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Author Topic: One-fourth Of HIV Patients Believe Their Doctors Stigmatize Them  (Read 2727 times)

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Offline Miss Philicia

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This is unsettling to read:

source

Quote
One-fourth Of HIV Patients Believe Their Doctors Stigmatize Them

Science Daily — Physicians might want to be extra careful about how they treat HIV-infected patients --not just in the clinical sense but in the way they behave toward them.

Even the perception that physicians are stigmatizing patients for carrying the virus that causes AIDS can discourage these individuals from seeking proper medical care, according to a new UCLA study.

The study, published in the August issue of the peer-reviewed journal AIDS Patient Care and STDs, found that up to one-fourth of patients surveyed in the Los Angeles area reported feeling stigmatized by their health care providers. This perception was also linked to low access to care among these patients, a large proportion of whom are low-income and minorities.

"Whether or not it is actual stigmatization is hard to measure, because it's coming from the patients that we interviewed," said UCLA researcher Janni J. Kinsler, the study's project director and lead researcher. "The point is that these people feel that way, and that's bad enough, because they're less likely to seek the care they need."
...
There are two types of stigma: external, or "public," stigma and personal, or "perceived," stigma. The latter refers to individuals' anticipated fears of societal attitudes or discrimination because their HIV infection.

Researchers questioned 223 patients during the baseline interviews and 171 during the follow-up. They were asked the following questions about stigmatization:

Since you contracted HIV, has any health care provider:

Been uncomfortable with you?
Treated you as inferior or in an inferior manner?
Preferred to avoid you?
Refused to serve you?
"I’ve slept with enough men to know that I’m not gay"

Offline milker

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Re: One-fourth Of HIV Patients Believe Their Doctors Stigmatize Them
« Reply #1 on: August 31, 2007, 11:48:02 PM »
I haven't seen my MD since diagnosed. She's the one that gave the news to me, and that day I didn't really pay attention to her attitude towards me. The only other doctors I've seen since then are my ID doctor, my dentist, and the eye doctor.

To answer the survey:

    *  Been uncomfortable with you? All fine
    * Treated you as inferior or in an inferior manner? Not at all
    * Preferred to avoid you? Not at all
    * Refused to serve you? Not at all

I would have added another question, and I'm surprised it's not on that survey, which doesn't seem to want to show positive attitudes:

* Treated you as before? Yes
* Paid special attention to your HIV status so that HIV specific problems are checked? Yes

My dentist sent me a card after I notified him of my status. It said that he was sorry to hear about my condition, that his practice welcomes all people, regardless of their health, and that it was good for him to know it so he will pay uber attention to my oral health. He admitted that he was not very knowledgeable about the new discoveries and meds, and he offered to talk to my ID if needed.

Milker.
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Offline sweetasmeli

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Re: One-fourth Of HIV Patients Believe Their Doctors Stigmatize Them
« Reply #2 on: September 01, 2007, 03:44:31 AM »
I guess I've been quite lucky as far as health providers go.

While I was in Greece all the doctors I saw were fine with me, although they did have a tendency of talking openly and loudly about stuff while surgery doors were wide open etc. It wouldn't bother me now, but earlier in my diagnosis when I wasn't comfy disclosing it used to bug me. The weird thing is the Greeks didn't find it weird!

The only person I had any issue with was the local dentist (who I nicknamed Dr Death). He agreed to treat me but always insisted that I have the final appointment of the day. He also used to wear this daft Darth Vadar-type mask when drilling and stuff and was rough as hell. Pissed me off but unfortunately he was the only dentist in the local area; otherwise I would have gone elsewhere.

Here in the UK all the GPs I've dealt with have been fine with me. Yesterday I visited my mum's dentist with her; he had no qualms about adding me to his patients list (his father used to treat me as a child), even after I disclosed my HIV status. In fact, he asked me to pop up on the chair there and then for a check up, even though I didn't have an appointment. No lollipop after he'd finished though... ::)

Melia 
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Offline GSOgymrat

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Re: One-fourth Of HIV Patients Believe Their Doctors Stigmatize Them
« Reply #3 on: September 01, 2007, 09:39:18 AM »
I'm sure there are exceptions but I think a lot of this is patient perception. I remember first going to a clinic with my partner after we were first diagnosed. We are sitting in the waiting room and he was saying things like "I feel like a leper." He was hypervigilant about being treated differently before we even met the staff. I think health care providers need to make an extra effort to help people with HIV feel comfortable.

