HIV/Aids stigma is putting patients at risk

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HIV/Aids stigma is putting patients at risk
Chularat Saengpassa
The Nation


Red Cross Aids Research Centre

Carriers worry about discrimination if their infection becomes known

BANGKOK: -- FRETTING about rejection, people suffering from HIV/Aids naturally hide their secret, even from other people. To doctors, this is putting medical staff at risk and could hamper the effectiveness of treatment.

Thai Network of People Living with HIV/Aids (TNP+) chairman Apiwat Kwangkeaw said many HIV-positive patients ended up the last persons to receive dental services when they spoke up about their infection. A specialist at a medical school also suggested that some dentist interns were reluctant to provide services to HIV-positive people.

Yet Medical Council president Dr Somsak Lolekha has firmly defended the latest Patient Rights Declaration that requires patients to disclose their health information, such as HIV status, to doctors.

"Rights must come with responsibility," he said, emphasising that HIV-positive people cannot exercise rights without showing their responsibility for others.

He said without knowing that their patients carry the human immunodeficiency virus that can cause Aids, doctors risked making a wrong diagnosis and prescribing the wrong drugs. "If damage is done, will doctors be held responsible?" he asked, emphasising that patients should show their responsibility too.

Launched in September, the latest Declaration of Patient Rights has caused uproar among HIV/Aids activists but support from medical workers.

"No matter if they have HIV or not, we will treat them. It's just that if they inform us about their infection status, we will be able to diagnose their symptoms more accurately," a female doctor said.

She also pointed out that HIV-positive patients sometimes needed different treatment than others. People in general could recover from shingles, for example, on their own, but HIV-positive people might need the help of medicinal injections.

Another doctor said that although universal precaution was the norm among medical workers, patients should understand that cleaners at medical facilities could face an infection risk if they did not know some items had been used for HIV-positive patients.

Under universal precautions, all patients were considered to be possible carriers of blood-borne pathogens. The guidelines recommended wearing gloves when collecting or handling blood and body fluids contaminated with blood, wearing face shields when there was danger of blood splashing on mucous membranes and disposing of all needles and sharp objects in puncture-resistant containers.

Universal precautions were designed for doctors, nurses, patients, and health care support workers who were required to come into contact with patients or bodily fluids. This included staff and others who might not come into direct contact with patients.

Thai Aids Society president Dr Winai Rattanasuwan emphasised that HIV-positive patients benefited from disclosing to their doctors that they had the virus.

"Some drugs may affect the efficacy of antiretroviral drugs. And if HIV is not a factor, their symptoms may be diagnosed in a different way."

Speaking on condition of anonymity, a woman who is not HIV-positive feels it would be safer for others to know if a patient had the Aids virus.

"Please don't think just about your rights, please think about others too," she said.

Apiwat, however, believes universal precautions should already be enough to protect others.

A 25-year-old woman who contracted HIV from her parents said she usually did not tell a nurse at a pre-screening counter that she had the infection.

"The nurse will usually ask loudly if I have any underlying illness. With so many other patients around, I have never had the courage to disclose such information," she said.

She believes she would feel more comfortable if the question was asked behind closed doors when she met face-to-face with her doctors.

She reckoned she was always worried that if she ever disclosed her HIV status to medical workers, they might not keep it confidential.

"I have a fear they may tell others and I will be discriminated against," she said.

A lecturer at a medical school admitted that his interns had refused to treat a patient after learning of a kid's infection. He in the end had to provide the services by himself but without going back to preach his students about ethics.

"They may be worried about the risk because dental services involve blood. But I have always taught students under my care that they must have ethics and do their best in delivering services to patients. When they know about infections, they can take precaution and minimise risks," he said.

Stigmatisation against people living with HIV/Aids continues, even though every year on December 1 the world celebrates World Aids Day with the mission of improving the quality of life for Aids/HIV patients.

- This is the final report in a three-part series to mark World Aids Day.

Source: http://www.nationmultimedia.com/national/HIVAids-stigma-is-putting-patients-at-risk-30274130.html


-- The Nation 2015-12-02

[thesetat2013]

This report is strictly about hospitals, doctors, and nurses. If these HIV people are scared to disclose that they are infected to medical personnel can you imagine them telling a friend or would be lover. This is a scary thought that they may be out there screwing people that have no idea their lover has AIDS. They should make a database accessible to the public showing AIDS carriers to protect those uninfected.

