Radio stories of living with HIV reduces stigma in Ethiopia

Betengna, a radio program in Ethiopia that showcases the diaries of ordinary people living with HIV, may contribute to reducing HIV-related stigma, according to the results of a research study disseminated September 24, 2008 in Addis Ababa. Results of the research indicate that listeners of Betengna were found to have lower stigma toward people living with HIV and had greater knowledge about HIV transmission, prevention and management.

The program has aired on Ethiopian radio stations over the past two years, and it boasts an exposure of 29% in Addis Ababa and SNNPR, according to the study. It is also available for downloading on the National AIDS Resource Center’s website (www.etharc.org).

The radio diaries narrate the everyday experiences and challenges of living with HIV in Ethiopia and are broadcast weekly on five radio stations in Amharic, Tigrigna, and Oromoiffa languages. Betengna aims to decrease the stigma and discrimination that HIV positive people face in Ethiopia by exposing the human face of living with the disease and providing a platform for creating discussion on these issues among the general public. Over time, diarists cover a broad range of their everyday life experiences such as teen pregnancy, relationships with partners, family, friends and their communities, health issues, emotional and physical stress and living positively.

The research findings come from a household study conducted in November 2007 in four regions – Amhara, Tigray, Addis Ababa and SNNPR - in order to determine exposure to Betengna and the extent to which changes could be linked with exposure to the broadcast. Data was collected by a local research organization, Addis Continental Institute of Public Health.

Study results indicated that listening to Betengna was associated with increased empathy and affinity for the diarists and a better understanding of the challenges of leading an HIV positive life. Other indicators of decreased stigma were a greater perceived identification with people living with HIV and a stronger belief that HIV positive persons should be treated with respect. Caller feedback from listeners supports that Betengna is increasing empathy and reaching listeners on a more emotional level than just promoting rational thinking.

“Many people go to test after they become very sick. Sirak’s story motivated me to get tested and I found out that I’m HIV+,” indicated a male listener. “I live in South Africa, Cape Town. I always listen to Hiwot Mamo’s program and it really amazes me; she really is a wonderful woman. I just wanna tell her be strong and to always look after her self. Stay blessed,” commented a web listener.

The Radio Diaries are produced by the National AIDS Resource Center (ARC) and Johns Hopkins Bloomberg School of Public Health/Center or Communication Programs (CCP). The program's design is based on and builds on similar projects run by CCP in Nigeria and Malawi. Betengna is produced in collaboration with the National HIV/AIDS Prevention and Control Office (HAPCO) with technical assistance from Internews Network-Ethiopia. Funding is provided by the President’s Emergency Plan for AIDS Relief (PEPFAR) through the U.S. Centers for Disease Control and Prevention (CDC).

Feeling "Unwelcome" a Barrier to Homeless Seeking Health Care: Toronto Study

Homeless people who have felt unwelcomed during past health care encounters are more likely to avoid health care institutions, according to a new study by St. Michael’s Hospital researchers.

The qualitative study of 17 homeless men and women at five shelters in Toronto found respondents often reported that unwelcoming experiences prompted strong emotional responses, making it less likely they seek health care in the future.

“The preliminary findings offer a new and unexplored way of thinking about patient-health professional interactions,” study author and St. Michael’s Hospital researcher Dr. Stephen Hwang explained. “While the concept of unwelcomeness being tied to accessibility of health care has been relatively unexplored, it is no less important.”

Following audiotaped in-depth interviews of study subjects, researchers found most participants perceived their experiences of unwelcomeness as acts of discrimination based on homelessness and low social class, lead author Chuck Wen explained.

“Participants characterized these health care experiences as dehumanizing,” he said. “The patients conveyed a sense that the health care provider reduced them to an object, did not empathize with them, ignored or failed to listen to them, and felt brushed aside, rushed, and treated rudely.”

Intense emotional responses associated with these feelings of unwelcomeness have created for some individuals a strong distrust of health care workers and avoidance of health care institutions, St. Michael’s Hospital researcher Pamela Hudak said.

“The results of the study encourage health-care professionals to approach each patient with openness and receptiveness,” she said. “Welcomeness brings to mind the idea of hospitality, a concept that differs from patient satisfaction and that could usefully be incorporated by health care professionals as part of their stance towards not only homeless people but patients in general.”

The study was published in the Journal of General Internal Medicine.