Offline Iggy

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Re: One-fourth Of HIV Patients Believe Their Doctors Stigmatize Them
« Reply #4 on: September 01, 2007, 10:38:36 AM »
This (in my mind) is closely related to the Gay doctor thread that was around before.

Being a gay man and going to first a gay doctor and then a doctor in a gay health facility counters this issue to me.  I don't feel stigmatized at all and and often encouraged to discuss items that I think other doctors wouldn't be so willing to inquire about....or maybe I perceive that other doctors wouldn't; II think GSO makes a good point about self-imposed stigma. 

My doc used to give me my hiv test results over the phone and then one day he told me to come into his office...and I knew I was poz.  When I got there I started to mentally judge the way the office assistant, nurse and even he would look at me or say hi while I was waiting to get into his office - I was certain that they were all giving me that "awwww...it's so sad - he is going to die" look.  Totally made up in my mind but it felt so real.

Offline leatherman

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Re: One-fourth Of HIV Patients Believe Their Doctors Stigmatize Them
« Reply #5 on: September 01, 2007, 12:37:20 PM »
I think this is an interesting article, as it points out that doctors need to be more receptive to the feelings of their patients in dealing with their illness.

However, I think it's too limited of a study of have a lot of meaning. Doctors are people, just like their patients, and both have their own pre-conceived ideas. While some doctors are nice, others are aloof. Conversely, some patients are nice and some are not. Then you have to consider the practices which range from big city clinics to small town doctors. The kind of person your doctor is, the type of practice they work in, and the type of patient you are all contribute to the mix.

For example, I live in a small city in Ohio. My first ID doctor in the early 90s, definitely wasn't the nicest guy. As an older white man, I don't think he was all that happy to see his practice, a specialty with few patients, end up with a waiting room full of gay guys. Even though I didn't appreciate his homophobic attitudes, I eventually came to feel sorry for the man as those patients, he never really wanted, died on him year after year. Perhaps all that is what drove him to drinking and having the problems he's going through now. I've thought long and hard about this after the way he treated my partner and I as my partner was dying, and although I was mad for a long time, I just have to pity him now for how he reacted to the situation that was thrush upon him.

On the other hand, my current doctor (the only other ID doctor in town) seems to have a varied clientele here in the 2000s (old, young, white, black, male, female - from what I've seen sitting in the waiting room), and has never treated me badly. (Unless you count his bitching about my smoking LOL) My partner has been going with me into the exam room for the last three yrs, and the doctor has always been friendly and interested in talking with both of us (about my HIV or what we've been up too since the last appt). This doctor treats me with the respect I think I deserve as a well educated 45 yr old man trying to deal with a critical health issue.

I think everyone wants a doctor that "cares" - not only about the disease but about each of us a person. That's one of my reasons for changing to the second doctor. However, how much can a physican really care about a patient as a person? Consider my first doctor. Think about the emotional damage to him, and how much more if he had really cared, as those patients passed away before the meds were improved. Then try to imagine how either of my doctors would react if instead of a bunch of gay guys to deal with, their HIV patients were drug addicts.  I'm sure either doctor would have seemd to be much "meaner" as they would have to work harder to get those patients to comply to the regimens and to stop their self-destructive behaviors.

It would be interesting to see a corollary study about how the doctors felt about their patients.  ;)
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline emeraldize

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Re: One-fourth Of HIV Patients Believe Their Doctors Stigmatize Them
« Reply #6 on: September 01, 2007, 02:11:16 PM »
I'm on the CAB at the clinic I attend and at our last meeting we reviewed all sorts of stats they track. One of them is adherence. The successful adherence percentage exceeds the national average and the staff attributes it to their good patients. In fact, we told them (and we think they know but are handing the credit to pts.) it is because of how they treat patients from Visit #1. Their style sets the tone and it is full of respect, kindness and topnotch care. I've never felt stigmatized for a second by any medical staff person since diagnosis whether ID, PCP, Eye or Dentist. I am sad to know others still have crummy, whether real or perceived, interactions in medical settings---2.5+ decades is a long time for people to make the appropriate adjustments for the sake of patients.
« Last Edit: September 01, 2007, 02:18:47 PM by emeraldize »

Offline J.R.E.

