Page 21 - Q BULLETIN, Ministry of Health Malaysia, VOLUME 1, NO. 31 (SUPPLEMENT 1), JAN-DEC 2022

Q Bulletin, Volume 1, No. 31 (Supplement 1), Jan - Dec 2022
th
11 National QA Convention, 4 – 6 October 2022
OP-07

Reducing HIV Stigma and Discrimination (S&D) towards People Living with HIV (PLHIV)
among Healthcare Workers (HCWs) at Tanglin Health Clinic

Fatimah Zahrah MZ , Nor Faizah G , Raudhah AR , Ismawati I , Mohd Nasirudin N 1
1
2
2
1
1 Tanglin Health Clinic, Kuala Lumpur
2 HIV/ STI/ Hepatitis C Unit, Kuala Lumpur & Putrajaya Health Department
SELECTION OF OPPORTUNITIES FOR IMPROVEMENT:
Several complaints from PLHIV were received on the act of S&D by HCWs. This was further supported by a
baseline survey where 19% of PLHIVs experienced discrimination from HCWs. This study aimed to reduce
the S&D among HCWs to encourage better communication between HCWs and PLHIV, thus improving their
treatment adherence.

KEY MEASURES FOR IMPROVEMENT:
To achieve the target of zero discrimination, we set a standard that 100% of PLHIV should not experience S&D
when they come to the clinic as the main indicator. HCW S&D domains were also measured and monitored
in this study.

PROCESS OF GATHERING INFORMATION:
Two cross-sectional studies were conducted to examine staff training, knowledge, attitude, and practice and
concluded with an in-depth interview. Laboratory forms were audited to determine the ‘Biohazard’ labelling
practice. ‘My Journey Survey (MJS)’ among PLHIV was conducted to identify areas associated with
discrimination.

ANALYSIS AND INTERPRETATION:
HCWs without training have more fear of contracting HIV, mean=47.6%, compared to those with training,
mean=38.9%. The paramedics and pharmacists had moderate to high scores on knowledge, but their attitude
and practice were average. ‘Biohazard’ labelling was found on 67% of laboratory forms. MJS identified the
bleeding room and pharmacy as areas frequently associated with the act of discrimination.

STRATEGIES FOR CHANGE:
Workshops using the HIV S&D HOPE module were conducted for the HCWs. Related posters and videos were
also disseminated to the staff. System-generated laboratory forms eliminate the ‘Biohazard’ labelling. HIV
clinic one-stop-centre, flip chart, and telegram channel were created to improve PLHIV education.

EFFECT OF CHANGE:
The percentage of PLHIV reported discrimination by HCWs reduced from 19% to 0% on the first cycle of
assessment. Significant improvements in HCW S&D domains were also observed mainly after the second
assessment.

THE NEXT STEP:
The study’s findings were presented to the national and state HIV/AIDS sectors. Intervention modules are now
used as a reference for other health facilities in Kuala Lumpur & Putrajaya for HIV S&D intervention in their
facilities.

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