January 22, 2008

Stigma From Health Care Providers Toward People With HIV

A new study published in AIDS Patient Care and STDs (and reported on by AIDSmap.com) claims some HIV-positive veterans say they have experienced discrimination by their doctors. The study, conducted by Lance S. Rintamaki, PhD, from the department of communication and health behavior at the State University of New York at Buffalo, and his colleagues, cites stigmatizing behaviors on the part of some health care providers when treating their HIV-positive patients.

Rintamaki’s team conducted focus groups, followed by one-on-one interviews, with 50 HIV-positive men who receive HIV care through Veterans’ Affairs (VA) health clinics. Fifty-two percent of the men were African American, 68 percent were heterosexual and 32 percent were gay or bisexual. The participants’ average length of time since their initial HIV diagnosis was six years, and fifty-six percent had an AIDS diagnosis.

Though some men reported fair treatment and excellent care from VA health clinic physicians, others stated they felt their health care providers stigmatized them because of their HIV status. Some HIV-positive men said their providers would not look them in the eye. There were also reports of providers donning what appeared to be overly cautious protective clothing and gear before conducting an examination. Other providers allegedly spoke with a terse tone of voice and/or expressed judgmental attitudes when dispensing medical advice to their positive patients.

Of those who reported having been the recipient of stigmatizing behavior, some said the behavior did not prevent them from receiving quality health care. More worrisome, however, were the men who reported that in addition to stigmatizing their patients, the providers gave them inferior care or refused to offer them some types of health care all together.

This is not the first study to reveal stigmatizing behavior by the health care community toward people living with HIV. In a similar study published in August of 2007, 25 percent of participating patients reported they believed their doctors had treated them poorly because of their HIV status.

Rintamaki’s team is encouraging health care providers to pay careful attention to avoid the kinds of behaviors study participants reported as stigmatizing.

For some advice on how to handle stigma at the doc, read POZ’s special report on the subject.

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Previous Comments:

edweird, Dallas, Texas, 2008-10-12 11:09:40
I believe that Doctors reflect the attitudes of society overall, and many are indeed homophobic, condescending, and judgmental. I was accused for year of not taking my meds properly, when I was actually taking contra-indicated drugs. I believe that personal homophobic prejudices played a strong role in accusing me of non-adherence, and the failure to identify a nasty drug interaction. I have voiced my opinions in writing to my health care provider and their funding sources.

phyllis marks, new york, 2008-02-02 18:15:00
I feel doctors have a tendency to act very scantily when seeing me over time, not doing physical exams if they can get away with it, everthing is about their time,time is money. My doctor essentially checks your blood work and that's it and if there are changes doesn't how do you account for the changes. They are too busy to care. It's a terribly unfortunate situation. We are fortunate compared to other nations and I have been pretty fortunate to have had an excellent doctor in Florida.

Greg, Los Angeles, 2008-01-26 22:19:22
I agree with the study. As a Vet who has experienced the judgemental attitudes from a few interns, with one young doctor who wanted to preach his beliefs to me. The VA is a teaching facility and most interns only do from a few weeks to maybe 3 months in the hiv clinic. I have had this disease for 22 years now and with my appts every 3 to 6 mos. I can dismiss it too, as long as my meds are refilled and my labs and #'s are okay. But then, I am very forgiving of stupid people.

Sessanga Arthur, Kampala, 2008-01-25 01:13:04
It is quite interesting to note this kind of stigma, if at all it actually does occur. Is it not that some doctors will be shy irrespective of whether they are dealing with infected or non infected HIV patients? Has a parallel study of non infected HIV patients been done to rule out this? I think it would give us lots of information before we conclude. Protective wear for instance is supposed to be standard practice in Medicine. Unless if someone is changing the practice of Medicine.

Harland, Morristown, 2008-01-24 13:58:10
I have been positive since 2005 I was getting good care from the VA in the Nashville area. Very straight talk. very open good treatment. Montain Home VA. Not good service. I ask for a print out of my lab work I can not even get it. They jsut talk 5 minutes and push me out. It is a 4 hours to Nashville 1 hour to Mountain Home. The Service and training needs to be better across the board for all VA on HIV and Aids.

ted, , 2008-01-24 11:36:13
While I have not experienced this from my VA clinic doctor I have from some of the interns but over the years because I conforted the situation and the Docs involved things have gotton better in the clinic but when sent to other departments ie X=Ray the situation remains unchanged. While working on a mental heath unit one of the security guards got a small drop of blood on the cuff of his pants from an HIV positive client the pants were new He threw the pants away.hospital staff educate yourself

steps, , 2008-01-23 17:20:55
so long as conservative sexually repressed self rightous judgemental types continue (otherwise known as republicans) to hide themselves in a singluar prison of self repression they will never learn to be a doctor let alone a human being