The Bamrasnaradura Infectious Disease Institute in Nonthaburi is one of Thailand’s premier hospitals in AIDS treatment and care. Its waiting rooms welcome many patients. This month, people waiting for appointments will see on hospital screens stories about people living with HIV who overcame stigma thanks to support from their communities. Bamrasnaradura is one of around 1000 hospitals in Thailand that have joined the zero discrimination in health-care settings campaign.
The Ministry of Public Health of Thailand, the Thai Network of People Living with HIV/AIDS (TNP+) and UNAIDS launched the campaign on 2 March at Bamrasnaradura.
“More than 30 years since HIV was detected in Thailand, stigma still remains a major challenge,” said Jessada Chokdamrongsuk, Director-General, Department of Disease Control, Ministry of Public Health. “Thailand is committed to ensuring health-care settings are safe and supportive environments.”
The campaign features a video with a short message from the popular Thai singer and UNAIDS National Goodwill Ambassador for Thailand, Chalatit Tantiwut, in which he encourages everyone to join the zero discrimination movement.
“Discriminating against anybody for any reason is always out of bounds,” said Mr Chalatit. “Making music is what I do best and I think it’s my duty to contribute to society and make some noise about zero discrimination.”
This initiative is part of an ongoing effort by the Ministry of Thailand to tackle stigmatizing behaviours and attitudes among staff towards people living with HIV. A survey of 1600 Thai health-care workers showed that more than 60% of workers feared an HIV infection while performing routine tasks and 90% admitted to at least one stigmatizing attitude.
The Ministry of Public Health, with support from civil society, UNAIDS and the United States Agency for International Development, has developed a comprehensive stigma reduction programme that is gradually being scaled-up to include all public hospitals.
“Thailand is showing how to tackle HIV-related stigma and discrimination in hospitals and clinics, “said Tatiana Shoumilina, UNAIDS Country Director for Thailand. “This problem is persistent and pervasive in many parts of the world. Only by overcoming this challenge will we Fast-Track the response to HIV and end the AIDS epidemic as a public health threat.”
“Zero Discrimination Day on 1 of March is now a well-recognized event both in Thailand and globally,” said Apiwat Kwangkaew of TNP+. “However, I would like to urge people to practice zero discrimination every day. Fear of HIV transmission and prejudice against people living with HIV are holding back access to treatment and care, employment and education.”
Thailand’s HIV-related stigma reduction programme for health-care workers is one of the world’s most ambitious initiatives and it has been such a success that it is being adapted and implemented in other South-East Asian countries.
After a survey in 2014 of people living with HIV found that stigma and discrimination in health-care settings was a significant issue in Viet Nam, health officials started exploring best practices and the Thai model seemed a good example.
In Ho Chi Minh City, the Viet Nam Administration for AIDS Control, with support from UNAIDS, has started pilot-testing the programme. The initiative began with a survey of three hospitals in the city, which led to a programme for health workers tailored to the Vietnamese context. A training in how to capacitate health-care workers to reduce stigmatizing attitudes and behaviours is under way in the city from the 28 February to 3 March.
“We will conduct an assessment at the end of this pilot project. I hope the lessons learned from this pilot will help further improve the methodology of measuring HIV-related discrimination in health-care settings and programme approaches, so we can expand the practice nationwide,” said Hoang Dinh Canh, Vice-Director, Viet Nam Administration for AIDS Control.
The Lao People’s Democratic Republic is also adapting Thailand’s initiative and Myanmar has expressed an interest in a similar approach. Discrimination is a barrier to accessing health services for people living with HIV globally, which is why UNAIDS dedicated this year’s Zero Discrimination Day on 1 March to elimination discrimination in health-care settings.