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Re: One-fourth Of HIV Patients Believe Their Doctors Stigmatize Them
« Reply #7 on: September 01, 2007, 04:44:56 PM »



I am very pleased with my doctor.

From the article:

Since you contracted HIV, has any health care provider:

Been uncomfortable with you?
Treated you as inferior or in an inferior manner?
Preferred to avoid you?
Refused to serve you?



The only time, I had an issue was when I was diagnosed positive in 1985. The nurse practioner at that time, who handed me my diagnosis, tried to avoid me at all costs. She wouldn't stand within three feet of me, refused to answer questions, and hurried me out the Health Departments "rear" door. This was in Clearwater,Fl.  Some things you don't forget.

I had more problems with the above issues, from so-called friends, then medical staff.
Current Meds ; Viramune, Epzicom, 40mg of simvastatin, 25 mg of Hydrochlorothiazide.
Metoprolol tartrate 25mg



http://forums.poz.com/index.php?topic=40802.0

http://forums.poz.com/index.php?topic=45159.0

http://forums.poz.com/index.php?topic=39722.msg495621;topicseen#msg495621

http://forums.poz.com/index.php?topic=46806.0

http://forums.poz.com/index.php?topic=39414.msg491701#msg491701


Diagnosed positive in 1985,.. In October of 2003, My t-cell count was 16, Viral load was over 500,000, Percentage at that time was 5%. I started on  HAART on October 24th, 2003.

 As of 12/10/14,  t-cells are at 350,  Previous 8/25/14--- 402/ Viral load remains <40

 Current % is at 13% / Previous 8/25/14 11%

  
 63 years young.

Offline J.R.E.

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Re: One-fourth Of HIV Patients Believe Their Doctors Stigmatize Them
« Reply #8 on: September 01, 2007, 04:52:38 PM »

I also want to add... In my doctors office, he has forms that anyone of his patients can fill out. Anytime you go to another specialist/doctor, for whatever reason, if something is not right,and/ or you are not treated right, you can complete these forms and list those grievances that you had, with that doctor.


Take care-----Ray

Current Meds ; Viramune, Epzicom, 40mg of simvastatin, 25 mg of Hydrochlorothiazide.
Metoprolol tartrate 25mg



http://forums.poz.com/index.php?topic=40802.0

http://forums.poz.com/index.php?topic=45159.0

http://forums.poz.com/index.php?topic=39722.msg495621;topicseen#msg495621

http://forums.poz.com/index.php?topic=46806.0

http://forums.poz.com/index.php?topic=39414.msg491701#msg491701


Diagnosed positive in 1985,.. In October of 2003, My t-cell count was 16, Viral load was over 500,000, Percentage at that time was 5%. I started on  HAART on October 24th, 2003.

 As of 12/10/14,  t-cells are at 350,  Previous 8/25/14--- 402/ Viral load remains <40

 Current % is at 13% / Previous 8/25/14 11%

  
 63 years young.

Offline VickieLeeNYC

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Re: One-fourth Of HIV Patients Believe Their Doctors Stigmatize Them
« Reply #9 on: September 02, 2007, 06:13:02 AM »
I must say this is the hardest thing for me to live with as a person who is HIV+.  I do not usually disclose my health status with people, particularly strangers.  I find it difficult, however, when I visit a new health care provider.  It is under these circumstances that I am usually compelled to reveal my HIV status.  There is always a risk in disclosing this to people you are not yet comfortable or familiar with.  This includes health care providers and their staff.  I guess I become most paranoid after filling out the forms and waiting to see if I can detect a negative reaction.  Most of the time, I am happy to say, this all turns out to be my own fears. 

Offline adrianmnk

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Re: One-fourth Of HIV Patients Believe Their Doctors Stigmatize Them
« Reply #10 on: September 03, 2007, 08:54:58 AM »
I had a doctor who examined (looked into my ears, listened to my breathing)  me while wearing surgical gloves.  Bear in mind this was back in 2003 when it has been clearly established HIV is not transmitted through casual contact. Needless to write, I saw this doctor only three times, until I could find a better doctor. Makes me wonder, though, why this woman chose to treat infectious disease patients if she were so apparently paranoid about contracting anything.

