HIV/AIDS Stigma in Kenya: Nursing Perspectives

This assignment delves into the complex issue of HIV/AIDS stigma within the context of Kenya, focusing specifically on its influence on psychosocial nursing care. Students are tasked with critically examining relevant academic literature to understand the multifaceted nature of stigma and its consequences for individuals living with HIV/AIDS and the nurses who provide care. The assignment emphasizes ethical considerations related to stigma reduction, patient confidentiality, and culturally sensitive nursing practices in addressing this critical public health challenge.

Name of student:
Registration number:
Unit Title:
Unit Code:
Name of supervisor:
Date due:

Introduction
This report discusses HIV stigma and discrimination as the subject title of the project
proposal. The report is a project proposal that aims at investigating ways in which
HIV stigma and discrimination can be minimized among the people with HIV and
their loved ones. Stigma and discrimination based on HIV are almost as old as the
virus. This is because, stigma and discrimination against people living with HIV
began immediately after the virus was discovered in the late 80s and scientists labeled
it as a sexually transmitted disease (Morisky, 2016).
Unfortunately, despite the advancements that have been made in research to
understand the way of transmission, to develop adequate drugs and to reduce the
effects that the virus has in the human body, very little has been achieved in helping
to reduce stigma and bring to end discrimination against people living with HIV.
People in the society are yet to understand that HIV is a disease like any other and
anyone can be a victim irrespective of their gender, race, and their status in the
society. Discrimination against people living with HIV/AIDS leads to poor quality
health care for the patients. It also scares away patients from seeking treatment or help
from close family members due to the fear of getting discriminated against. HIV
treatment programs are becoming increasingly affordable and available in poor
countries. For the programs and the funds invested in this program and medication, it
is important that the people in charge of the health facilities and the society in general
respect the rights of HIV positive patients (Ullah & Huque, n.d).
The research proposal is designed to fill the gap identified in dealing with
discrimination and stigmatization related to HIV/AIDS. The report also contains an
in-depth literature review that is carried out thoroughly using seven secondary sources
of information as indicated in the body of the report. The research methodology used
in this research is a combination of qualitative research method and quantitative
method. This is to fulfill the objectives of the research as required.
Statement of the problem
The HIV/AIDS is an epidemic in Kenya and it has resulted in the loss of many lives
over the years. The loss of these life results in loss of livelihoods for many children,

men and women. Their close relatives are left as orphans, widows, and widowers.
Apart from the physical suffering that the HIV patients undergo, there is a lot of
stigmatization and discrimination against people living with the HIV virus. This has
entered with the spirited fight against this epidemic since stigmatization and
discrimination resulting from the HIV virus has discouraged many people from going
for testing and seeking medical help. The fear of discrimination has made many
people fail to disclose their true HIV status and this has resulted in increased
transmission and hence eroding the efforts that had been made in the past against the
HIV epidemic (Jonas & Morton, 2012). This study seeks to establish ways in which
stigmatization and discrimination resulting from the HIV virus can be reduced.
Research questions
1. What are the effects of HIV/AIDS stigma on the patient and their families?
2. What are the factors that bring about stigma and discrimination for the people
living with HIV?
3. How can stigma and discrimination for HIV patient be reduced?
4. How can access to treatment and care for HIV patients be improved, especially in
resource poor countries?
Aim
The aim of this study is to investigate the factors that bring about discrimination and
stigma against the people living with HIV virus in Kenya. This helps to evaluate the
steps and actions which need to be taken to reduce discrimination and stigma against
the people living with HIV/AIDS.
Objectives
This study is conducted with a variety of objectives. These objectives have been
defined by a review of the subject and personal experience where I have identified the
need to fill a gap in research on stigma and discrimination against people living with
HIV. The research objectives will be a guide to the researcher throughout the research

