What is HIV-related

Stigma ?
And Its Consequences...

Disscussion
Background
Definition of stigma
Stigma, Prejudice and Discrimination
Why is HIV/AIDS so Stigmatized?
Forms & consequences
What can we do to minimize HIV/AIDS
Stigma?

Media further fueled HIV/AIDS Hysteria.

Open-mouth
kissing was "a
possible health
hazard!"

Rocker Sebastian
Bach wore a shirt
in concert
asserting that
"AIDS Kills Fags
Dead."

In 1986 Surgeon General

C. Everett Koop issued
a message to every
U.S. household.

In 1987, The FDA approved

AZT, the first AIDS drug, at a
cost of more
than $10,000 per year,
making it

AIDS Activism Spurred

Increasing HIV Cases in

Philippines

Increasing casual sex activity, poor condom use,

poor education and inadequate public health
response make a HIV epidemic just a matter of
time.

What is Stigma?
Historically, stigma has had two components:
It's a mark of an enduring condition or attribute
The condition is negatively valued by society
As a consequence, those with
the condition become
discredited and disadvantaged.

Stigma, Prejudice and

Discrimination
Related but not synonymous:
Prejudice: An attitude.
An individual evaluation or
judgment of a group
Discrimination: A behavior.
Refers to treatment of
individuals based on their
membership in a group.

Why is HIV/AIDS so stigmatized?

Stigma is more intense
when the condition
is:
1) Perceived as lethal
and incurable
2) Perceived to be the
responsibility of the
bearer

Types of Stigma
Felt Stigma - the real experience of stigma
as the consequence of a particular condition
Enacted Stigma - overt acts of stigma and
discrimination
Note: Even a few dramatic and public
enactments of stigma can drastically
increase the perception of felt stigma.

What drives AIDS Stigma?

Research both in the US and
abroad suggests that it's
fueled by two sub-types:
1) Instrumental stigma
- fear of casual transmission
2) Symbolic stigma
- pre-existing prejudice toward
those groups who have been
hardest hit by disease

AIDS Stigma is not LIMITED

To PLHIV
Courtesy stigma:
Refers to shared stigma by anyone
associated with the condition, even if
uninfected.
Has been reported by family members,
care-givers, AIDS healthcare workers and
anyone else associated with PWAs, even if
not infected themselves.

Forms of Stigma in the Healthcare

Setting
Neglect
Had to wait longer
Not having bed pans changed
Receiving less care/attention
Denied care
Denied treatment
Referral to another provider/facility
Senior provider pushed client to a junior provider
Junior provider pushed client to a senior provider

Forms of Stigma in the Healthcare

Setting
Differential treatment
HIV test required before
care was given
HIV test required before
scheduling surgery
Using gloves for noninvasive exams
Extra precautions in
sterilizing instruments

Verbal stigma
Gossip about a clients HIV
status
Scolding or blaming a client
Lack of consent
HIV testing without
consent
Disclosing HIV status to
family without clients
consent

Example of Stigma in
Healthcare
A pt was taken to the ER with a severe
breathing problem. While in the midst of
emergency treatment, the doctors
discovered that he was HIV positive. They
screamed and jumped away from him,
discontinuing treatment. The patient died
within an hour. (Delhi)

Health Consequences of AIDS

Stigma
Barriers to:
Prevention
Treatment
Research
Care
Mental health

Create Understanding:

Close the Intention-Action Gap

Foster understanding and
motivation for stigma
reduction by creating:
Recognition of stigma
The benefits of reducing it
Safe space to reflect and
gain skills for change

Address HIV Transmission

Fears & Misconceptions
How it is and is not transmitted
In-depth information
Interactively: Allow for
Yes I know that, but why?

Listen, learn & respond to specific fears

related to daily living & work context

Discuss and Challenge the Taboo

Provide safe spaces
to
discuss, reflect,
understand and
question:
The values and beliefs
that underlie stigma
and discrimination
Where they come from?
What they do?

Address the multiple

intersecting &
associated stigmas
of HIV
eg: Sex workers,
men who have sex
with men, drug users

Discuss and Challenge the Taboo.

Time Asia

Immediately Actionable Causes

Lack of awareness
Fear of casual contact
Linking HIV with socially improper behavior

Individual

Environmental

Structural

Address
attitudes
and behaviors

Meet needs for information,

training, and supplies

Policies, laws, and

institutions

Lastly..your HIV patient is just like any other

ordinary one. Needing of your care and empathy.

David Kirby an AIDS activist at his death bed.