[micmichd]

This report is strictly about hospitals, doctors, and nurses. If these HIV people are scared to disclose that they are infected to medical personnel can you imagine them telling a friend or would be lover. This is a scary thought that they may be out there screwing people that have no idea their lover has AIDS. They should make a database accessible to the public showing AIDS carriers to protect those uninfected.

Such a database would only make sense with mandatory HIV tests for everyone (including Farangs)

[Toknarok]

Transgender women are 49 times more likely to contract AIDS than any other group. With the large number of ladyboys in this Country perhaps concentrating on this group might be a good idea..

http://www.huffingtonpost.com/2013/04/02/transgender-women-49-times-likely-hiv-stu

[micmichd]

Transgender women are 49 times more likely to contract AIDS than any other group. With the large number of ladyboys in this Country perhaps concentrating on this group might be a good idea..

http://www.huffingtonpost.com/2013/04/02/transgender-women-49-times-likely-hiv-stu

No. This would mean discrimination again.

[micmichd]

Believe me, I know what I'm talking about.

I'm Farang, and I was (falsely) suspected and discriminated for having AIDS because I had been in Thailand "too often".

I was a blood donator before. You get automatically banned from blood donation in Germany if you've been in Thailand "too often", too. Even if your blood is actually urgently needed for patients that suffer from blood cancer.

[DM07]

This report is strictly about hospitals, doctors, and nurses. If these HIV people are scared to disclose that they are infected to medical personnel can you imagine them telling a friend or would be lover. This is a scary thought that they may be out there screwing people that have no idea their lover has AIDS. They should make a database accessible to the public showing AIDS carriers to protect those uninfected.

Not only that: they should wear a fancy yellow star, so everybody can identify them right away!

[thesetat2013]

This report is strictly about hospitals, doctors, and nurses. If these HIV people are scared to disclose that they are infected to medical personnel can you imagine them telling a friend or would be lover. This is a scary thought that they may be out there screwing people that have no idea their lover has AIDS. They should make a database accessible to the public showing AIDS carriers to protect those uninfected.

Not only that: they should wear a fancy yellow star, so everybody can identify them right away!

You must be German! Zig Heil! Why would you want them to stand out like that. A database for those who have an interest to know would be enough. You want them to walk around advertising their infection. Idiocies at its best

[micmichd]

You don't need that yellow star for getting discriminated anymore. Rumours are enough.

[Krataiboy]

This report is strictly about hospitals, doctors, and nurses. If these HIV people are scared to disclose that they are infected to medical personnel can you imagine them telling a friend or would be lover. This is a scary thought that they may be out there screwing people that have no idea their lover has AIDS. They should make a database accessible to the public showing AIDS carriers to protect those uninfected.

Not only that: they should wear a fancy yellow star, so everybody can identify them right away!

Playing the race card is silly. One's ethnic or cultural origins can't kill anybody. AIDS can and does, by the million. The poster makes a valid point. The difficulty is finding an acceptable and practical way of protecting uninfected individuals from carriers of the virus who know they are infected but don't tell their sexual partners. Maybe you can come up with a better idea than he suggested.

[micmichd]

Without "playing any race card": There is a chance that Farangs can contaminate Thais with AIDS, whether they know it or not. The probability may be small, but it is there. You would at first need a 100% screening of the whole Farang population coming here to "play the safe card". Are you sure you want that?

If not, why not?

BTW, that's why I had an HIV test in Germany before I came to Thailand. The test (which turned out to be negative) was enough to make me an AIDS suspect in my community.

[DM07]

This report is strictly about hospitals, doctors, and nurses. If these HIV people are scared to disclose that they are infected to medical personnel can you imagine them telling a friend or would be lover. This is a scary thought that they may be out there screwing people that have no idea their lover has AIDS. They should make a database accessible to the public showing AIDS carriers to protect those uninfected.

Not only that: they should wear a fancy yellow star, so everybody can identify them right away!

