Qualitative exploration of manifestations of HIV-related stigma in Kano State, Nigeria

Background: HIV-related stigma is an important barrier to the containment of the epidemic and adversely affects the wellbeing of patients. This study explored the manifestation and consequences of HIV-related stigma in Kano State, Nigeria.Methods: The study was descriptive and cross-sectional, that used qualitative methods involving Focus Group Discussions, in-depth interviews, and passive observations. Thematic analysis for the qualitative data was done with the aid of NVivo10.Results: HIV-related stigma was identified by stakeholders and patients to be perverse in Kano, and often manifest in manner distinct from what is known in places where HIV stigma has been well researched. These include facial covering with “Burqah” to shield identity at the clinics, “proxy patients”, travelling long distance away from home to access care, and use of false names to hide identity. A spot observation on four consecutive days at a HIV clinic and an ante-natal clinic yielded an interesting finding: In the antenatal clinic only 2 patients out of the 435 patients who attended the clinic on the four days (0.46%) were wearing Burqah. Conversely, in the HIV Clinic, 18 of the 216 female (8.33%) patients who attended the clinic in the four days period were wearing Burqah (p = 0.0034).Conclusion: These findings lend credence to the fact that HIVrelated stigma is a big reality in Kano State, and has some context specific manifestations, consequences and coping mechanisms. Follow-up quantitative and intervention studies are recommended.Keywords: HIV, stigma, manifestations, consequences, Nigeri