The impact of stigmatisation of infectious diseases on compliance and access to medical care in the detention environment

Abstract

Individuals with penetration often experience stigmatization of contagious diseases, which can affect treatment compliance and therapeutic response. The stigma causes social isolation and a lack of desire to seek medical care, which affects the progression of disease and infection control in prison. Investigating how stigmatization of the disease impacts medical compliance among inmates, as well as identifying several obstacles that hinder adherence to medical services. Study conducted in the premises of a prison in the Republic of Moldova, using a questionnaire applied to a group of detainees diagnosed with stigmatizing diseases (eg: TB, HIV, mental disorders). Thematic analysis allowed us to identify the factors that influence the stigmatization and compliance to treatment among them. Most of the inmates investigated said they avoid seeking or undergoing medical treatment for fear of being isolated or discriminated against, being perceived with fear or rejection by both colleagues and medical staff. They pointed out that they are treated differently, negatively, if they have an infectious disease, and for this reason they avoid starting treatment, because they could also find out about their condition. Inmates believe they would be more willing to seek medical help if they were guaranteed greater confidentiality, adequate education about contagious diseases, and consistent psychological support. The stigmatisation of the disease negatively influences the treatment compliance of prisoners. It is necessary to implement measures to raise awareness of prison staff in ensuring confidentiality and to involve a multidisciplinary team that guarantees equitable access to medical care.