Offline Pilot

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Re: One-fourth Of HIV Patients Believe Their Doctors Stigmatize Them
« Reply #11 on: September 03, 2007, 02:04:28 PM »
I have always gone to a gay MD and have never had any situation where I felt uncomfortable.  As far as a doctor wearing gloves when giving an examination, I would not think anything about it.  I am sure many doctors use them and of course change gloves between patience.  Its simply a precaution to prevent the possible spreading of something from one patient to another.  I watched a program where they showed how easy it was to spread illnesses in hospitals where doctors did not use gloves or clean their stethoscopes between patients.

Offline bear60

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Re: One-fourth Of HIV Patients Believe Their Doctors Stigmatize Them
« Reply #12 on: September 03, 2007, 03:43:15 PM »
Pilot has a very good point....we see a doctor wearing gloves coming at us and we take it as a personal affront that he/she is afraid of touching us when we should be happy that our doctor is keeping his/her hands clean.  I mean you dont know where those hands had to go before seeing you!
Poz Bear Type in Philadelphia

Offline Iggy

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Re: One-fourth Of HIV Patients Believe Their Doctors Stigmatize Them
« Reply #13 on: September 03, 2007, 04:48:10 PM »
I agree with Bear and Pilot about the gloves....and I advise everyone to get used to it.  There is a specific and conscious movement in the medical profession to have doctors wash hands and change gloves for every patient.

I read a recent article about it is being pushed in many medical environments as a way to combat MRSA transmission rates that have been rising steadily.

Offline GSOgymrat

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Re: One-fourth Of HIV Patients Believe Their Doctors Stigmatize Them
« Reply #14 on: September 03, 2007, 06:20:35 PM »
Even though I'm a mental health counselor and often don't have any physical contact with patients I'm required to use antiseptic gel before and after going into a room with a patient. We are encourage by hospital administrationto do this in front of the patient to model good hygiene.

Offline DonDPaul

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Re: One-fourth Of HIV Patients Believe Their Doctors Stigmatize Them
« Reply #15 on: September 03, 2007, 06:24:27 PM »
Ford, a "newbie" here, yet reading your posts and especially the posts on lipodystrophy. Patient of Dr. Abrahms here in Los Angeles, thought I'd introduce myself and perhaps you could contact via profile here. DP
Don (DP)

Offline GSOgymrat

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Re: One-fourth Of HIV Patients Believe Their Doctors Stigmatize Them
« Reply #16 on: September 03, 2007, 10:19:57 PM »
Hey, Don! Feel free to send me a PM.

Offline Ann

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Re: One-fourth Of HIV Patients Believe Their Doctors Stigmatize Them
« Reply #17 on: September 04, 2007, 02:40:36 PM »
About the gloves thing - I once had a registrar (intern to you Yanks) sit in front of me for about ten minutes, trying to double bag before he took my blood. I finally asked him what the hell he thought he was doing and he sputtered out some lame explanation about it being for MY safety as he'd just come from the surgical ward. I pointed to the sink, told him to go wash his hands, put ONE pair of gloves on and then he could proceed.

I ended up kicking him out anyway - he was shaking so hard there was no way I was going to let him near my delicate veins. The ward sister in charge that evening came into my room a few minutes later to ask what happened, so I told her about the double bagging and having to tell him to wash his hands, and how he was shaking so much I didn't want him digging for a vein.

She went back out and he admitted to her (I was on the ID ward following a surgery and my room was right outside the nurses' station, so I heard every word) that he'd never had to take blood from an hiv positive patient before and let me tell you, she read him the riot act.

For a start, she explained that he probably had but didn't know and that's why they're REQUIRED to follow universal precautions with EVERYONE. Next she explained how double gloving made it more likely he'd get an accidental needle-stick injury. She topped if off by telling him if he ever stepped foot on HER ward again without immediately using the sanitizing gel and repeating between patients and before leaving the ward, she'd have his nuts in a sling.

He might have been shaking when in my room, but I'm surprised he hadn't pissed himself by the time the sister was finished with him. :D

Jan, if you're reading this, the nurse in question was Scottish and ruled the place as only a Scots woman can. ;) ;D

Ann

edited for clarity
« Last Edit: September 04, 2007, 02:47:34 PM by Ann »
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