PLHIV Stigma Index in Nepal

Felt pressure to discloseHIV statusDevelopment regionEastern Central WesternFelt pressure from other individuals not living with HIVMid-WesternFar-WesternOften (%) 0.7 2.2 5.0 — 0.6 2.3A few times (%) 5.3 11.8 8.9 3.5 3.3 7.3Once (%) — 0.5 0.8 3.5 1.1 .8TotalNever (%) 94.1 85.5 85.3 93.0 95.0 89.6N 152 186 259 57 181 835When asked whether they were aware of any incident wherein a health worker had disclosedtheir HIV status to others, 12% of the respondents reported at least once such incidentwherein their status was disclosed without their permission. Two-fifths of the respondents(40%) reported that they were unsure if their status had been disclosed by a healthcareworker. These figures demonstrate that confidentiality is a major concern for PLHIV.Figure 7.3Disclosure of status by healthcare workerwithout consentFigure 7.3 Disclosure of status by healthcare worker without consent (N = 814)Not sure40%Yes12%Figure 7.4 Confidentiality of records relating to HIV (N = 805)My recordsarenot beingkeptconfidential10%I do not knowwhether myrecords arebeing keptconfidential36%7.4.1 Attitudes and reactions to disclosure of HIV statusI am sure myrecords arebeingkeptconfidential54%Table 7.8 presents the analysis of the general reactions of various individuals to thedisclosure of respondent’s HIV status. Positive reactions were observed in most cases afterdisclosure. A large majority of the PLHIV community showed their support (74% including56% supportive and 18% very supportive) after the HIV status disclosure. The attitudes of coworkers,friends and relatives towards PLHIV also did not change after their status disclosureand they were found to be supportive. The study found that overall, the attitudes of familymembers and spouses/partners were either supportive or remained unchanged after theywere informed about the respondent’s HIV status; however, 17 per cent of the respondentsfaced discrimination from adult family members and 9 per cent faced discrimination from theirspouses/partners.Table 7.8 Attitudes and reactions to disclosure of HIV statusNo48%The chart below depicts the awareness levels of respondents regarding the confidentialityof their HIV-related medical records. Approximately half of the respondents (54%) believedthat their records were kept confidential. Over 36 per cent of the respondents were not surewhether their HIV records were kept confidential and 10 per cent claimed that their HIVrecords were not being kept confidential (Figure 7.4).Verydiscriminatory(%)Religious leaders 0.1 0.4 4.1 3.7 0.7 91.058 59Discriminatory(%)Nodifferent(%)Supportive(%)Verysupportive(%)Notapplicable/NR (%)Spouses/partner 3.4 6.1 20.0 21.2 16.2 33.0Adult family members 8.1 9.1 22.8 24.8 8.8 26.4Children in your family 1.1 1.3 18.6 17.7 6.3 55.1Your friends/neighbours 7.4 8.0 22.4 19.7 1.9 40.6Other PLHIV 0.6 0.9 9.7 56.1 17.9 14.7Your co-workers 0.7 1.9 10.4 25.8 3.7 57.5Your employer/boss 0.9 0.8 4.5 13.1 4.5 76.2Your clients 0.2 0.1 2.4 2.1 0.6 94.6Injecting drug partners 0.6 2.5 6.1 6.4 0.2 84.2