exercise since they will be used as the benchmark upon which the data is collected,
and the analysis is done.
The following are the research objectives of this study:
- To identify the factors that lead to discrimination and stigma against the
people living with HIV
- To investigate the level of knowledge that patients have about HIV and how
they should live to prolong life to almost normal.
- To investigate how and to what extend Kenya has been able to achieve the
stigmatization and discrimination goals of minimizing HIV stigma and
discrimination and promoting an inclusive society.
- To investigate whether gender is a basis of discrimination for people living
with HIV
- To examine the role that the Government and the society in general can play
reducing stigma and discrimination against the people living with HIV.
Justification of the study
Stigma and discrimination are among the biggest barriers to prevention, treatment,
and care for HIV. Previous research has indicated that stigma and discrimination
undermine HIV prevention efforts since it makes people fear seeking information
about the disease. Fear to seek information on testing and medication has resulted in
many people opting against visiting health centers to seek advice and undergo an HIV
test. The previous researches have linked the fear of stigma and discrimination to the
fear of violence and discouragement as well as isolation from family members. The
fear of isolation by sexual partners if a person is diagnosed with the disease has led to
many people being discouraged from seeking medical attention and this has made it
difficult to counter the spread of the disease and to treat the patients (Nginya, 2016).
HIV is an infection that is feared by many people, especially in Africa. This is
because people have limited knowledge about HIV and it has become difficult to
make people understand the disease. People usually see an HIV positive person and
they see a person who is dying or a person who is not fit to interact with others freely
since they have the fear of contracting the disease. The society has many myths and
believes about the HIV virus and it has been difficult to make people aware of the

different ways the disease can be transmitted. Some people still believe that a hand
shake with an HIV positive patient can result in them getting infected too. Other
believes sharing of facilities like toilets and plates and spoons can result in
contracting the disease. Despite the high number of people in our society who have
lived with the disease and the various community education programs to educate
people about HIV, the issue of stigmatization and discrimination of HIV patients has
hardly been resolved. Due to these unending cases, some of the HIV positive patient
may end up believing that what is said about them is true and may lose hope in life
and fall into depression. The society thinks that people who are HIV positive is
because of immorality and the people end up being outcasts in the society.
Some of the reasons why people with HIV in a society are stigmatized is that HIV is a
serious life-threatening illness. There is a history of the infection being accompanied
by other diseases such as TB and hence bringing about fear among the people in the
society (Nginya, 2016).
The other reason why people with HIV infection may be stigmatized or discriminated
against is that many people do not understand how the virus is transmitted or
contracted and they therefore fear getting the infection through social interactions
with an HIV positive patient. The patient ends up isolated. Most traditional African
societies have very strong views on sexual behavior. People may therefore think that a
person engaged in irresponsible sexual behavior and, as a result contracting the
disease, should not be allowed in the society. The issue of stigmatization and
discrimination of HIV positive patients has brought about the increase in the spread of
the HIV virus.
Stigmatization also discourages many people in Kenya from going for testing.
Consequently, the sickness is been diagnosed when the virus has brought the body in
the final stage and has left the patient completely weak. (Liamputtong, 2013). It is
impossible to save the patients at this stage and death within a short period of time is.
From the above findings, it is very evident that there is need to come up with ways in
which stigma and discrimination against HIV positive people can be reduced in
Kenya It is key to find out why people with HIV are stigmatized by their close family
members, their communities, or society in general. This study seeks to answer the
research questions listed in the report to help fill the gap identified in research.

