Understanding the Impact of Stigma and Discrimination on Adherence to Medication amongst People Living with HIV in Nigeria: A Mixed Method Study

The present study determines the impact of Stigma and Discrimination amongst People Living with HIV and their Adherence to Medication in North Central Nigeria. Stigma has been and will continue to be one of the factors influencing the prevention and treatment of some diseases in the health sector if adequate measures are not taken to address it. In spite of the identification of stigma as a factor impeding public utilisation of HIV counselling, testing, and treatment services in Nigeria, gaps still exist in knowledge on the impact of stigma, and discrimination on adherence to medication and outcomes amongst people living with HIV (PLWH). It has been observed that even healthcare workers isolate HIV/AIDS patients from other ones, refuse to admit them to the hospital, wear extra cloves when examining them, and charge very high fees for care. This study adopted mixed methods to examine the impact of stigma and discrimination on adherence to medication amongst PLWH in Nigeria. A sample of 1,621 respondents was collected using multi-stage and purposive sampling methods. Structured interviews using questionnaires and in-depth interviews (using a guide) were utilised for data collection. SPSS (version 21) was used for quantitative data analysis while the qualitative data was analysed thematically. There are 46.3% men and 53.7% women respondents. Generally, their income is low, 70.7% are earning less than N25,000 (approximately $125 USD) per month. Some of the HIV patients are stigmatised. In reaction, they avoid public places, and travel long distances away from their immediate community to collect drugs and to avoid being noticed around the centers. They sometimes miss taking drugs regularly as prescribed, suffer depression and die. Those who are alive continue to suffer social exclusion within the communities. Stigma and discrimination impede adherence to medication amongst PLHW in Nigeria. More efforts should be made to create awareness to reduce the stigma and discrimination of HIV patients while augmenting their income to meet up with the challenges of adherence to medication and social acceptability. Policies addressing discrimination of PLWH in the family, marriage and employment domains would be of great help. The overall benefits would be enhanced mechanisms of HIV prevention, treatment and control in the study area.