Addressing Stigma and Discrimination HIV Care Support and

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Addressing Stigma and Discrimination HIV Care, Support, and Treatment Office of Overseas Programming &

Addressing Stigma and Discrimination HIV Care, Support, and Treatment Office of Overseas Programming & Training Support (OPATS)

Introduction and Definition § HIV-related stigma and discrimination is a process of devaluation of

Introduction and Definition § HIV-related stigma and discrimination is a process of devaluation of people living with or associated with HIV. § Stigma is linked to power and domination in society as a whole and reinforces inequality. § When stigma is acted upon, the result is discrimination.

Causes of HIV-Related Stigma and Discrimination § Blame: “PLHIV did something wrong” § Moral

Causes of HIV-Related Stigma and Discrimination § Blame: “PLHIV did something wrong” § Moral judgments or biases § Fear: Life-threatening illness, death, visible debilitation § Misinformation: HIV transmission, treatment efficacy § Existing social inequalities: race, gender, ethnicity, profession, sexuality

Forms of HIV-Related Stigma and Discrimination Stigma § Those infected or suspected to be

Forms of HIV-Related Stigma and Discrimination Stigma § Those infected or suspected to be infected § Stigma-by-association § Self-stigma/internalized stigma Discrimination § Arbitrary distinction, exclusion, restriction § Takes place in family, community, institutional, national settings

Causes of TB-related Stigma and Discrimination § Perceived risk of transmission § Association with

Causes of TB-related Stigma and Discrimination § Perceived risk of transmission § Association with HIV, urban poverty, overcrowding, physical frailty, low social class, malnutrition, “disreputable behavior” § Impact on women, poor, less-educated § High death rate

Stigma and Discrimination and Care, Support, and Treatment § Major barrier deterring PLHIV from

Stigma and Discrimination and Care, Support, and Treatment § Major barrier deterring PLHIV from – Voluntary testing – Access and retention in care and support services across the Continuum of Care – Treatment adherence § Non-disclosure § Self-stigma

Stigma and Discrimination and Care, Support, and Treatment § At the same time, despite

Stigma and Discrimination and Care, Support, and Treatment § At the same time, despite challenges, CST helps address HIV stigma and discrimination: – Care and support acknowledges reality of HIV; demonstrates shared concern and that close and sustained contact does not pose risk of infection – Recruiting and training PLHIV – Access to treatment enables PLHIV to live positively and productively; encourages testing for HIV

Analyzing and Taking Action § Social Ecological Model

Analyzing and Taking Action § Social Ecological Model

Evidence-based Practices to Address Stigma and Discrimination § Training and involvement of PLHIV as

Evidence-based Practices to Address Stigma and Discrimination § Training and involvement of PLHIV as advocates and role models § Mobilization of influential community leaders, especially religious leaders § Community engagement through participatory, nonformal education (community dialogue, local radio, and other media, forum theatre that engages the audience, etc. )