You must be German! Zig Heil! Why would you want them to stand out like that. A database for those who have an interest to know would be enough. You want them to walk around advertising their infection. Idiocies at its best

Yeah,maybe I am from Germany!

And you must know what sarcasm is!

A database, where everyone interested can get information?

Interested as in "love interest"? Or "professional interest"? Or just "general interest"?

If a HIV- patient wants to become a teacher, should "interested" parents check on him?

What a moronic and dangerous idea!

[DM07]

This report is strictly about hospitals, doctors, and nurses. If these HIV people are scared to disclose that they are infected to medical personnel can you imagine them telling a friend or would be lover. This is a scary thought that they may be out there screwing people that have no idea their lover has AIDS. They should make a database accessible to the public showing AIDS carriers to protect those uninfected.

Not only that: they should wear a fancy yellow star, so everybody can identify them right away!

Playing the race card is silly. One's ethnic or cultural origins can't kill anybody. AIDS can and does, by the million. The poster makes a valid point. The difficulty is finding an acceptable and practical way of protecting uninfected individuals from carriers of the virus who know they are infected but don't tell their sexual partners. Maybe you can come up with a better idea than he suggested.

What the...?

Race card?

There is no difficulty in "finding ways"!

FYI: you don't get AIDS like you catch a cold!

Uninfected individuals will be quiet fine, if they practice safe- sex!

End of story!

[Krataiboy]

HIV/Aids stigma is putting patients at risk

And what, pray, about the rest of us? The "stigma" of being HIV positive is a weak excuse for the irresponsible sexual behavior of thousands of Asian gays and transgenders highlighted by the latest shocking figures on the spread of the disease among these minority groups in Thailand and other parts of Asia.

Blaming the prevalence of phone apps, which make it easier for gays and transgenders to date, for the rocketing numbers is just a cop-out. We are all responsible for our own sex lives. The risks of catching HIV from reckless sexual behavior are well documented - and have been for over thirty years. We seem to forget that AIDS was known originally, and not entirely without justification at the time, as "the gay plague".

It appears from the latest figures, which indicate that a gay man in Bangkok has a chilling one in three chance of becoming infected, that we are going back to the bad old days when it was commonplace for homosexuals to express their recent liberation by having multiple sexual partners, often daily, without using protection or showing any responsibility whatsoever. We are now harvesting the bitter fruits of those heady, hedonistic times.

The wheel has turned full circle in the sense that homosexuals and transgenders are groups are once more the most prone to infection. And it makes sense to ask why. The answer may well lie in the freewheeling lifestyle of many members of these communities, which leads them to be more at risk.

Everyone, I am sure, believes that society has a duty to support those individuals who have become accidentally infected with HIV through no fault of their own - for example, children infected by mothers, someone who has received tainted blood, or the unwitting partner of a person already infected. But are people whose cavalier attitude to catching on passing on the virus makes their eventual infection an almost inevitable self-inflicted wound as deserving of the same consideration?

Many Thai sex workers sensibly protect themselves and their clients by insisting on the use of condoms and having regular checkups to ensure they are HIV-free Gays and transgenders, whose sexual practices by their very nature tend to put them in greater danger than heterosexuals, should do the same - and, if infected,inform any subsequent sexual partners in advance. To do otherwise is reprehensible.

While the stigma of being HIV-positive is clearly a burden on victims which needs to be eased by spreading greater awareness and knowledge abut HIV/AIDS among the community generally, it does not excuse irresponsible, and potentially life-threatening, sexual behavior - whether by gays, transgenders or heterosexuals.

[micmichd]

And how would you tell a gay from a heterosexual?

[micmichd]

And how would you tell a gay from a heterosexual?

[1star]

No incorrect

It is not puitting any Thai doctor at risk !

Patient has the right to keep it to himself or herself. If the staff are not compitent they should not be in this field simple

[thailand49]

I understand the hospital or physcian point of view and I understand how a carrier can feel the way they do? In Pattaya, I've seen a number of Dentist offices clearly state with a sign that HIV patients are not wanted. When you have a whole communty in Chon Buri who force a HIV home and care facility out into the street I can understand why one might want to hide from telling.

There is no easy solution but for starts the government need to do everything to educate their people and problem.