Manifestations of Stigma among HIV Infected Adolescents in Samia Sub-County, Busia, Kenya

Abstract

Human immunodeficiency virus (HIV) is a leading cause of global burden of disease. Recently, significant progress has been made in increasing access to antiretroviral therapy (ART) for people living with HIV to suppress the replication of the virus. Suppressed viral replication facilitates restoration of the immune function and significantly reduces the risk of onward HIV transmission. Despite the increasing access to ART, compelling evidence indicate suboptimal levels of viral suppression among adolescents in many low-resource settings. This has been associated with failure of adolescents to adhere to medication due to stigma. The purpose of this study was to examine the manifestations of enacted stigma among adolescents living with HIV in Samia Sub County, Busia County, Kenya. The study was guided by the theory of planned behavior and the Social cognitive theory. The study adopted the mixed method research design. The study population comprised 4 peer educators,740 caregivers, 1580 adolescent HIV+ boys and girls, and 1 Sub County Aids and Sexually Transmitted Infections Coordinator (SCASCO). The sample size was 4 Peer educators, each drawn from the four wards, 74 caregivers for HIV + adolescents, 158 HIV+ adolescents   and the I SCASCO. The stratified and simple random sampling techniques were used to select the 158 HIV+ adolescents and 74 caregivers, while saturated sampling was employed to select 4 peer educators and one health officer. Questionnaires, Focus Group Discussion and interview schedule were used to collect data from the respondents. All the instruments were piloted before administration in order to determine their validity and reliability. The test-retest method was used and a reliability coefficient of 0.70 was accepted. Data wasanalysed using descriptive statistics such as the frequency counts and percentages. Qualitative data was organized in terms of relevant themes and sub-themes and interpreted. Data analysis was performed using the Statistical Package for the Social Sciences (SPSS) Version 23.0. The study established that enacted stigma mainly manifests itself in the form of discrimination towards infected adolescents in Samia Sub-County. They experience discrimination in health care settings, including being denied health services because of their HIV status and health care professionals disclosing their HIV status without their consent. In addition, these adolescents experienced negative stereotypes such as sexual promiscuity, deviant sexual behaviors and discrimination, all of which create social barriers including access to healthcare. It is recommended that there is need to address enactment of stigma in community, homes and schools in Samia Sub County which are significant settings for the safety and welfare of HIV infected adolescents.