Reflective Writing: HIV Stigma, Patient Privacy, and Public Health

This reflective writing piece examines the pervasive issue of HIV stigma within healthcare settings. Utilizing the Gibbs reflective cycle, the author, a health professional, details personal experiences with patients facing discrimination and societal misconceptions about HIV. The reflection explores the ethical dilemmas encountered when balancing patient privacy with public health concerns, particularly regarding the disclosure of HIV status to sexual partners. The analysis delves into the feelings, evaluations, and actions taken in response to these challenges, highlighting the impact of stigma on patient care and the need for education to combat misconceptions. The author reflects on the importance of legislative support and counseling to address the psychological and social impacts of HIV stigma, concluding with insights on improving clinical practices and advocating for societal changes to reduce discrimination.

REFLECTIVE WRITING

TABLE OF CONTENTS
INTRODUCTION...........................................................................................................................1
GIBBS REFLECTION CYCLE: ....................................................................................................1
Description...................................................................................................................................1
Feelings........................................................................................................................................2
Evaluation ...................................................................................................................................3
Analysis .......................................................................................................................................4
Conclusion...................................................................................................................................5
Action plan...................................................................................................................................6
REFERENCES ...............................................................................................................................7

INTRODUCTION
Reflective writing can be defined as an analytical writing in which personal reflection on
a certain incident, thought, feeling etc. is described. These reflections can be written using
various models but in those models Gibbs model is most commonly used. Gibbs model is a
reflective cycle which encourages a person to think systematically, share their experience and
analyse it. It is useful as it helps a person to write their reflection in a systematic order in details
(Brown and et.al., 2016). This reflection will focus on reflective writing on the topic HIV stigma.
HIV stigma is the negative belief or attitude of people about and towards HIV positive people.
Such people are insulted, gossiped, rejected etc. from all the social activities by the society.
GIBBS REFLECTION CYCLE:
Description
There has been several experiences of observing instances related to HIV associated
stigma's in society. As a health professional, I come across such types of incidences regularly.
Most of the patients who visited me are very hesitate to discuss the topics such as HIV test. In
may opinion the key issue behind this perspective is that most of the people are very confident
that they cannot suffer from this disease and even if they then it is safe and better to hide this
claim from other people. During one of my clinical practices I observed a patient who required
blood.
However, when we performed several blood tests and he was diagnosed with HIV then
his first concern was that this should not be disclosed in society. As a part of the society I am
well aware with his concern and fear. In our society there are several misconceptions related to
HIV. People believe that HIV is contagious and even a normal handshake can make them
infected (Turan and et.al., 2017). The belief is not only followed by less educated communities
but is strongly followed among well educated groups as well. I tried to explain him that his
privacy will be respected and he should not worry regarding this. The disclosure of the patient
identity has been unethical and unacceptable clinical practice. The situation becomes more
critical when the case is of HIV patients.
HIV patients undergoes into lot of discrimination. They often face discriminatory
behaviour in their organisations, public places and even in families (Rueda and et.al., 2016). I
used to have interaction with many patients and their families who informed me that how their
lives changed how diagnosis of HIV. One of my patient informed me that his family members
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have refused to continue any relation with him as they are afraid that in any case if this will be
disclosed then there will be huge criticism and discrimination. Despite having several laws of
equality and dignity of HIV patients still there are wide gaps in the reality. He was verbally
abused, rejected from all the social or family activities even form his family members. As this
HIV stigma is present at each and every level of the society and even in legislation, he was not
supported by anyone and didn't revived any help from any one.
Along with the treatment and care services as a health professional I am expected to
ensure this privacy and safety concerns of my patients. If my patients are not comfortable to
disclose their identity then, I am supposed to follow this. However, I have to face huge dilemma
in such situation as along with the privacy rights and dignity of my patient I also have to consider
about public health. For instance the sexual partners of the patient have the right to know that
their partner is diagnosed with HIV so that they can follow the precautions in future and they can
be prevented from the infection (Brown and et.al., 2016). But many patients feel uncomfortable
whenever it comes to disclosing their information to their sexual partners.
Feelings
The events when the patients are diagnosed with HIV or when the concern for describing
their condition to their family members occur then I felt like in tough state. On one hand I have
complete understanding that the social discrimination is preventing patient from describing their
identity to others. And thus I think I should take decision to respect the privacy issue. On the
other hand I feel that as a health professional I am not only responsible for one particular
individual instead I must also assure public health. My decision to hide the identity and HIV
status of patient can be life threatening for others.
