Discrimination of HIV infected persons in medical settings in Madagascar

Objective. - The objective of our study was to describe the discrimination profile of healthcare personnel towards people living with HIV/AIDS (PLWHA) in medical settings in Madagascar. Method. - A prospective, multicentric, descriptive, and analytic study was made with a questionnaire filled in anonymously, between February and August 2009, in 17 Madagascar hospitals (public and private). Results. - Thirty-six percent of PLWHA reported that they had been confronted with discrimination in the medical field. The age (30-40 years) and the level of education had an impact on discrimination in our study (p<0.05). Paramedics were the most responsible for discrimination (n=8/13) (61.5%). Discrimination in the medical field was listed as: refusal of the patient to be managed in the hospital (n=5/27) (18.5%) because of the fear of discrimination (n=4/5) (80%) and sharing serological status with healthcare providers. Discrimination by the medical staff was listed as the unjustified use of some tools (stethoscope, tensiometer, thermometer) and by the refusal to manage PLWHA (p>0.05). Fifty-three percent of healthcare providers answered the question on HIV transmission mode correctly. Fifteen percent replied that HIV was transmitted by saliva, and 20% by physical contact. Conclusion. - As elsewhere, discrimination of PLWHA in the medical field is present in Madagascar. Fighting discrimination should be included in the strategy against propagation of HIV infection. (C) 2010 Elsevier Masson SAS. All rights reserved.