The dissertation develops theoretical provisions and develops scientifically-based practical recommendations for improving public policy to overcome stigma and discrimination against HIV/AIDS-infected patients in Ukraine.
It is established that stigma and discrimination are still common phenomena in Ukraine. The stigma and discrimination associated with HIV/AIDS infringe on the rights of HIV-positive people and result in their maladaptation in public life.
The current state of the HIV/AIDS problem indicates the imperfection of the state policy to combat the stigma and discrimination associated with HIV/AIDS.
It has been determined that the mechanisms for implementing public policy to overcome stigma and discrimination against HIV/AIDS-infected patients – this is the set of the national decisions made, developed, and adopted with the participation of the state and non-state institutions, implemented by systematic actions of public authorities through the application of a comprehensive mechanism to counteract stigmatization and discrimination of HIV/AIDS-infected patients based on the principles of publicity, transparency, equality, openness, interaction, feedback and the public good in order to preserve the health of the population in the interests of both a particular person (individual) and society as a whole.
In particular, it is established that the main mechanisms of public policy of Ukraine to overcome stigma and discrimination against HIV/AIDS-infected patients are as follows: regulatory, medical and social, financial and economic, organizational and functional, information and communication, and educational mechanisms.
It has been demonstrated that ineffective communications are one of the main obstacles to success in combating stigma and discrimination against HIV-positive people. It is found out that digitalization and the use of IT technologies are the parts of the modern effective communication processes.
The main determinants of the emergence and spread of stigma and discrimination against HIV-positive people are identified, which should be taken into account when forming and implementing the appropriate public policies. Among the determinants that contribute to the spread and strengthening of stigma and discrimination of HIV-positive people, there are modified ones that can be influenced, and unmodified ones that are difficult to change.
A significant willingness to stigmatize and discriminate on the part of teachers and students of the medical educational institutions – future healthcare professionals – was revealed. The high level of stigmatization and discrimination against HIV-positive people by the students and teachers of the medical educational institutions is reflected in the willingness to refuse medical care to HIV/AIDS-infected patients.
It has been proven that they need to review and improve the training program on the problem of stigmatization and discrimination of HIV/AIDS-infected patients in medical educational institutions. For this purpose, the author developed, tested, and proposed a program for the medical educational institutions of the I-II accreditation level in the curriculum of the subjects “Nursing in Infectology, Dermatology, Therapy, and Pediatrics “Fundamentals of Law” of the course “Countering Stigmatization and Discrimination of HIV-positive People” and “Regulatory Support in the Field of Combating HIV/AIDS, Stigmatization and Discrimination against People Living with HIV”. It has been demonstrated that an important reason for the high level of stigmatization and discrimination of HIV-positive people by future healthcare professionals and teachers of the medical educational institutions is the imperfection of the national state program in this area, in particular, the lack of the set of measures to prevent and counteract stigmatization and discrimination of HIV/AIDS-infected patients.
The model of public policy for overcoming stigma and discrimination of HIV/AIDS-infected patients in Ukraine has been scientifically based and developed, which covers the subjects of the formation and implementation of the public policy in the field under study based on a cross-sectoral approach, taking into account the determinants of the emergence and spread of stigma and discrimination of HIV/AIDS-infected patients, international practice and regulatory legislation.
In order to implement the set of measures, organize and coordinate the efforts of all the interested artists, it is proposed to create a unit for monitoring and countering stigmatization and discrimination of HIV/AIDS-infected patients within the Public Health Center of the Ministry of Health of Ukraine.
Keywords: public policy, healthcare, stigma, discrimination, overcoming stigma and discrimination, HIV/AIDS-infected patients, the person living with HIV, the mechanism for implementing public policy to overcome stigma and discrimination against HIV/AIDS-infected patients.