Research methods and methodology
This research study uses qualitative research methods to ensure to carry out the
research. Qualitative research methods depend on descriptive data to analyze the
variables being investigated in this research study. The study will also use the
qualitative research method to fill the research questions listed in the research
proposal. The qualitative research method is used to uncover trends in thoughts and
opinions of the people of Kenya on HIV infected people. The research method will
help to understand the beliefs and myths that influence people to stigmatize and to
discriminate against people living with HIV. This method is very effective for this
study. The descriptive nature of this study allows to capture the different opinions and
views of people or communities (Chenneville, 2017). The qualitative research method
will also help the researcher to answer the questions on how stigmatization and
discrimination against people living with HIV can be reduced.
Data collection methods
The research depends on secondary sources of data. The study will be conducted
based on literature from recently written and verifiable sources of secondary data.
Many books have been written over the years concerning the HIV epidemic in Kenya
and other African countries. The studies carried out by authors both in Kenya and
other countries where the issue of stigmatization and discrimination against people
living with HIV is common have been evaluated and analyzed to provide secondary
data for this study.The study will also be conducted using journal articles that are peer
reviewed. This makes the results of the research on which the articles are based
credible.. For this research, the internet provides also up to date data on stigmatization
and discrimination against HIV positive people. Data collected by various
nongovernmental organizations that is available online will be evaluated. Trends in
the thoughts and beliefs of people towards people with HIV are established data from
the ministry of health Kenya. Those will be also important in conducting this
research.
The government has spearheaded various campaigns aimed at educating the masses
on the HIV virus and how people can live healthy and productive lives despite being
infected with the virus (Streck, 2013). The data will help to provide information on

the effectiveness of these campaigns and to what extent they have helped to reduce
discrimination and stigmatization of the people living with the HIV virus.
Data analysis
The analysis of the qualitative data collected will be done by comparing the historical
data with the primary data collected in this study. The comparison will be done to
establish the achievements in the reduction of stigma and discrimination against
people with HIV. The comparison will help to determine the difference between now
and then (Macharia, 2015). The data collected will be coded and classified into
different classes depending on how similar the data is. A framework for comparison
will then be established against which the data collected will be compared and
conclusions made from the data.
Conceptual Framework
HIV/AIDS related stigmatization and discrimination have been mainly influenced by
the actions and attitudes of the families, communities and communities where the
people are living in. This framework focuses on stigmatization and discrimination as
individual aspect and on how individuals behave and act to one another to bring about
stigmatization and discrimination (Opiyo et al., 2016) Mostly, stigmatization is
viewed as a social process and it is largely associated with the beliefs, traditions and
customs of a society. Stigmatization and discrimination are used to create differences
and hierarchies in the society. Most societies tend to create a difference between what
is viewed as normal and what is not considered normal. They tend to discriminate
against the people living with HIV as they see them as less human than others. The
society creates a perception where people with HIV are viewed as being immoral and
engaging in reckless sexual activities. People in a society tend to view people with
HIV as people who bring misfortune to the whole family and the community in
general. There has been widespread physical violence directed towards the people
living with HIV. Sociological analysis of discrimination is important in this
framework since it emphasizes on the structural aspects of discrimination. It also
concentrates on trends of dominance and oppression as a group of people struggle for
power and equal treatment (Azetsop, 2016). Stigmatization and discrimination of HIV

HIV/AIDS related
stigma and
discrimination
Sexual relations and
stigmatization
Race issue e.g. AIDS is
a disease for Africans
and it originated from
the white man
Class relations. Poor
people are more prevalent
to the virus than better off
people in the society.
Gender divisions and
discrimination related
to HIV
patients are linked to a variety of factors that will form the basis of this conceptual
framework for this study. These factors include:
 Sexuality-stigmatization and discrimination related to HIV/AIDS is mostly
associated with sexual stigma. This is because HIV is mainly sexually
transmitted, and this has created a perception in the society that every person who
gets infected with the virus is sexually immoral.
 Gender- stigmatization is also related to gender of an individual. The impact of
HIV/AIDS stigma has been more profound among women than among men
(O'Connor & Earnest, 2011). This reinforces pre-existing economic, cultural, and
social discrimination and disadvantages that women undergo in the society.
 The factor of race and ethnicity is established as another factor upon which
stigmatization and discrimination related to HIV/AIDS is based. It has been
perceived in some quarters that African sexuality is more susceptible to the virus
while others believe that the immorality of the people of the west brought the
virus to Africa (Omonaiye, 2013)
 The social class has also been used as a basis of discrimination with some people
perceiving the virus as a preserve of the poor people in the society.

