Healthcare across the Border: Stigmatization Experiences and Healthcare-seeking Behavior of Male Expatriates with HIV/AIDS in Thailand

Mr. Dennis C. Casing

Abstract

In ASEAN (Association of Southeast Asian Nations), Thailand is considered as the region’s leader with regards to its effective response to the HIV/AIDS epidemic. In order to understand the epidemic, it is essential to investigate one of its significant drivers: HIV-related stigma. Hence, this research study assessed the experiences of stigma as well as the healthcare-seeking behavior of male expatriates with HIV/AIDS in Thailand.

A PLHIV (People Living with HIV) questionnaire was used as the survey tool in this study. The questionnaire focused on three main domains: socio demographic characteristics, health-related stigma, and disclosure and confidentiality. Health-related stigma targeted three specific forms: anticipated stigma, experienced stigma, and internalized stigma. Together with the questionnaire is a semi-structured interview which probed further the answers provided by the respondents as they were guided during data collection. The methodology of this study is descriptive qualitative and explanatory in describing the stigmatization experiences of the respondents and their healthcare-seeking behavior.

Findings suggest that health-related stigma is still persistent, which made the respondents avoid or delay going to a healthcare facility. Specifically, the response categories that were prominent in anticipated stigma include the feeling of not being sick enough, high cost of healthcare services, and the location of healthcare facilities being near their workplace that induces fear that they might be seen by their colleagues. Internalized stigma was also prominent as majority of the respondents felt guilty and ashamed of their HIV status resulting to their avoidance or delay in going to a healthcare facility.

The results of the study can be used in the development of programs and interventions that will help reduce the three forms of health-related stigma. Moreover, there is a need for expatriates in Thailand to be oriented with the details of their health insurance in order for them to determine if HIV-related laboratory tests and procedures are included in their health insurance program. This research study also suggests the recognition of expatriates as an HIV-affected group that is in need of intervention in order that national policies can focus on their development.

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