Experience and Management of Stigma Among Persons Infected With HIV in Bali, Indonesia

Abstract

A descriptive cross-sectional study was conducted to describe the level of HIV stigma experience and management strategies among persons infected with HIV (PIWH) in Bali, Indonesia. Two-hundred and fifteen respondents selected from four locations were enrolled from March to May 2019. The Demographic Characteristics Form Persons Infected With HIV (DCFPIWH), the 28-Item Internalized HIV Stigma Scale, and the Stigma Management Strategies Checklist (SMSC) developed by the researcher were used to gather the data. Descriptive statistics were used for data analysis. A moderate level of HIV stigma experience was reported among PIWH respondents (M = 42.88, SD ± 17.59). The highest mean score from the content of items was in the self-acceptance subscale (M = 85.50, SD ± 24.25) and the lowest was in the social-relationships subscale (M = 6.50, SD ± 16.00). In addition, among 37 stigma management strategies, the three highest percentage which most often used by PIWH were praying (70.7%), positive thinking (70.2%), and keeping HIV status a secret (66.0%). The most common reason to manage stigma was to decrease and/or avoid stress (68.8%) through self-study to manage stigma and support from friends, family members, spouses, and health care providers. The majority of the respondents (96.3%) stated having effective stigma management strategies and 65.6% of respondents expressed being satisfied with their stigma management strategies. The first most effective strategy was praying (28.8%) and the first least effective was staying alone (21.9%). Imply the importance of understanding stigma experience among PIWH particularly in such a multi-ethnic and religion country as Indonesia. This understanding is believed to be a significant attempt to stigma management strategy. Additionally, in order to avoid increasing stigma towards PIWH, maintaining the confidentiality of PIWH's HIV status is of a great importance. Strategies to manage stigma could involve the implementation of religious teachings. Finally, future HIV stigma experience and management strategies studies demand further in-depth exploration, primarily when associated with PIWH's religion and culture.