1.1 Introduction
Stigma is a Greek term denoting a mark that, in ancient times, was burned or cut into the flesh of an unsavoury character such as a traitor, criminal, or a slave (Harvey, 2001). It is a fundamental cause of health inequities (Hatzenbuehler et al., 2013). Employees with HIV/AIDS often experience stigma and discrimination. Discovering that one is HIV positive brings with it a multitude of anxieties and concerns that result from fear and uncertainty about how other people will react (Alexandrova et al., 2004).
HIV/AIDS is a disaster which disrupts the family’s equilibrium by placing a dark and frightening cloud over their future; it is one of the most challenging public health problems of our country. For persons living with HIV/AIDS, stigma is one of the most insidious barriers affecting access to and provision of health services, particularly in Southern Africa and India (AIDS Alert, 2002).
As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are Significance of the study, Scope of work, Research hypothesis and questions, Limitation of the study and Definition of terms.
1.2 Background of Study
According to UNAIDS Report (2004), almost five million people became newly infected with HIV in 2003, the greatest number in any one year since the beginning of the epidemic. At the global level, the number of people living with HIV continues to grow – from 35 million in 2001 to 38 million in 2003. In the same year, AIDS killed almost three million; over 20 million have died since the first cases of AIDS were identified in 1981 (UNAIDS Report, 2004).
HIV knows no social, gender, age or racial boundaries, but it is accepted that socio-economic circumstances do influence the disease patterns. HIV thrives in an environment of poverty, rapid urbanization, violence and destabilization. Transmission is exacerbated by disparities in resources and patterns of migration from rural to urban areas. Women particularly are more vulnerable to infection in cultures and economic circumstances where they have little control over their lives.
The HIV/AIDS epidemic continues to spread, with the majority of infections occurring in sub-Saharan Africa. It is estimated that 25 million people are living with HIV in sub – Saharan Africa. There seems to be stabilization in HIV prevalence rates, but this is mainly due to a rise in AIDS deaths and a continued increase in new infections. In addition to being a disease that is associated with a number of physical malfunctions and progressive discomforts like pain, shortness of breath, altered sexual functions and disfigurement, HIV/AIDS is associated with social stigma, it is highly stigmatized disease and this stigmatization can lead to a progression of other grievous psychological stressors such as anxiety, depression, fear, suicidal tendencies and so on, on the prospect of real and anticipated losses, worsening quality of life, fear of physical decline and death, coping with uncertainty, unemployment, homelessness, financial doldrums and the breakup of relationships.
The HIV/AIDS infected patients can live healthy lives for longer if proper care and support is provided; their immune system can be strengthened by medical treatment, healthy food, regular exercise, rest, care and support. They need a compassionate multifaceted assistance and support which will enable them to find meaning to life, appraising their survival, taping new resources of psychic strength and courage. Some of the feelings the PLWHA experience include shock or anger at being positively diagnosed with HIV, fear over how the disease will progress, fear of isolation by family and friends and worries about infecting others. By bearing such a heavy burden, it is not surprising that depression is twice as common in PLWHA compared to general population (American Psychiatric Association, 2013).
Globally, there are about 33.3 million PLWHA, in South East Asia region it has been estimated that about 3.5million people are living with HIV/AIDS, India has the world’s third highest total HIV burden, the prevalence of the infection is estimated to be about 0.34% of the population which translates to 2.3million people. In Nigeria, it is estimated that about 3.1million people are living with HIV, 2.8% adult HIV prevalence (15-49years), 210,000 new HIV infections, 150,000 AIDS- related deaths, 34% adults on retroviral treatment. Nigeria has the second largest HIV epidemic in the world, unprotected heterosexual sex accounts for 80% of new HIV infections in Nigeria with the majority of HIV infections occurring in affected populations such as sex workers.
Therefore, in Nigeria where the research was carried out, the activities that was conducted is to know the Managing HIV and Aids Stigma in the Workplace.
1.3 Statement of Problems
Investigation revealed that HIV/AIDS not only affects workers on the job, it also causes a major drain on family savings and resources. Just as a company experiences increased expenses due to HIV/AIDS, so does a household when members are all ill with HIV/AIDS. Despite advances in HIV care, PLWHA face numerous psychological challenges, HIV stigma has been defined as the social discrediting and devaluation of HIV infected persons.
