNODEFICIENCY VIRUS INFECTION; INTERVIEW; MAJOR CLINICAL STUDY; MALE; PROGRAM DEVELOPMENT; RURAL AREA; SCALE UP; SEXUAL BEHAVIOR; STIGMA; TANZANIA; TRUST;

ADOLESCENT; ADULT; ANTI-RETROVIRAL AGENTS; ATTITUDE OF HEALTH PERSONNEL; FEMALE; HEALTH KNOWLEDGE, ATTITUDES, PRACTICE; HEALTH SERVICES ACCESSIBILITY; HIV INFECTIONS; HUMANS; MALE; MIDDLE AGED; PATIENT ACCEPTANCE OF HEALTH CARE; PREJUDICE; RURAL HEALTH; RURAL HEALTH SERVICES; SEXUAL BEHAVIOR; TANZANIA; YOUNG ADULT;

SAHARA; TANZANIA;

EID: 77955393693     PISSN: 13602276     EISSN: 13653156     Source Type: Journal    
DOI: 10.1111/j.1365-3156.2010.02587.x     Document Type: Article

References (37)

1. Angrosino M (2007) Doing Ethnographic and Observational Research. Sage Publications Ltd, London.
2. Atuyambe L, Neema S, Otolok-Tanga E, Wamuyu-Maina G, Kasasa S, Wabwire-Mangen F (2008) The effects of enhanced access to antiretroviral therapy: a qualitative study of community perceptions in Kampala city, Uganda. African Health Sciences 8, 13 19.
3. Banteyerga H, Kidanu A Abebe F (2005) Perceived stigmatization and discrimination by health care providers toward persons with HIV/AIDS. Miz-Hasab Research Center, Addis Ababa, IntraHealth International, USAID.
4. Castro A Farmer P (2005) Understanding and addressing AIDS-related stigma: from anthropological theory to clinical practice in Haiti. American Journal of Public Health 95, 53 59.
5. Delobelle P, Rawlinson J, Ntuli S, Malatsi I, Decock R Deporter AM (2009) HIV/AIDS knowledge, attitudes, practices and perceptions of rural nurses in South Africa. Journal of Advanced Nursing 65, 1061 1073.
6. Dootson S (1995) An in-depth study of triangulation. Journal of Advanced Nursing 22, 183 187.
7. Eisele T, Mathews C Chopra M (2008) High levels of risk behavior among people living with HIV initiating and waiting to start antiretroviral therapy in Cape Town South Africa. AIDS and Behavior 12, 570 577.
8. Ezekiel MJ, Talle A, Juma JM Klepp KI (2009) "When in the body, it makes you look fat and HIV negative": the constitution of antiretroviral therapy in local discourse among youth in Kahe, Tanzania. Social Science & Medicine 68, 957 964.
9. Graneheim UH Lundman B (2004) Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Education Today 24, 105 112.
10. Gray RH, Li X Wawer MJ (2003) Stochastic simulation of the impact of antiretroviral therapy and HIV vaccines on HIV transmission; Rakai, Uganda. AIDS 17, 1941 1951.
11. Greenbaum T (1999) Moderating Focus Groups: A Practical Guide for Group Facilitation. Sage Publications Inc, CA.
12. Hargreaves JR, Linda AM Jane C (2002) Socioeconomic status and risk of HIV infection in an urban population in Kenya. Tropical Medicine & International Health 7, 793 802.
13. Heywood MJ (2005) The routine offer of HIV counseling and testing: a human right. Health and Human Rights 8, 13 19.
14. Horsman JM Sheeran P (1995) Health care workers and HIV/AIDS: a critical review of the literature. Social Science & Medicine 41, 1535 1567.
15. Kalichman SC Simbayi LC (2003) HIV testing attitudes, AIDS stigma, and voluntary HIV counselling and testing in a black township in Cape Town, South Africa. Sexually Transmitted Infections 79, 442 447.
16. Kalichman SC, Simbayi L Cain D (2009) HIV transmission risk behaviours among HIV seropositive sexually transmitted infection clinic patients in Cape Town, South Africa. European Journal of Public Health ckp127.