Figure 1: Conceptual Framework indicating the relationship between HIV/AIDS and
pre-existing sources of Stigmatization and Discrimination
Literature review
There is a lot of literature available that on this subject of study. The literature review
of this study is obtained from the sources of references listed at the end of the
report.The issues of stigmatization and discrimination of the people living with HIV
have been going on for a long time. HIV/AIDS related stigmatization and
discrimination have tremendous negative effects towards the fight against the HIV
epidemic (Odindo & Mwanthi, 2008). Stigmatization and discrimination of people
with the virus has discouraged people against seeking treatment and further
information regarding the HIV virus and ways in which the disease can be managed.
The healthcare professionals in charge of testing and treatment of HIV
positivepatients, sometimes fail to keep patient information confidential.
(Liamputtong, n.d.) This has brought about an issue where very few people are
willing to get tested since they fear that people will know about their status and
stigmatize them.
According to Omonaiye (2013), there are approximately 37 million people worldwide
infected with the HIV virus. More than 65% of these people are from sub Saharan
Africa. In Kenya, by the year 2017, there were approximately 1.6 million people
living with the HIV virus, there are approximately 62,000 new HIV infections each
year. The HIV prevalence in Kenya had fallen to 5.9% by the year 2015 (Gitonga,
Waithaka & John, 2017). The government has been able to make big strides towards
reducing HIV prevalence rate and reducing the mortality rate resulting from HIV
related illnesses in Kenya. However, despite these strides made in reducing HIV relate
deaths, the social problem related to the disease has been increasing (Choi, 2014).
One of the biggest challenges faced by the government to reach the people infected
with HIV is the stigma that comes with people realizing that someone is suffering
from the disease. Stigma sparks secrecy and denial, which are catalysts to
transmission of HIV (Corno & de Walque, 2013). The reaction of the society and
family towards people with the virus varies depending on various factors such as the
level of education of the family members and their understanding of the disease.

There are several factors that increase stigma. Such factors include cultural
constructions and stereotypes. Most communities in Kenya live a communal life or
the societies are closely knit. This means that what affects one person is a concern for
the whole community and it’s difficult to conceal your own life. The closely-knit
society can be a positive for HIV patient or a negative. It can be a positive when the
community is be able to provide the support and care that a person needs to live
longer with the disease (Van, 2013). However, this factor has been a negative for
most people in the society that tend to stigmatize and discriminate against the people
living with the virus. This is mostly influenced by the beliefs, culture, and traditions
of the society. Many people know HIV as a very deadly disease and they fear the
people with the disease since they are afraid of getting infected (Van, 2013). This can
be attributed to lack of proper education on the HIV/AIDS disease. Stereotyping is
also widespread despite schooling and education, people still have their own
assumptions and beliefs on HIV, its effects and how it is transmitted. The stereotypes
have brought about unending pain and suffering for people with HIV since they are
treated differently in the society (Stangl & World Bank, 2010). Access to and the role
of antiretroviral therapy has also impacted by the level of stigma and discrimination
against HIV/AIDS patients. Access to antiretroviral therapy in Kenya has increased
more than 15 times between the year 2005 and the year 2017. However, despite this
increase in accessibility, many people are not ready to accept their new condition and
prefer to live in denial hence they don’t get the much-needed medical care and
medication. Even after getting tested, many people are not ready to disclose their
status to close family members. A research carried out in Kenya in the year 2015
indicates that of the 72% of people who were found to disclose their status, 23%
disclosed it to their parents, 10% of siblings, and 29% of pastors (Y Hong, 2012). The
HIV virus is also associated with changes in body such as getting thinner and loss of
hair. This means that any person showing those symptoms or body changes risk to be
discriminating against. People living with HIV/AIDS have also been discriminated
and stigmatized in relation to religious beliefs and practices. Some religions do not
allow people living with HIV to attend church or join their congregation (Kapungwe,
2009). Other religions preach against people living with HIV and portray them as
immoral and not fit to live in the society. This has catalyzed stigmatization and
discrimination for these people. Gender is another factor that is commonly associated

