STIGMA AND DiSCRIMINATION IN RELATION TO HIV AND AIDS

PRESENTER; MRS ALICE ANIKA ACU COORDINATOR PWANI UNIVERSITY

NON-TEACHING TECHNICAL STAFFS TRAINING AND WORKSHOP 6TH-7TH AUGUST 2013 AT NOTH COST HOTEL

Presentation objective
Define and identify HIV/AIDS-related

stigma and discriminated people.

Better understand international and

national human right issues.

Clarify personal values and attitudes with

regard to HIV/AIDS prevention and care

address stigma and discrimination in the

context of providing HIV services

NON-TEACHING TECHNICAL STAFFS TRAINING AND WORKSHOP 6TH-7TH AUGUST 2013 AT NOTH COST HOTEL

Definition Stigma - shame or disgrace attached to something regarded as socially unacceptable. Sociologists have taken this a bit further. In a seminal study, stigma was defined as an attribute that is seen as deeply discrediting to a person or group (Goffmann 2009). Those attributes could be an illness, physical deformity, aberrant behavior or social group (based upon religion or ethnicity, etc.).

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Cont Stigma makes people perceive others in a negative light while confirming their own sense of normalcy and decency. Subsequent researchers have viewed this as a social process that creates or perpetuates social inequities and which is used to legitimize discrimination. While this is generally true, stigma can also be a primal human responseparticularly in the case of fearing a disease that is transmissible and
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Stigma and discrimination

Stigma refers to unfavourable

attitudes and beliefs directed toward someone or something

Discrimination is the treatment of an

individual or group with partiality or prejudice

Stigmatization reflects an attitude
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Root causes

1.The role of knowledge about HIV

and AIDS and fear surrounding it Ogden and Nyablade (2007) believe that the fear of transmission from casual transmission, and the various "what if scenarios" are the result of; 1) the lack of specific, in-depth information about HIV transmission, 2) fear-based public messaging,
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 2.The role of values, norms, and moral

judgment This stigma is exacerbated by the seriousness of the illness, its mysterious nature, its association with behaviors that are either illegal or socially sensitive (e.g., sex, prostitution, and drug use, homosexuality). The perception that HIV infection is the product of personal choice: that one chooses to engage in "bad" behaviors that put one at risk and so it NON-TEACHING TECHNICAL STAFFS WORKSHOP is "one's own fault" if HIV infection

 3 Misinformation, beliefs and myths

carries moral baggage -wrong perception -Personal risks -Irrational behaviors A punishment for immoral behaviors A war ( VIRUS brought down to finish human race and must be fought) Horror ( infected pple are
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cont

4 personal irresponsibility 5. Religious moral beliefs 6Effects of ARVs

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Forms of stigma and discrimination

Ogden and Nyblade divide stigma into

four loosely defined groups: physical, social, verbal and institutional. Social stigma Isolated from community Voyeurism: any interest may be morbid curiosity or mockery rather than genuine concern Loss of social role/identity: social `death`, loss of standing and respect
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Cont
Physical stigma

Isolated, shunned, abandoned

Separate living space,

eating utensils sepated

Violence

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 Verbal stigma
Gossip, taunting, scolding Labeling: in Africa:

"moving skeleton,
"walking corpse,"

"keys to the mortuary.

In Vietnam: "social evils," and

"scum of society."

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In Kenya- victims Aids sufferers Aids patient Kakachawa Slim Walking coffin Baridi Wave Wind Fagia

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Institutionalized stigma
Barred from jobs, scholarships, visas Denial of health services Police harassment (eg of sex

workers, HIV-positive activists in China, outreach workers in India)

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Cont
UGANDA- armed forces not

promoted and dismissed if HIV positive CHINEESE compulsory HIV testing when you come back to the country UK prosecution if you pass the virus to someone HEALTHCARE-put on up to 3gloves NON-TEACHING TECHNICAL STAFFS for HIV positive patients WORKSHOP

 TRUST AT THE VCT- FEAR that the

counselors will reveal my HIV status. It will change my relationship with others Explanation for sick leaves Restrictions on travels Side linings of certain inclusions in meetings Abandonment by family memberswhispers No sharing of plates, bathrooms,
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Challenges
HIV-related stigma is increasingly

recognized as the single greatest challenge to slowing the spread of HIV/AIDS

HIV/AIDS a threefold epidemic
HIV

AIDS
Stigma, discrimination, and denial
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Human rights concepts

