HIV-related stigmatized attitudes among health care providers in Aceh, Indonesia: The findings from a very low HIV case-load region
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Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Indonesia
Tropical Diseases Centre, School of Medicine, Syiah Kuala University, Banda Aceh, Indonesia
Department of Microbiology, School of Medicine, Syiah Kuala University, Banda Aceh, Indonesia
Department of Applied Mathematics, National Dong Hwa University, Taiwan, ROC
Department of Family Medicine, School of Medicine, Syiah Kuala University, Banda Aceh, Indonesia
Epidemiology Unit, Faculty of Medicine, Prince of Songkhla University, Songkhla, Thailand
Department of Population Sciences, University of Dhaka, Bangladesh
Department of Public Health, School of Medicine, Syiah Kuala University, Banda Aceh, Indonesia
Aceh Provincial Health Office, Banda Aceh, Indonesia
Submission date: 2015-02-05
Acceptance date: 2015-05-04
Online publication date: 2015-07-08
Publication date: 2020-03-26
Corresponding author
Harapan Harapan   

Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Indonesia. Tel.: +62 651 7551843; fax: +62 651 7551843.
Pol. Ann. Med. 2015;22(2):74-81
Study of HIV-related stigmatized and discriminatory attitudes is predominantly conducted in the regions with high HIV prevalence; therefore, understanding about stigmatized and discriminatory attitudes dynamic in the region with a very low HIV prevalence is needed.

To identify the levels of stigmatized attitudes toward people living with HIV (PLHIV) and their predictors among health care providers (HCPs) in Aceh, the lowest HIV prevalence province in Indonesia.

Material and methods:
A cross-sectional study was conducted in seven regencies in Aceh. Structured questionnaires were used to collect data from 589 HCPs (doctors, nurses, midwifes and supporting staffs). Univariate analyses including one-way analysis of variance, t-test and correlation test were performed according to data type. Multiple linear regression was conducted to identify the predictors of stigmatized attitudes

Results and discussion:
The level of HIV-stigmatized attitudes among HCPs in Aceh was high. Univariate analysis revealed that location, experience of direct contact with PLHIV, knowledge on HIV transmission and prevention, value-driven stigma and overestimated risk to HIV transmission were associated significantly with stigmatized attitudes levels (P < 0.05). A multiple linear regression model identified that high level of value-driven stigma and high level of overestimated risk to HIV transmission were robust predictor factors for stigmatized attitudes (R2 = 0.212; F = 14.113; P < 0.001).

This study demonstrates that the value-driven stigma and overestimated risk to HIV transmission are the major predictors of stigmatized attitudes toward PLHIV among HCPs in Aceh. Therefore, programs to reduce value-driven stigma and overestimated risk are needed.

