Socio-Economic Impact of HIV and AIDS in Tamil nadu

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hiring and promotion practices and work allocation, establishment of unfair benefit packages and negative attitude of employers, co-workers and managers. In the present study, details about the type of discrimination faced by the PLWHA in the workplace, attitude of employers and their colleagues were gathered from those who were currently employed. Table 8.7 Distribution of the PLWHA according to their work status Characteristics Number Percent Currently working 363 76.0 Never employed 57 11.9 Stopped working 58 12.1 at the time of survey Total 478 100 Table 8.8 Distribution of PLWHA by disclosure of status and discrimination faced at workplace Characteristics Percentage of PLWHA who changed the job after testing HIV-positive Percentage of PLWHA who disclosed their HIV status to the employer Percentage of PLWHA who faced discrimination Percentage of PLWHA receiving support from employer About 12 percent of the respondents were never employed. The workplace, which is considered to be the second home and where an individual spends his maximum time, is a microcosm of the whole community, which mirrors societal attitudes. (in Percentages) HIV household Rural Urban Total 11.3 13.4 12.2 18.5 27.5 22.6 14.3 8.6 11.1 75.0 85.7 81.0 The PLWHA who were currently employed were asked whether they changed their job after they were tested positive. As seen in Table 8.8, only about 12 percent had changed jobs and this percentage is more or less the same for urbanites as well as rural folk. Only 23 percent of the PLWHA who are currently employed have disclosed their HIV status to their employers and the main reason for not disclosing their HIV status is the fear of losing the job. It may be surprising to know that only a small percentage of those who have disclosed their HIV status have reported that they have faced discrimination and in fact many of them, especially in the urban areas, have reported that they are receiving support from their employers. This could be due to the fact that a number of them are working in a protective environment with NGOs and institutes which are in the field of HIV and AIDS. These employees are receiving support in the form of reimbursement of medical expenditure and paid leave. In the FGD, many of the participants informed that they had not disclosed their HIV-positive status to their employers fearing discrimination. However, some women working as labourers mentioned that neither those who were working with them nor their employers treat them badly or differently although they are unable to attend to work on many days due to ill health. 8.6.3 Discrimination at health facilities The healthcare setting has emerged as the most frequently encountered place of discrimination, followed by familial and community contexts. The various forms of discrimination in a health facility include refusal of treatment, discriminatory precautions and lack of confidentiality. Doctors often refuse to aid in the delivery of a positive pregnant woman, despite 114 Socio-Economic Impact of HIV and AIDS in Tamil Nadu, India
minimal risk of contracting the infection (ILO 2003). The discrimination can also appear in the form of refusal to touch a patient, levying additional charges, and agreeing to treat only if the mode of infection was not sexual. In a study conducted in Mumbai and Bangalore, many healthcare providers and facilities were found to deny care, treat patients poorly, and stipulate conditions for agreeing to treat HIV patients (Bharat et al 2001). Table 8.9 presents percentage distribution of PLWHA reporting discrimination at health facilities in Tamil Nadu. About 17 percent of male and 11 percent of female PLWHA in Tamil Nadu reported that they had faced discrimination at healthcare facilities although there is no urban/rural divide. Among those reporting discrimination at health Table 8.9 Distribution of PLWHA reporting discrimination at health facilities (in Percentages) Characteristics Rural Urban Total Male Female Male Female Male Female PLWHA reporting discrimination at health 17 11.1 17.2 10.8 17.1 11 facilities Place of discrimination PHC/CHC 17.4 14.3 -- 11.1 8.7 13 Government hospital 56.5 64.3 82.6 77.8 69.6 69.6 Private doctor/hospital 26.1 21.4 17.4 11.1 21.7 17.4 Type of discrimination* 1 Neglected, isolated 16.7 16.7 31.7 23.5 24.7 19.5 2 Verbally or physical abused, teased 22.2 20.9 9.8 23.5 15.6 21.9 3 Refused medical treatment 19.4 16.7 12.2 17.6 15.6 17.1 4 Referred to another health facility 22.2 16.7 21.9 23.5 22.1 19.5 5 Refused access to basic facilities -- 4.2 2.4 -- 1.3 2.4 6 Unnecessary use of protective gear 11.1 16.7 12.2 5.9 11.7 12.2 7 Others** 8.3 8.3 9.8 5.9 9.1 7.3 Attitude of other patients 1 Neglected, isolated 11.5 21.4 40.7 25 26.4 23.1 2 Verbally or physically abused, teased 3.8 -- 3.7 8.3 3.8 3.8 3 Refused to seek treatment with HIV -- -- 14.8 8.3 7.5 3.8 4 Restrictions on movement in ground -- 7.1 3.7 -- 1.9 3.8 5 Status not known to others 19.2 14.3 14.8 25 17 19.2 6 Not discriminated 53.8 50 22.2 16.7 37.7 34.6 7 Others (refused to seek treatment along 11.5 7.1 -- 16.7 5.7 11.5 with PLWHA) Reporting denial of admission at health facility 3 4 8.2 3.6 5.6 3.8 *Multiple Responses **Others include refused access to facilities like toilets and common eating and drinking utensils, non admission, shunting between wards/hospitals, doctor did not touch/gave wrong information Stigma and Discrimination 115
