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AIDS Behav. 2019 Apr;23(4):1039-1047. doi: 10.1007/s10461-018-2362-4.

Evaluating Physicians' Intention to Discriminate Against Patients Living with HIV in Malaysia.

Author information

1
Centre of Excellence for Research in AIDS, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
2
Department of Human Development and Family Sciences, University of Delaware, Newark, DE, USA.
3
Department of Internal Medicine, Section of Infectious Diseases, AIDS Program, Yale University School of Medicine, New Haven, CT, USA.
4
Department of Epidemiology of Microbial Diseases, Yale University School of Public Health, New Haven, CT, USA.
5
Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA.
6
Centre of Excellence for Research in AIDS, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. jeffrey.wickersham@yale.edu.
7
Department of Internal Medicine, Section of Infectious Diseases, AIDS Program, Yale University School of Medicine, New Haven, CT, USA. jeffrey.wickersham@yale.edu.

Abstract

People with HIV (PWH) in Malaysia experience high levels of stigma, which may act as a barrier to accessing healthcare. Stigma against PWH in medical settings is understudied in Malaysia. In the present study, we examine factors associated with physicians' intention to discriminate against PWH in Malaysia. A cross-sectional online survey was emailed to all 1431 physicians at two major university hospitals in Malaysia; 568 (39.6%) participants completed the survey and were included in this analysis. Measures included intention to discriminate against PWH, stigma-related constructs, and socio-demographic characteristics. Multivariate linear regression was used to identify factors associated with intention to discriminate against PWH. Participants were comprised of women (53.5%), Malays (43.1%), and Chinese (35.0%) with nearly 10 years of clinical experience. Most participants were from non-surgical specialties (77.6%). The final multivariate linear regression showed that physicians who expressed greater discriminatory intent against PWH also expressed more negative feelings toward PWH, more HIV-related shame, were more fearful of HIV, and believed that PWH do not deserve good care. Physicians from surgical-based specialties were also significantly more likely to endorse discriminatory intent toward PWH. Stigma and intentions to discriminate against a class of patients, including PWH, can undermine engagement in care, which is central to international HIV prevention and treatment strategies. Interventions that reduce stigma toward PWH among physicians are crucial to ensuring equitable and stigma-free healthcare.

KEYWORDS:

Discrimination; HIV; Healthcare; Malaysia; Physicians; Stigma

PMID:
30560483
PMCID:
PMC6459712
[Available on 2020-04-01]
DOI:
10.1007/s10461-018-2362-4

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