HIV/AIDS can lead to ostracism and social isolation; some children have a difficult time because of the interminable bullying and mockery at school and neighborhood which may lead to loneliness and low self esteem. Because of the stigma of HIV/AIDS, families are fearful of disclosing the diagnosis and have limited support systems from both inside and outside their family.
HIV and AIDS are serious public health problems, which have socioeconomic, employment and human rights implications. It is recognized that the HIV/AIDS epidemic will affect every workplace, with prolonged staff illness, absenteeism, and death impacting on productivity, employee benefits, occupational health and safety, production costs and workplace morale (Code of Good Practice, 2000).
Furthermore HIV/AIDS is still a disease surrounded by ignorance, prejudice, discrimination and stigma. In the workplace unfair discrimination against people living with HIV and AIDS has been perpetuated through practices such as pre-employment HIV testing, dismissals for being HIV positive and the denial of employee benefits.
1.4 Aim and Objectives of Study
The aim of the study is to examine the Management of HIV and Aids Stigma in the Workplace. In achieving this aim, the following specific objectives were laid out as follows:
- To determine the barriers to treatment and care and not just to reduce stigma itself in the area under review;
- To identify the barriers of testing and disclosure of HIV and Aids;
- To assess the extent of theoretical models of stigma in the workplace;
- To analyze the content of the local beliefs around HIV/ AIDS; and
- To examine the impact of stigma on people living with HIV/AIDS and their response to the impact in the area under review.
1.5 Research Questions
The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:
- What are the barriers to treatment and care and not just to reduce stigma itself in the area under review?
- What are the barriers of treatment, care, testing and disclosure of HIV and Aids?
- What are the content of the local beliefs around HIV/ AIDS?
- What are the impact of stigma on people living with HIV/AIDS and their response to the impact in the area under review?
1.6 Research Hypothesis
In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.
Hypothesis One
- H0: There are no significant factors affecting the management of HIV and AIDS Stigma among Employees in the area under review
- H1: There are significant factors affecting the management of HIV and AIDS Stigma among Employees in the area under review
1.7 Significance of Study
The study will benefit the Governments Departments by enabling them make use of the findings of the research in addressing the HIV/AIDS pandemic issues in the department. The findings and recommendations based on the outcome of this study will inform policy makers in the study area and the country as a whole on the psychological implications of HIV and also serve as a reference source to future researchers contributing to the existing body of literature on the subject matter.
1.8 Scope of Study
The scope of the research is focused on Managing HIV and Aids Stigma in the Workplace using Nigerian Bottling Company (Coca Cola) in Abia State as a case study.
1.9 Limitations of the Study
During the course of this study, many things militated against its completion, some of which are:
- Time Constraint: The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
- Establishment Policies: Establishment policies posed a serious limitation as most staffs are not ready to release information needed for this research work. There were lots of information needed from the staffs of this establishment to enhance the study which took them time to release or they did not release at all for security purposes, hence the scope was reduced.
- Research material: availability of research material is a major setback to the scope of the study.
- Frequent power failure: This made the researcher append more money on fuel to ensure sustainable power.
- Financial Constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).
1.10 Definition of Terms
Stigma: It is a mark of disgrace associated with a particular circumstance, quality, or person.
HIV Stigma: It is a irrational or negative attitudes, behaviors, and judgments towards people living with or at risk of HIV.
1.11 Organization of the Study
Chapter one of the study, provides background of the study, stating the problem of the study and the research questions and hypotheses to be tested in the study. It also highlights the significance of the study and scope of the study.
Chapter two reviews related literature on Managing HIV and Aids Stigma in the Workplace.
Chapter three discussed the research methods to be used in designing the study which will include research design, population, sample size and sampling technique, data collection and data analysis methods.
Chapter four presents the data gathered in frequency and percentage tables. The data will also be analyzed and research hypotheses will be tested with chi-square statistical test.
Chapter five summarizes the outcome of the study, draw conclusions based on the findings of the study and make necessary recommendations.