Freedom from discrimination is a

fundamental human right

Discrimination on the basis of

HIV/AIDS status, actual or presumed, is prohibited by existing human rights standards

Discrimination against persons living

with HIV/AIDS (PLWHA), or those thought to be infected, is a clear humanTECHNICAL rights violation NON-TEACHING STAFFS
WORKSHOP

Effects of stigma and discrimination Social isolation

Limited rights and reduced

access to services
HIV/AIDS related stigma fuels new

HIV infections
Secondary stigma (stigma by

association)
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 Discourages access to CORRECT

INFORMATION
Prevents access to counselling , HIV

testing and PMTCT services, VMMC, BLOOD SAFETY

Discourages disclosure of HIV test

results to partner(s)
Discourages acceptance of MTCT

interventions
Inhibits use of safer infant-feeding

practices
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Confers secondary stigmatisation on the

 Poor healthcare services Loss of marriages Affects home based care Worthlessness feeling Loss of reputation Internal stigma- HIV positive

perception about themselves Self-stigma-orphans face hostility and self rejection discrimination at school, among peers, in health care, and become aggressive
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Addressing stigma
Interventions addressing HIV-related

stigma can take place at all levels:

Individual and family Community and social/cultural Work place , health facilities and

National

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Individual and family level

Personal responsibility Positive living Psycho-social support

Seek correct information

Knowledge of HIV status

Frequent VCT access

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Community level
HIV awareness and knowledge

MTCT activities as integral to

health care and HIV/AIDS prevention and treatment

Referrals to and from MTCT

services
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Awareness of MTCT

Work place ,Health facility and nation

Ambassador on stigma reduction

in the department
Integrate MTCT into antenatal

services
Encourage partner involvement Enlist partner and family support

to decrease HIV transmission

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The gorverment
Formulation of friendly policies

Funding of capacity building

Community development support

Human rights activities

ARVS support VCT services support condom

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distribution, trainings and workshops

ACUS ROLE

Enlist managers help to ensure policies and procedures are in place and implemented for:

Non-discrimination policies Confidentiality

Universal precautions
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 Educate and train WORKERS IN the

institution on;
HIV transmission and treatment
Activities to address stigma and

discrimination
Awareness of language that describes

PLWHA
MTCT-related policies and services Counselling and VCT testing for healthy

living NON-TEACHING TECHNICAL STAFFS

Safer adult relationships at work place
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Summary Stigmatisation reflects an attitude

Discrimination is an act or

behaviour
Stigma and discrimination are

often linked to violations of human rights Human rights declarations affirm all peoples rights to be free from discrimination, including discrimination based on HIV/AIDS status.
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 HIV/AIDS-related stigmatisation

and discrimination can discourage access to key HIV services, including:

Testing

MTCT services
Antenatal care ARV prophylaxis
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 Stigma discourages

-Disclosure of HIV status -Acceptance of HIV positive status -Access to education, -Access to counselling, -treatment VCT services

even when such services are available and affordable

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Role of participants
Lets reduce stigma and

discrimination in our departments, in the community, and at the national level

Serve as role models Involve PLWHA in departmental

discussions
Solicit community support
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 Understand the damage caused by

stigma Be aware of own prejudices Create awareness about stigmatization Challenge stigma and discrimination Respect self and others Seek for information than assuming hear say or I know status
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CONCLUSION
We can fight stigma, make laws and

policies but unless we begin to speak openly about how we feel, about ourselves and perceive others feelings on the same a gender , our fears , aspirations and despair will continue to derail the acceleration of HIV to zero infection and zero stigma and discrimination. Lets give each other support and reduce stigma NON-TEACHING TECHNICAL STAFFS
WORKSHOP

 In the beginning of epidemic ,people

never knew or understood how contagious the disease would be. Fear , ignorance became powerful drivers for stigma and discrimination. Despite our progress in understanding and treating HIV, stigma and discrimination continues to devour various nation and outstanding characters of great nations (President Barrack Obama June 8 2011) We must therefore become our brothers keepers for the sake of human race NON-TEACHING TECHNICAL STAFFS WORKSHOP survival.

THANK YOU

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