STIGMA AND DISCRIMINATION OF PEOPLE LIVING WITH HIV-AIDS IN THE ECUADORIAN HEALTH SYSTEM

Abstract

Introduction: Stigma and discrimination against people living with HIV-AIDS (PLWHA) during healthcare is a public health problem that still persists in Ecuadorian society. To understand this situation, the situation of PLWHA is analyzed through a cause-effect model constructed based on the application of grounded theory. Objective: To describe the perceptions of stigma and discrimination in the Ecuadorian health system, both among health professionals and PLWHA. Method: The standard questionnaire was used to assess stigma and discrimination from the Policy Health Project 2015, applied to the health team, Nursing students with direct care and PLWHA. To further explore the causes/factors of discrimination, mixed workshops were held between healthcare staff and PLWHA and, by triangulating stakeholder consensus, strategies were developed to minimize the impact of stigma and discrimination. Due to the COVID-19 pandemic, telematic means were used to develop workshops, which included actors from Ecuador and Bolivia (parallel study) and a final ScienceShop with 350 participants, to determine lines of intervention. Results: An improvement in the quality of care provided by health services was identified in recent years in Ecuador, although stigma and discrimination are still perceived and related to three groups of factors – service provision, training and updating, and belief systems and values. Conclusion: Analyzing the causes of stigma and discrimination against PLWH in the Ecuadorian health system is a powerful strategy to reduce stigmatizing and discriminatory attitudes on the part of health professionals.