Unmasking the Truth: Addressing Stigma in the Fight Against HIV (original) (raw)
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Stigma in the HIV/AIDS epidemic: a review of the literature and recommendations for the way forward
AIDS, 2008
Although stigma is considered a major barrier to effective responses to the HIV/AIDS epidemic, stigma reduction efforts are relegated to the bottom of AIDS program priorities. The complexity of HIV/AIDS related stigma is often cited as a primary reason for the limited response to this pervasive phenomenon. In this paper, we systematically review the scientific literature on HIV/AIDS related stigma to document the current state of research, identify gaps in the available evidence, and highlight promising strategies to address stigma. We focus on the following key challenges: 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 the literature, we conclude by offering a set of recommendations that may represent important next steps in a multifaceted response to stigma in the HIV/AIDS epidemic.
Journal of the International AIDS Society
Introduction: There is robust evidence that stigma negatively impacts both people living with HIV and those who might benefit from HIV prevention interventions. Within healthcare settings, research on HIV stigma has focused on intra-personal processes (i.e. knowledge or internalization of community-level stigma that might limit clients' engagement in care) or interpersonal processes (i.e. stigmatized interactions with service providers). Intersectional approaches to stigma call us to examine the ways that intersecting systems of power and oppression produce stigma not only at the individual and interpersonal levels, but also within healthcare service delivery systems. This commentary argues for the importance of analysing and disrupting the way in which stigma may be (intentionally or unintentionally) enacted and sustained within HIV service implementation, that is the policies, protocols and strategies used to deliver HIV prevention and care. We contend that as HIV researchers and practitioners, we have failed to fully specify or examine the mechanisms through which HIV service implementation itself may reinforce stigma and perpetuate inequity. Discussion: We apply Link and Phelan's five stigma components (labelling, stereotyping, separation, status loss and discrimination) as a framework for analysing the way in which stigma manifests in existing service implementation and for evaluating new HIV implementation strategies. We present three examples of common HIV service implementation strategies and consider their potential to activate stigma components, with particular attention to how our understanding of these dynamics can be enhanced and expanded by the application of intersectional perspectives. We then provide a set of sample questions that can be used to develop and test novel implementation strategies designed to mitigate against HIV-specific and intersectional stigma. Conclusions: This commentary is a theory-informed call to action for the assessment of existing HIV service implementation, for the development of new stigma-reducing implementation strategies and for the explicit inclusion of stigma reduction as a core outcome in implementation research and evaluation. We argue that these strategies have the potential to make critical contributions to our ability to address many system-level form stigmas that undermine health and wellbeing for people living with HIV and those in need of HIV prevention services.
Reducing HIV-related stigma: lessons learned from Horizons research and programs
Public health reports (Washington, D.C. : 1974)
Since the early years of the human immunodeficiency virus (HIV) epidemic, stigma has been understood to be a major barrier to successful HIV prevention, care, and treatment. This article highlights findings from more than 10 studies in Asia, Africa, and Latin America-conducted from 1997 through 2007 as part of the Horizons program-that have contributed to clarifying the relationship between stigma and HIV, determining how best to measure stigma among varied populations, and designing and evaluating the impact of stigma reduction-focused program strategies. Studies showed significant associations between HIV-related stigma and less use of voluntary counseling and testing, less willingness to disclose test results, and incorrect knowledge about transmission. Programmatic lessons learned included how to assist institutions with recognizing stigma, the importance of confronting both fears of contagion and negative social judgments, and how best to engage people living with HIV in progra...
HIV therapy, 2009
Addressing HIV-related stigma "Ending the AIDS pandemic will depend largely on changing the social norms, attitudes and behaviors that contribute to its expansion. Action against AIDS-related stigma must be supported by top leadership and at every level of society" [1].
Breaking Barriers: Mitigating Stigma to Control HIV Transmission
Elite Journal of Public Health, 2024
Human Immunodeficiency Virus (HIV) remains a significant global health concern, with stigma acting as a critical barrier to effective control and prevention. This review article delves into the complex interplay between stigma and HIV transmission, emphasizing the detrimental impact of societal attitudes on testing, treatment adherence, and healthcare access. Stigma perpetuates the cycle of transmission by fostering fear, discrimination, and reluctance to seek care, contributing to increased infection rates. Addressing stigma necessitates a comprehensive approach involving education, awareness campaigns, advocacy, and the creation of supportive environments. Efforts to mitigate stigma and discrimination not only enhance prevention strategies but also uphold the dignity and rights of individuals affected by HIV. This review advocates for a concerted global effort to break down barriers, combat stigma, and create inclusive systems that promote equitable access to healthcare and support services for all affected populations.