If the sexual partners of the patient will not be aware with the HIV status then, it can
make other individuals infected (Sweeney and Vanable, 2016). The risk becomes more
vulnerable when infection is caused to women as HIV virus is transmitted from mother to child.
Few years back when I undergo into same dilemma then it was very challenging for me to
interact with the patient and to convince him that it is important to inform to sexual partners.
Today I feel that patient's privacy is a must concern because social stigmas are still not capable
to completely regulated by regulations. HIV victims undergoes into lot of difficulties in their
routine life.
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However, the safety of others cannot be neglected and thus an important decision and
intermediate decision must be taken (Rydström and et.al., 2016). I feel that in such situations at
first I must communicate with the patient so that they can understand that by hiding the HIV
status they are putting their love ones at risk. I realised that patient was not agreed to this aspect
and was very firm on his decision to hide his status from his spouse as well. At that moment also
I had sympathy with the patient but I was not agreed to put her spouse at risk. Thus, I discussed
the issue with my senior professionals and they informed me the legislative perspective that
though it is illegal to disclose the HIV status but since it can lead to complications I can inform
to spouse only under certain conditions.
Evaluation
When I informed about my decision to patient then he was very nervous and got
depressed. I tried to explain him the actual perspective and necessity but he was very afraid. I
thought this can lead to have adverse psychological impact on him so I just decided to have some
interaction with him. My colleagues suggested me that I can take help from the psychologists or
counsellor and can seek their advise. After interaction with the counsellor I was very confident
and assured that I will convince the patient. In my interaction I tried to evaluate the reasons that
which social stigma are bothering him. Then I explained him that how government regulations
and rights can help him to overcome such situations.
Such counselling sessions can be helpful for the HIV patients to deal with the social
stigmas. From this experience I evaluated that in order to reduce the HIV prevalence it is
important that along with the precaution practices people must also overcome these social
stigmas. Most of the people does not avail HIV screening on time due to fear that if they will
have HIV then people will discriminate with them (Emlet and et.al., 2015). The delayed
screening and testing enhances the severity of infection which ultimately turns into AIDS. From
this event I also evaluated that communities must be given education regarding misconceptions
associated with the HIV so that discriminatory practices can be prohibited.
The ineffective diagnosis and treatment strategies of HIV are the result of fear due to
social stigma. In my opinion there are significant number of infection cases which are caused just
because the sexual partners are not informed regarding HIV status. The current legislative
practices gives protection to the privacy rights of the patients however I believe that these
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regulations must be explored to further extent so that interest of public health are not
compromised and health professionals can fulfil their duties towards community safety as well.
Analysis
The experience has been valuable and has provided a lot of learnings which can improved
my future clinical practices. I have learned from the incidence that legislations are very
important part of the healthcare practices. The HIV diagnosis in the initial phase can help to
lower the prevalence of AIDS. However, for this purpose there is need to enhance the scope of
existing regulations (Chan and et.al., 2015). There must be strict monitoring that HIV patients
does not face any kind of discrimination. As a regular practitioner I must communicate with my
patients so that they can freely inform me regarding any kind of difficulties. In order to deal with
the chronic diseases such as HIV which are often equipped with the social stigma awareness
programs can be organised. These awareness programs will help in generating awareness about
this disease and actual facts related to the disease can be communicated to the patients so that
people can remove their misconceptions regarding the same.
From this incident I have also learned that in society people are often depressed that HIV
cannot be treated completely. Among social communities it is also assumed that if HIV status is
disclosed then they may lost their jobs or family members. In such situations it is required that
patients must be given necessary counselling. More than that counselling and education is
required for the social groups who have various misbeliefs regarding HIV. It will help to reduced
the discrimination and other threats related to HIV(Darlington and Hutson, 2017). So, that not
only all the HIV patients can live their life with equality but will also be able to receive their
family and friends support that they require.
In my opinion it is also assumed by many people that there is no treatment for the HIV
and thus they must go for the diagnosis only when it is emergency or critical condition. Contrary
to this if HIV infection is diagnosed or screened on time then AIDS can be prevented and
sufferings can be reduced. I have analysed from my experience then if in future I will face
similar situation again then I will try to assure that I may convince the victim that they can live
normal social life without any discrimination or isolation. I will also help to give them sufficient
information which can help them in living normal life without any discrimination. However
social stigma cannot be overcome without legal support. Though there are equality regulation but
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still there is need to overcome the indirect stigma related to the disease (Darlington and Hutson,
2017).
