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

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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.

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Funding

This research was funded by a University of Malaya Postgraduate Research Grant (PO059-2015B), Grants from the National Institute on Drug Abuse (K01 DA038529 for JAW, K01 DA042881 for VAE, and K24 DA017072 for FLA) and the Ministry of Higher Education High Impact Research Grant (E000001-200001 for AK).

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Authors and Affiliations

  1. Centre of Excellence for Research in AIDS, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia

    Ying Chew Tee, Frederick L. Altice, Adeeba Kamarulzaman & Jeffrey A. Wickersham

  2. Department of Human Development and Family Sciences, University of Delaware, Newark, DE, USA

    Valerie A. Earnshaw

  3. Department of Internal Medicine, Section of Infectious Diseases, AIDS Program, Yale University School of Medicine, New Haven, CT, USA

    Frederick L. Altice, Adeeba Kamarulzaman & Jeffrey A. Wickersham

  4. Department of Epidemiology of Microbial Diseases, Yale University School of Public Health, New Haven, CT, USA

    Frederick L. Altice

  5. Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA

    Harry Jin

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  1. Ying Chew Tee
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  2. Valerie A. Earnshaw
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  3. Frederick L. Altice
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  4. Harry Jin
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  5. Adeeba Kamarulzaman
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  6. Jeffrey A. Wickersham
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Correspondence to Jeffrey A. Wickersham.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Tee, Y.C., Earnshaw, V.A., Altice, F.L. et al. Evaluating Physicians’ Intention to Discriminate Against Patients Living with HIV in Malaysia. AIDS Behav 23, 1039–1047 (2019). https://doi.org/10.1007/s10461-018-2362-4

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