No financial support in this research.
All authors have none to declare.
Health Policy Initiative, Task Order 1. Measuring the Degree of HIV-related Stigma and Discrimination in Health Facilities and Providers: Working Report. Washington, DC: Futures Group, Health Policy Initiative, Task Order 1; 2010.
Kipp W, Bajenja E, Karamagi E, Tindyebwa D. AIDS-related stigma: perceptions of family care givers and health volunteers in Western Uganda. World Health Popul. 2007;9(2):5–13.
Varas-Diaz N, Serrano-Garcia I, Toro-Alfonso J. AIDS-related stigma and social interaction: Puerto Ricans living with HIV/AIDS. Qual Health Res. 2005;15(2):169–187.
UNAIDS. HIV and AIDS-related Stigmatization, Discrimination and Denial: Forms, Contexts and Determinants Research Studies from Uganda and India. Geneva, Switzerland: UNAIDS; 2000.
UNAIDS. HIV/AIDS Related Stigma and Discrimination: A Review and Suggested Ways Forward for South Asia. Geneva, Switzerland: UNAIDS; 2002.
Brown L, Macintyre K, Trujillo L. Interventions to reduce HIV/AIDS stigma: what have we learned? AIDS Educ Prev. 2003;15(1):49–69.
Herek GM, Capitanio JP, Widaman KF. HIV-related stigma and knowledge in the United States: prevalence and trends, 1991–1999. Am J Public Health. 2002;92(3):371–377.
Letamo G. Prevalence of, and factors associated with, HIV/AIDS-related stigma and discrimination in Botswana. J Health Popul Nutr. 2003;21(4):347–357.
Aggleton P, Wood K, Malcolm A, Parker R. HIV-related Stigma, Discrimination and Human Rights Violations: Case Studies of Successful Programmes. Geneva, Switzerland: UNAIDS; 2005.
Banteyerga H, Kidanu A, Nyblade L, MacQuarrie K, Pande R. Exploring HIV and AIDS Stigma and Related Discrimination in Ethiopia: Causes, Manifestations, Consequences, and Coping Mechanisms. Addis Ababa: Miz-Hasab Research Center; 2004.
Hossain MB, Kippax S. Stigmatized attitudes toward people living with HIV in Bangladesh: health care workers' perspectives. Asia Pac J Pub Health. 2011;23(2):171–182.
Monjok E, Smesny A, Essien EJ. HIV/AIDS-related stigma and discrimination in Nigeria: review of research studies and future directions for prevention strategies. Afr J Reprod Health. 2009;13(3):21–35.
Ulasi CI, Preko PO, Baidoo JA, et al. HIV/AIDS-related stigma in Kumasi, Ghana. NIH Pub Acc. 2009;15(1):255–262.
Mahendra VS, Gilborn L, George B, et al. Reducing AIDS-related Stigma and Discrimination in Indian Hospitals. New Delhi: Population Council; 2006.
Oe A. HIV related stigmatizing attitude and practice among health care workers in Northern Nigeria. J Infect Dis Immun. 2011;3(13):226–232.
Hossain MB, Kippax S. HIV-related discriminatory attitudes of healthcare workers in Bangladesh. J Health Popul Nutr. 2010;28(2):199–207.
Wong LP, Syuhada ARN. Stigmatization and discrimination towards people living with or affected by HIV/AIDS by the general public in Malaysia, Southeast Asian. J Trop Med Public Health. 2011;42(5):1119–1129.
Shapiro PD. How close is too close? The negative relationship between knowledge of HIV transmission routes and social distancing tendencies. Soc Sci J. 2005;42(4):629–637.
UNAIDS. Global report: UNAIDS report on the global AIDS epidemic 2010. UNAIDS; 2010.
KPA. Laporan KPA Nasional Tahun 2010. 2010. Available from:; Accessed 01.08.11.
Departemen Kesehatan Republik Indonesia. Profil kesehatan Aceh tahun 2012. 2012. Available from:; Accessed 10.07.2013.
Aggleton P. HIV and AIDS-related Discrimination, Stigmatization and Denial. Comparative Analysis: Research Studies from India and Uganda. Geneva, Switzerland: UNAIDS; 2000.
Harapan H, Khalilullah SA, Anwar S, et al. Discriminatory attitudes toward people living with HIV among health care workers in Aceh, Indonesia: a vista from a very low HIV caseload region. Clin Epidemiol Global Health. 2015;3(1):29–36.
Jean-Baptiste R. HIV/AIDS-related stigma, fear, and discriminatory practices amongst healthcare providers in Rwanda. In: Operations Research Results. Published for the U.S. Agency for International Development (USAID) by the Quality Assurance Project. Bethesda, MD: University Research Co., LLC; 2008.
Badan Nasional Penanggulangan Bencana. Peta sumberdaya jumlah tenaga kesehatan di Indonesia. 2011. Available from:; Accessed 10.07.2011.
Harapan H, Feramuhawan S, Kurniawan H, Anwar S, Andalas M, Hossain MB. HIV-related stigma and discrimination: a study of health care worker in Banda Aceh, Indonesia. Med J Indones. 2013;22(1):22–29.
Tanzania Stigma-Indicators Field Test Group. Measuring HIV Stigma: Results of a Field-Test in Tanzania. Washington, DC: Synergy; 2005.
Nyblade L, Carr D. Towards a Stronger Response to HIV and AIDS: Challenging Stigma. Washington, DC: International Center for Research on Women; 2008.
Li L, Wu Z, Wu S, Zhaoc Y, Jia M, Yan Z. HIV-related stigma in healthcare settings: a survey of service providers in China. AIDS Patient Care STDS. 2007;21(10):753–762.
Feyissa GT, Abebe L, Girma E, Woldie M. Stigma and discrimination against people living with HIV by healthcare providers, Southwest Ethiopia. BMC Public Health. 2012;12:522.
Massiah E, Roach TC, Jacobs C, et al. Stigma, discrimination, and HIV/AIDS knowledge amongst physicians in Barbados. Rev Panam Salud Publica. 2004;16(6):395–401.
Umeh NC, Essien JE, Ezedinachi NE, Ross WM. Knowledge, beliefs and attitudes about HIV/AIDS-related issues, and the sources of knowledge amongst healthcare professionals in Southern Nigeria. J R Soc Health. 2008;128(5):233–239.
Kalichman SC, Simbayi LC, Jooste S, et al. Development of a brief scale to measure AIDS-related stigma in South Africa. AIDS Behav. 2005;9(2):135–143.
Walusimbi M, Okonsky JG. Knowledge and attitude of nurses caring for patients with HIV/AIDS Nursing in Uganda. J Appl Nurs Res. 2004;17(2):92–93.
Aggleton P, Parker R. A conceptual Framework and Basis for Action: HIV/AIDS Stigma and Discrimination. Geneva, Switzerland: UNAIDS; 2002.
Bharat S, Aggleton P, Tyrer P. India: HIV and AIDS-related Discrimination, Stigmatization and Denial. Geneva, Switzerland: Joint United Nations Programme on HIV/AIDS; 2001.
UNAIDS. Reducing HIV Stigma and Discrimination: A Critical Part of National AIDS Programmes. Geneva, Switzerland: Joint United Nations Programme on HIV/AIDS; 2007.
Parker R, Aggleton P, Attawell K, Pulerwitz J, Brown L. HIV/AIDS-related Stigma and Discrimination: A Conceptual Framework and an Agenda for Action. Horizon Program. New York: Population Council; 2002.
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