Conclusion
From this indecent I have learnt that however and how much we try it is extremely
difficult to change people's or society mentality. Government has made lots of regulations for
HIV patients safety, security, equality and privacy but there are still lots of changes that are
required by the society. People need to change their mentality and their point of view towards
HIV positive patients. I was feeling bas when my patient was feeling uneasy and uncomfortable
when I asked him to share his with his spouse. People are not ready to accept this fact and are
still scare of HIV. Government is trying to aware people about HIV, its symptoms how it is
spread but still there are lots of misconceptions about this disease. I feel sad whenever I see
people discriminate HIV patients and leave them all alone when they need someone the most.
Patients who suffer with HIV should take this information very much supportingly and others
should understand this. I have also learnt that there is a need of providing education regarding
HIV as there are lots of misconceptions related to it. I have observed that sometimes many other
health care professions just go with the flow and doesn't even try to make their patient
understand the actual facts of HIV.
I have observed that people in our society lives with half information and made their
perception regarding it. I have seen that people are unaware that even a HIV patient can live a
healthy life for many years if precautions are taken and healthy life style is followed. But people
does not even understand this and due to this half information they discriminate HIV patients,
make them feel inferior and makes their life even more difficult to live then it is. Sometimes, I
have bad issues regarding this issue as there is no doubt that there are some legislations that
support HIV patients but still many times such patients does not receive any support from this
legal system and many times these patients even hesitate to ask for help for the legal system as
they do not want to disclose their details with others due to a fear that they will be treated
unequally. I have also observed that this HIV stigma as it is spread at different levels of the
society and even in legislative levels. Due to this patients are abused physically, verbally, they
are denied for any kind of service, they are treated unfairly within their job organizations. I feel
sad whenever I see that this HIV stigma is not being reduced but however it is continuously
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spreading day by day. But there are many organisations that are trying to reduce this sigma and
some what they are successful in reducing this stigma till a certain extent.
Action plan
There is no doubt that will not receive such type of cases in my future practise as it is one
of the biggest misconception of people and they live with this half information. But if in future I
receive any such case then I will try to communicate to the patient and with their family
members. I will try to explain them all the details related to HIV so that the patients are
supported by their family members and they can supportingly accept this fact and try to live their
lives. I will also try to explain all the legislations, acts related to HIV for the patients so that they
feel confident and do not feel scared of this disease. I will try to arrange counselling session for
both the patient as well as for their family members so that their misconceptions related to HIV
can re removed. I will also be aware of my surrounding and if I feel that any patient is being
discriminated because of HIV I will support them and try to bring justice to the patient. I will
also try to monitor all my patients and the medicines they are taking so that their health can be
improved and they do not face any difficulties in future. I will also support all the in care homes
for such patients who are neglected by their families and societies so that they are taken care of
in a better way. I will participate in social organizations who try to reduce this HIV sigma and
will support them to generate awareness so that next time whenever I receive any care related to
HIV they can feel safe regarding the same.
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REFERENCES
Books and Journals
Brown, M.J. and et.al., 2016. Psychological reactance and HIV-related stigma among women
living with HIV. AIDS care. 28(6). pp.745-749.
Chan, B.T. and et.al., 2015. Persistent HIV-related stigma in rural Uganda during a period of
increasing HIV incidence despite treatment expansion. AIDS (London, England). 29(1).
p.83.
Darlington, C.K. and Hutson, S.P., 2017. Understanding HIV-related stigma among women in
the Southern United States: A literature review. AIDS and Behavior. 21(1). pp.12-26.
Emlet, C.A. and et.al., 2015. The impact of HIV-related stigma on older and younger adults
living with HIV disease: does age matter?. AIDS care. 27(4). pp.520-528.
Rueda, S., and et.al., 2016. Examining the associations between HIV-related stigma and health
outcomes in people living with HIV/AIDS: a series of meta-analyses. BMJ open. 6(7).
p.e011453.
Rydström, L.L. and et.al., 2016. HIV-related stigma and health-related quality of life among
children living with HIV in Sweden. AIDS care. 28(5). pp.665-671.
Sweeney, S.M. and Vanable, P.A., 2016. The association of HIV-related stigma to HIV
medication adherence: a systematic review and synthesis of the literature. AIDS and
Behavior. 20(1). pp.29-50.
Turan, B. and et.al., 2017. Framing mechanisms linking HIV-related stigma, adherence to
treatment, and health outcomes. American journal of public health. 107(6). pp.863-869.
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