The role of health information in reducing HIV transmission, reducing HIV stigma & achieving the right to health
Author(s):
Crawford, Pammie Renee
Format:
Thesis
Degree granted:
Ph.D.
Publisher:
Ann Arbor : The Johns Hopkins University, 2012.
Pages:
357
Language:
English
Abstract:
Health education campaigns have been provided in Northern Thailand, but this study's objective were to determine if there are: 1) unmet HIV and ART health information needs in the region, 2) if so, if there are any relationship between health information gaps and HIV-related stigma and discrimination, and 3) understand the role of health information gaps on the Right to Health (RH). Through an exploration of awareness and perceptions of HIV transmission and antiretroviral therapy (ART) in Northern Thailand, qualitative and Right to Health analyses were performed to achieve the study objectives. Data utilized were in-depth interviews (n=117) comprised of Thai and ethnic minority participants from Project Accept, a randomized controlled trial conducted in high HIV prevalence areas, including a Northern Thailand site. Data were collected using semi-structured interview guides with Northern Thai (n=81) and ethnic minority (Chinese and Pakistani and hill tribes (Thai-Yai, Black Lahu, Red Lahu, Lisu, Hmong, Akha, Karen, Yao, Shan, Sam/Zam (immigrants from Burma/Myanmar), (n= 36)), participants. Interviews were conducted in Northern Thai, an ethnic language, or a combination of both (depending upon the comfort level and fluency of the respondent). Data analysis was conducted primarily in Atlas.ti, but Microsoft Office products (Word, Excel and Powerpoint) were also utilized when deemed useful and appropriate. The analytic processes were iterative, included preliminary data analysis with feedback from advisors, open coding, data quality assessment, theme development, focused coding, memo and integrative memo development and conceptual framework construction. The human rights analysis included application of right to health (RH) criteria (defined by elements of normative content put forth by the United Nation's Special Rapporteur on the Right to Health, and by General Comment #14 of the Economic and Social Council in 2000): Availability, Accessibility (including non-discrimination, physical accessibility, economic accessibility, and information accessibility), Acceptability, and Quality to qualitative data themes showing the types of health information gaps. The purpose was to evaluate the role of health information in the Right to Health and to determine if the RH was achieved in Northern Thailand within the study communities. The raw data were frequently revisited to guide analysis and qualitative data results showed widespread and diverse HIV and ART health information gaps and a direct correlation between widespread health information gaps and increased HIV-related stigma, with intensified stigma resulting from a higher prevalence of unmet health information needs. The RH analytic results showed health information gaps resulted in the inability to achieve the RH for communities in Northern Thailand. It also showed the RH cannot be fully achieved or realized in the presence of HIV and ART health information gaps. Overall there are sizable and widespread HIV and ART information gaps among both Northern Thai and ethnic minority communities in Northern Thailand.