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Socio-Economic IMPACT of HIV and AI
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© United Nations Development Progr
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Acknowledgements This report would
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CHAPTER 6 Impact of HIV and AIDS on
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Table 5.2 Average per capita per mo
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Table 8.2 Distribution of sample PL
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Executive Summary Introduction AIDS
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The work force participation rate r
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In the HIV households, both the rat
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discrimination. This discrimination
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2 Socio-Economic Impact of HIV and
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Tamil Nadu has been identified as o
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Table 1.3 Source of infection in Ta
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interviewed for the study. A detail
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Household selections were made with
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In o rd e r t o s e l e c t t h e n
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Chapter 3 Profile of Sample Househo
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Table 3.3 Distribution of sample ho
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households use firewood. Liquified
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Table 3.7 Current and the past occu
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Table 4.1 Distribution of sample ho
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income class, it is seen that while
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That the impact of the epidemic is
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Table 4.6 Change in job due to HIV
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Table 4.9 The situation with respec
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Most of the loss in income has been
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Occupational category Table 4.13 Lo
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4.6 Observations The prevalence of
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lesser than that of non-HIV househo
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Table 5.3 ...(Contd.) HIV household
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Table 5.4 ..... (Contd.) HIV househ
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Table 5.5 Distribution of consumpti
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Table 5.6 Distribution of consumpti
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While the non-HIV households are po
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Table 5.7 .... (Contd.) HIV househo
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Page 86 and 87: Table 5.10 Distribution of savers a
Page 88 and 89: households is, however, the highest
Page 90 and 91: growth of CPI in 2004-05 over 1999-
Page 92 and 93: the expenditure of households that
Page 94 and 95: While the burden of illness is bein
Page 96 and 97: 76 Socio-Economic Impact of HIV and
Page 98 and 99: impact is measured not only by aski
Page 100 and 101: Annual household income (Rs) Age 6-
Page 102 and 103: The percentage of girls from HIV ho
Page 104 and 105: In both HIV and non-HIV households,
Page 107 and 108: Impact of HIV and AIDS on Health
Page 109 and 110: Chapter 7 Impact of HIV and AIDS on
Page 111 and 112: 7.1.2 Prevalence rates of illnesses
Page 113 and 114: 7.2 Details about nonhospitalised i
Page 115 and 116: Again, it is seen that fever remain
Page 117 and 118: Table 7.9 Distribution of non-hospi
Page 119 and 120: Table 7.12 Frequency of hospitalisa
Page 121 and 122: It is seen that both in rural and u
Page 123 and 124: Table 7.18 Distribution of hospital
Page 125 and 126: Stigma and Discrimination, Knowledg
Page 127 and 128: Chapter 8 Stigma and Discrimination
Page 129 and 130: 8.3 Reaction to HIV status 8.3.1 In
Page 131 and 132: from counsellors helped them to com
Page 133: provide supportive environment for
Page 137 and 138: Table 8.10 Distribution of responde
Page 139 and 140: Table 8.12 Distribution of responde
Page 141 and 142: to mingle with children belonging t
Page 143 and 144: Conclusion and Policy Implications
Page 145 and 146: Chapter 9 Conclusion and Policy Imp
Page 147 and 148: also reluctant to divulge their sta
Page 149 and 150: Annexures Conclusion and Policy Imp
Page 151 and 152: Annexures Annexure I Summary of foc
Page 153 and 154: Discrimination at workplace Many of
Page 155 and 156: that now. One of the participants w
Page 157 and 158: Annexure II Box 1 Case study 1: Tam
Page 159 and 160: Box 2 Case Study 2: From riches to
Page 161: United Nations Development Programm
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Socio-Economic Impact of HIV and AIDS in Tamil nadu

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