Tackling Stigma One Label at a Time

Dear Partners:

Stigma surrounding HIV and AIDS exists world-wide, although it can manifest itself differently across regions, communities, religious groups, or even individuals.  More often than not, HIV related stigma links itself to other forms of stigma like tribalism, homophobia, sexism, classism and can be specifically targeted to create “unacceptable groups” or activities. Stigma not only makes it more difficult for someone HIV-positive to come to terms with their status and manage their well-being at a personal level, but it also interferes with our ability to face and fight against the continued spread and impact it has. 

Stigma and discrimination, though often linked are two very separate issues. Stigma, is defined as a “mark” or “brand” associated with an infamy or disgrace.  In the context of HIV, stigmas are labels, judgments, assumptions and prejudices that are associated with the virus and becoming infected by it. Discrimination however, is the result of stigma. Discriminations are the actions that follow as a result of a stigma, which although vary in expression, are often categorized as punishments, exclusions or criminalization. In order to tackle these, they must be understood on separate terms: Cause and Effect. Because one would not exist without the other and thus to put an end to discrimination, you must address the root causes of and put an end to the stigma surrounding HIV.

The UN Secretary General Ban Ki Moon says, “Stigma remains the single most important barrier to public action. It is a main reason why too many people are afraid to see a doctor to determine whether they have the disease, or to seek treatment if so. It helps make AIDS the silent killer, because people fear the social disgrace of speaking about it, or taking easily available precautions. Stigma is a chief reason why the AIDS epidemic continues to devastate societies around the world.”

Why is there still stigma around HIV and AIDS?  On the simplest of terms, stigma is the result of a lack of understanding or mis-information which infiltrates and shapes cultural norms, value systems, individual and collective behavior in the most complex of ways.  When this takes root it wrongly answers the questions: who contracts HIV and why? Who doesn’t? What does it do to you? What does it mean to be associated with someone who is infected?  What will happen to you if you are positive or know someone who is?  Combating stigma becomes a conscious effort to transform the labels that come from these questions and supporting people to cope with the facts. 

Facilitating change is not an easy process. However, we have seen successes in programs working to address this! The attached resources have been selected to help your programs better understand the concepts surrounding stigma, apply tested approaches, and use the appropriate indicators that  will you monitor your work and bring your communities closer to being HIV-Stigma-Free!

1. Stigma in the HIV/AIDS epidemic: A review of the literature and recommendations for the way forward:
   This article published in the AIDS journal focuses on defining, measuring, and reducing HIV/AIDS related stigma as well as assessing the impact of stigma on the effectiveness of HIV prevention and treatment programs. Based on a systemic literature review, the authors conclude by offering a set of recommendations that may represent important next steps in a multifaceted response to stigma in the HIV/AIDS epidemic. 
2. Reduction of HIV-Related Stigma and Discrimination:
   This Guidance Note is part of the resource kit for high-impact programming that provides simple, concise and practical guidance on key areas of the AIDS response. The resource kit is jointly developed by the Joint United Nations Programme on HIV/AIDS. 
3. Reducing Stigma and Discrimination Related to HIV and AIDS:
   Engender Health has developed this two-volume curriculum offering a unique training opportunity for health workers in countries hardest hit by the AIDS pandemic. The training course guides health workers through an investigation of the root causes of stigma and discrimination while helping them to understand their own attitudes about HIV, AIDS, and individuals affected by these conditions and how these attitudes might affect the care they offer. The training also provides a review of clients’ rights in receiving health care services, information about the use of standard precautions and proper infection prevention techniques to help minimize the risk of occupational exposure to HIV, and guidance in developing action plans to help the participants put what they have learned into practice at their service settings. The curriculum consists of a participant’s handbook and a trainer’s manual. The training employs participatory education techniques—such as role-plays, small- and large-group discussions, and brainstorming—that have been shown to be critical to successful adult learning.
4. Integrating Stigma Reduction into HIV programming:
   The aim of this toolkit is to present different examples of stigma reduction activities that have been integrated into HIV programs for long-term impact and sustainability. These examples have been taken from organizations and programs around Africa Developed by the International HIV/AIDS Alliance, this toolkit is designed to help trainers plan and organize educational sessions with community leaders, or organized groups raise awareness and promote practical action to challenge HIV stigma and discrimination. 

More to Come!