The Impact of Stigma on HIV Care Access

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The Impact of Stigma on HIV Care Access in the African American Community David

The Impact of Stigma on HIV Care Access in the African American Community David P. Lee, MSW, MPH, LICSW African Americans Reach and Teach Health Ministry & Northwest AIDS Education and Training Center Seattle, Washington

About the Sponsors n n African Americans Reach and Teach Health (AARTH) Ministry. The

About the Sponsors n n African Americans Reach and Teach Health (AARTH) Ministry. The Northwest AIDS Education and Training Center.

PIFs and Evaluation Forms ■ Please complete the Participant Information Form (PIF) which is

PIFs and Evaluation Forms ■ Please complete the Participant Information Form (PIF) which is used to track educational events conducted by AARTH & NW AETC. ■ Funding grants are based upon the type and quantity of educational events and the number of attendees!

Introductions § What is your name? § What is your profession? § What are

Introductions § What is your name? § What is your profession? § What are you hoping to learn in this training?

Learning Objectives l l l Define stigma and discrimination. Identify the basis for HIV/AIDS

Learning Objectives l l l Define stigma and discrimination. Identify the basis for HIV/AIDS stigma. Describe how HIV stigma manifest in the African American community. Discuss the impact of HIV stigma on care access for African Americans. Explore strategies to reduce HIV/AIDS stigma and stigmatizing practices in African Americans.

QUESTION What is the definition of sigma?

QUESTION What is the definition of sigma?

Definition of Stigma is a discrediting mark or attribute of shame. It is a

Definition of Stigma is a discrediting mark or attribute of shame. It is a feeling of undesirability that an individual possesses, thus reducing that individual’s selfesteem and status both in their own eyes and those of society.

Definition of Stigma often arises from a dynamic process in which community and/or society

Definition of Stigma often arises from a dynamic process in which community and/or society perceives that there has been a violation of shared attitudes, beliefs and values by the stigmatized individual, his/her group, significant others and associates.

QUESTION What is the definition of discrimination?

QUESTION What is the definition of discrimination?

Definition of Discrimination is a specific prejudicial act that is specific to a distinct

Definition of Discrimination is a specific prejudicial act that is specific to a distinct stigmatizing mark, theory, fear or perception. It is a distinctive act based on prejudice, emanating from distinguishing features of stigma.

Identify Basis for HIV/AIDS Stigma

Identify Basis for HIV/AIDS Stigma

HIV/AIDS Stigma n n n Homosexuality Substance use Sex workers Injection drug users Minorities

HIV/AIDS Stigma n n n Homosexuality Substance use Sex workers Injection drug users Minorities

Stigma Manifestations

Stigma Manifestations

Institutionalized Stigma Institutionalized stigma is when an institution, such as a hospital or church,

Institutionalized Stigma Institutionalized stigma is when an institution, such as a hospital or church, practices stigma either actively or passively.

Example Give 2 examples of institutionalized stigma.

Example Give 2 examples of institutionalized stigma.

Individualized Stigma The acting out of stigmatizing attitudes directed towards an individual. It can

Individualized Stigma The acting out of stigmatizing attitudes directed towards an individual. It can be done by one person or a group of people directed at an individual or done to oneself based on negative societal attitudes and perceptions.

Example Give 2 examples of individualized stigma.

Example Give 2 examples of individualized stigma.

Impact of Stigma on Care Access

Impact of Stigma on Care Access

Impact of Stigma on care access n n Avoid HIV testing and treatment Less

Impact of Stigma on care access n n Avoid HIV testing and treatment Less likely to disclose HIV status Access care late in disease process Refuse to take HIV medications

Strategies to Reduce Stigma

Strategies to Reduce Stigma

EXERCISE List 5 strategies to reduce HIV stigma and stigmatizing practices in African Americans.

EXERCISE List 5 strategies to reduce HIV stigma and stigmatizing practices in African Americans.

Summary l l Stigma is defined and differs from discrimination. HIV stigma manifests in

Summary l l Stigma is defined and differs from discrimination. HIV stigma manifests in the African American community in many ways. Stigma impacts the way that African Americans access HIV care. Several strategies are effective in reducing HIV stigma in African Americans.

QUESTION How will you be able to use what we talked about today in

QUESTION How will you be able to use what we talked about today in your own work?

Additional Resources n David P. Lee – 206 -543 -3319 n AARTH -- 206

Additional Resources n David P. Lee – 206 -543 -3319 n AARTH -- 206 -850 -2070 n [email protected] washington. edu

Additional Reading n n NAPWA Facts At-A-Glance: HIV/AIDS Stigma and Discrimination, National Association of

Additional Reading n n NAPWA Facts At-A-Glance: HIV/AIDS Stigma and Discrimination, National Association of People with AIDS, 2005. HIV, Stigma, and Rates of Infection: A Rumor without Evidence, Daniel D. Reidpath, PLo. S Medicine, October 2006. Stigma, Distrust, Fear, Kai Wright, HIVPLUSMAG. COM, 2007. HIV/AIDS Stigma: An Impediment to Public Health, Ronald O. Valdiserri, American Journal of Public Health, 2002.