17. Kober K Van Damme W (2004) Scaling up access to antiretroviral treatment in southern Africa: who will do the job? The Lancet 364, 103 107.
18. Letamo G (2005) The Discriminatory Attitudes of Health Workers against People Living with HIV. PLoS Medicine 2, e261.
19. Meena R (2009) Paid Care Workers in Tanzania: A general description of nurses and home base care givers. Available at: http://www.hrhresourcecenter. org/node/2684 (accessed 24 June 2010).
20. MOH T (2003) Burden of Disease Profile- Coastal Zone - TEHIP Coastal Sentinel Surveillance System Data for 2002. Available at: http://www.ihi.or.tz/ docs/TzHIV-MalariaIndicatorSurvey-07-08-PreliminaryReport.pdf (accessed 5 July 2010).
21. MOH T (2008) Tanzania HIV/AIDS and Malaria Indicator Survey 2007-2008. Available at: http://www.ihi.or.tz/docs/TzHIV-MalariaIndicatorSurvey-07-08- PreliminaryReport.pdf (accessed 12 December 2008).
22. Moszynski P (2008) International protocols are needed to boost public confidence in universal HIV testing. BMJ 337, a2680.
23. Mschana GH (2006) Barriers to accessing antiretroviral therapy in Kisesa, Tanzania: a qualitative study of Early rural referrals to the national program. AIDS Patient Care and STDs 20, 649 657.
24. Mustone L (2007) Public Health and Clinical Medicine, Epidemiology and Public Health Sciences. Umeå: OPEN CODE. Available at: http://www.umu.se/phmed/epidemi/forskning/open-code.html (accessed 20 February 2008).
25. NBS T (2002) Household budget survey 2000/01.
26. Obermeyer CM Osborn M (2007) The utilization of testing and counseling for HIV: a review of the social and behavioral evidence. American Journal of Public Health 97, 1762 1774.
27. Ojikutu B, Makadzange A Gaolathe T (2008) Scaling up ART treatment capacity: lessons learned from South Africa, Zimbabwe, and Botswana. Current HIV/AIDS Reports 5, 94 98. (Pubitemid 351656423)
28. Patton M (2002) Qualitative Research & Evaluation Methods. Sage Publications, Inc, CA.
29. Reis C, Heisler M, Amowitz LI et al. (2005) Discriminatory attitudes and practices by health workers toward patients with HIV/AIDS in Nigeria. PLoS Medicine 2, e246.
30. Roura M, Urassa M, Busza J, Mbata D, Wringe A Zaba B (2008) Scaling up stigma? The effects of antiretroviral roll-out on stigma and HIV testing. Early evidence from rural Tanzania. Sexually Transmitted Infections sti.2008.033183.
31. Sadoh AE, Sadoh WE, Fawole AO, Oladimeji A Sotiloye O (2009) Attitude of health care workers to patients and colleagues infected with human immunodeficiency virus. SAHARA J 6, 17 23.
32. Somi G, Matee M Makene CI (2009) Three years of HIV/AIDS care and treatment services in Tanzania:achievements and challenges. Tanzania Journal of Health Research 11, 136s.
33. UNAIDS (2009) AIDS Epidemic Update December 2009. Available at: http://data.unaids.org/pub/Report/2009/JC1700-Epi-Update-2009-en.pdf.
34. UNGASS (2008) UNGASS Country Progress report Tanzania Mainland, reporting period jan 2006-dec 2007.
35. Wolfe WR, Weiser SD, Leiter K et al. (2008) The impact of universal access to antiretroviral therapy on HIV stigma in Botswana. American Journal of Public Health 98, 1865 1871.
36. Worthington C Myers T (2003) Factors underlying anxiety in HIV testing: risk perceptions, stigma, and the patient-provider power dynamic. Qualitative Health Research 13, 636 655.
37. Wringe A (2008) Uptake of HIV voluntary counselling and testing services in rural Tanzania: implications for effective HIV prevention and equitable access to treatment. Tropical Medicine and International Health 13, 319 327.