with stigmatization. Women living with HIV are more stigmatized and discriminated
against compared to men living with the virus (Loue, 2013).
There are different ways through which stigmatization and discrimination against
people living with HIV can be reduced. One of these methods is by starting programs
to educate the people about the causes of the HIV/AIDS, infection and ways in which
its contracted from one person to another. The people in rural areas are very ignorant
on matters relating to HIV/AIDS (Connerley & Wu, 2016). The customs and beliefs
of the people in the society have had a huge impact on the people living with HIV for
many of them fear disclosing that they have the diseases and they end up infecting
others. The other way through which stigmatization can be reduced is through focus
groups. People should be organized in focus groups where they can get educated on
how to live with the disease and to resist getting stressed due to discrimination by the
society (Mwaura, 2008). Religious groups need to play a role in reducing
stigmatization and discrimination against people living with HIV. Religious leaders
need to understand the HIV disease and can educate their followers on the importance
of caring for people living with the virus and to stop treating them differently
(Clement, 2016). Introduction of a school curriculum where HIV lessons can be
taught to children from an early age can play an important role in reducing
discrimination in the society since the children will grow up understanding that even
the people with HIV are normal human beings and they should be taken care of
(Bohle, 2013)
Conclusion
This research project focuses on researching on ways in which stigmatization and
discrimination against people living with HIV in Kenya can be reduced. The report
begins with the listing of the problem statement and setting out of goals and
objectives of the research study. The research questions are also designed to help
guide the researcher in carrying out the real research. The methodology to be used in
this study is a qualitative research method and it will depend mostly on secondary
data. The report also contains a detailed literature review that reviews the past
literature about discrimination and stigmatization resulting from the HIV infection.
The conceptual framework used in this study is clearly defined and explained in
detail.

References
1. In Azetsop, J. (2016). HIV & AIDS in Africa: Christian reflection, public health,
social transformation
2. Bohle, L. F. (2013). Stigmatization, Discrimination and Illness: Experiences
among HIV-Seropositive Women in Tanga, Tanzania. Göttingen, Niedersachs:
NiedersächsischeStaats- und Universitätsbibliothek.
3. Choi, J. (2014). HIV Stigmatization Harms Individuals and Public Health.
Infection & Chemotherapy, 46(2), 139. http://dx.doi.org/10.3947/ic.2014.46.2.139
4. Clement, S. (2016). Sputum Smear Conversion Time of HIV Infected and
Uninfected Patients with Rifampicin and Isoniazid Mycobacterium tuberculosis
gene Mutations in Western Kenya. Journal Of Medical Science And Clinical
Research, 04(12), 14463. http://dx.doi.org/10.18535/jmscr/v4i12.28
5. Corno, L., & de Walque, D. (2013). Socio-Economic Determinants of
Stigmatization and HIV Testing in Lesotho. SSRN Electronic Journal.
http://dx.doi.org/10.2139/ssrn.2733621
6. In Chenneville, T. (2017). A clinical guide to pediatric HIV: Bridging the gaps
between research and practice.
7. In Connerley, M. L., & In Wu, J. (2016). Handbook on well-being of working
women.
8. In Jonas, K. J., & In Morton, T. A. (2012). Restoring civil societies. Hoboken,
New Jersey: Wiley-Blackwell.
9. Gitonga Ragwa, F., Waithaka, S., & John Henry Ouma, P. (2017). Comparative
Renal Function Tests between HIV Patients on and not on Antiretrovirals and HIV
Negative individuals at Nyeri Provincial General Hospital, Nyeri County, Kenya.
International Journal Of Advanced Multidisciplinary Research, 4(3), 51-58.
http://dx.doi.org/10.22192/ijamr.2017.04.03.006
10. Kapungwe, A. K., & Organization for Social Science Research in Eastern and
Southern Africa. (2009). Youth and government's fight against HIV/AIDS in

