Stigma forces HIV patients to opt for home-based care: Experts

HIV infection casesAnnual number of new HIV infection cases has been steadily declining but people are unwilling to disclose their status
People Living with HIV (PLHIV) still fight shy of declaring their status, scientists with National AIDS Research Institute (NARI) said pointing out that studies indicate they preferred home-based care as it was free of stigma and ensured confidentiality.

Dr R S Paranjape, Director of NARI, said even if people are on anti-retroviral therapy (ART) they preferred to hide their HIV status. Dr Seema Sahay, scientist at NARI who has been part of a recent Pune-based study that assessed caregivers of PLHIV, found that the fear of stigma surfaced when the women members of the family visualized neighbours coming to know about the HIV status.

The qualitative study conducted between 2008 and 2010 had a total of 44 in-depth interviews with 20 PLHIVs and 24 caregivers. Published in Plos One journal, the findings show that half of the PLHIVs (10/20) and their caregivers (13/24) preferred home-based care owing to affordability, free of stigma and convenience, Sahay said.

Some of the caregivers reinforced that there was no fear of stigmatisation and disclosure in case the PLHIV received home-based care. Even as the annual number of new HIV infections has been steadily declining, people are not disclosing their status. According to Dr R R Bamble, Pune Municipal Corporation's HIV/AIDS nodal officer, there were 1,891 new HIV cases detected in Pune from January to July.

"There has been a significant drop in new infections due to awareness measures taken over the period of years," he said. However Kalyani Patil, Pune district officer of Maharashtra State AIDS Control Society (MSACS), said people were not willing to come out in the open and disclose their HIV status.

Over the years, the government welfare programmes have helped bring down the prevalence rate of HIV infection. In Pune district it is a mere 5.48 per cent of the population while the numbers of HIV positive people have gone down among the high risk population like sex workers.

According to Bamble, out of the 3,587 brothel-based sex workers , 149 tested for HIV infection in 2012 while out of 2,523 non-brothel-based workers, 53 tested positive. Vinod Jamble, programme director of Network of PLHIV in Maharashtra, said despite improvement in their health conditions, there was a need to also provide a better quality of life for them.

A total of 34 care support centres are being set up in Maharashtra and Goa under the programme 'Vihaan' to ensure that they can work without fear of stigma and discrimination.

Bindumadhav Khire, President of Sampathik Trust that reaches out to 1,600 Men having sex with Men (MSM) high-risk group, said 23 were tested HIV positive. However, they are so scared to reveal their HIV status that they cannot even get hospitalised, he rued.

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