Developing and evaluating a community-based HIV/AIDS stigma reduction intervention in Ongenga constituency of Ohangwena Region, Namibia.
Loading...
Date
2012
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Background: Namibia has been affected by the HIV/AIDS pandemic with infected and
affected persons experience stigma at different levels. As there were no local stigma
reduction intervention tools, this study aimed to develop, implement and evaluate tools at
different levels in a rural Namibian community.
Methods: An intervention research with a quasi-experimental non-equivalent control
group pre-and post-test sample plan was used, with both qualitative and quantitative
approaches. Four groups of participants participated: People Living with HIV/AIDS
(PLWHA), their family members, community leaders and health care workers (n=224).
The LINMODEL community participation and Frohlich Model informed the participant
selection, and the Diffusion of Innovations theory provided the framework for justifying
the use of targeted intervention tools in specific groups. Seven communities and a clinic
were divided into the control (n=107) and intervention (n=117) arms. The study consisted
of pre- and post-intervention questionnaires for both arms, intervention training workshops
for the PLWHA and community leaders, and in-depth interviews for the community and
opinion leaders.
The post-intervention results showed that stigma decreased significantly in social isolation
(p=0.017), workplace stigma (p=0.008) and negative self perception (p=0.006) in the
PLWHA intervention arm. Verbal abuse (p=0.07) has slightly decreased but there was no
statistically significant difference between the two study arms. Fear of contagion (p=0.12)
has slightly increased after intervention in both arms. All mean scores (PLWHA) for the
control arm increased significantly after the intervention. Regarding the family and
vii
community leaders results, only the household stigma score (p=0.01) decreased
significantly in the intervention arm. Health care workers reported increased stigma after
intervention, stigma against PLWHA (p=0.04) and associated stigma towards health care
providers (p=0.005).
Discussion: A comparison of the results in both arms indicated that the intervention was
effective in reducing stigma in the intervention arm in three groups (group 4 excluded)
with varying degrees of success. Stigma scores were significantly decreased in PLWHA
from the intervention arm. The intervention was effective although it did not decrease all
stigma scores significantly. This may require more time for the issues addressed in the
intervention workshops to diffuse through the different groups.
Description
Ph. D. University of KwaZulu-Natal, Durban 2012.
Keywords
Community health nursing--Namibia--Ohangwena., HIV infections--Namibia--Ohangwena., AIDS (Disease)--Namibia--Ohangwena., Stigma (Social psychology)--Namibia--Ohangwena., Theses--Community health nursing.