Zambia: A closer look at some underlying assumptions. Addis Ababa, Ethiopia:
Organisation for Social Science Research in Eastern and Southern Africa.
11. Liamputtong, P. (n.d.). Stigma, Discrimination and Living with HIV/AIDS
[recursoelectrónico]: A Cross-Cultural Perspective.
12. Liamputtong, P. (2013). Stigma, discrimination and living with HIV/AIDS.
Dordrecht: Springer.
13. Loue, S. (2013). Mental health practitioner's guide to HIV/AIDS. New York, NY:
Springer.
14. Macharia, K. (2015). Applying Margaret Newman’s Theory of Health as
Expanding Consciousness to Psychosocial Nursing Care of HIV Infected Patients
in Kenya. American Journal Of Nursing Science, 4(2), 6.
http://dx.doi.org/10.11648/j.ajns.s.2015040201.12
15. Morisky, D. E. (2016). Overcoming AIDS: Lessons learned from Uganda.
Greenwich, Conn: IAP-Information Age Pub.
16. Mwaura, P. (2008). Stigmatization and Discrimination of HIV/AIDS Women in
Kenya: A Violation of Human Rights and its Theological Implications. Exchange,
37(1), 35-51. http://dx.doi.org/10.1163/157254308x251322
17. Nginya, M. (2016). Effects of Stigma and Discrimination on the Right to
Education of Children with HIV/AIDS Aged 4-8 Years in Kikuyu Sub-county,
Kenya. International Journal Of Elementary Education, 5(1), 1.
http://dx.doi.org/10.11648/j.ijeedu.20160501.11
18. Stangl, A., & World Bank. (2010). Tackling HIV-related stigma and
discrimination in South Asia. Washington, D.C: World Bank.
19. Streck, V. (2013). Theology and HIV & AIDS in Latin America. Saõ Leopoldo:
Editora Oikos.
20. Ullah, A. K. M. A., & Huque, A. S. (n.d.). Asian Immigrants in North America
with HIV/AIDS [recursoelectrónico]: Stigma, Vulnerabilities and Human Rights.
21. Opiyo, E., Ongeri, L., Rota, G., Verdeli, H., Neylan, T., &Meffert, S. (2016).
Collaborative Interpersonal Psychotherapy for HIV-Positive Women in Kenya: A
Case Study From the Mental Health, HIV and Domestic Violence (MIND) Study.
Journal Of Clinical Psychology, 72(8), 779-783.
http://dx.doi.org/10.1002/jclp.22359

22. O'Connor, P., & Earnest, J. (2011). Voices of resilience: Stigma, discrimination
and marginalisation of Indian women living with HIV/AIDS. Rotterdam: Sense
Publishers.
23. Odindo, M., &Mwanthi, M. (2008). Role Of Governmental And Non-
Governmental Organizations In Mitigation Of Stigma And Discrimination Among
Hiv/Aids Persons In Kibera, Kenya. East African Journal Of Public Health, 5(1).
http://dx.doi.org/10.4314/eajph.v5i1.38968
24. Omonaiye, O. (2013). Hiv/aids in nigeria. Place of publication not identified:
Rosedog Pr.
25. Van, H. C. C. (2013). Birth in the age of AIDS: Women, reproduction and
HIV/AIDS in India. Palo Alto: Stanford University Press.
26. Y Hong, S. (2012). Knowledge of HIV Transmission and Associated Factors
among HIV-Positive and HIV-Negative Patients in Rural Kenya. Journal Of AIDS
& Clinical Research, 03(07). http://dx.doi.org/10.4172/2155-6113.1000170