A vital partnership: Stigma reduction and the health of PLWHAs
A report from the last International AIDS Conference, in Bangkok Thailand, July 2004
Stigma and discrimination have been shown at this conference to be alive and well, and continuing to trouble the lives of people living with HIV/AIDS.
Stigma and discrimination against people with HIV/AIDS is seemingly entrenched in many areas across the world. A report published recently by the Asia Pacific Network of People Living with HIV/AIDS (APN+) – “AIDS Discrimination in Asia” – suggests 26% of people living with HIV experience some degree of stigma and discrimination in the community. The study also found women experience significantly more stigma than men, including twice the levels of violence. This raises the spectre of a strong gender component to stigma.
Other studies presented during the conference confirm that negative perceptions of PLWHA are as endemic as the virus itself. This is not news to many, of course.
But as talk of “scaling-up” and “mainstreaming” continues, initiatives will be seriously compromised if stigma and discrimination remain as common as they are now. Any healthcare initiative designed to improve the lives of HIV-positive people or to expand testing must consider the difficulties presented by current levels of stigma.
The situation is further complicated by stigma and discrimination experienced in the health sector – the subject of many papers presented at this conference. The APN+, for example, found that 26% of PLWHA experienced healthcare-related stigma. This is a clear disincentive to treatment, and could reduce the effectiveness of otherwise well-designed programmes.
For example, treatments intended to extend the lives of people with HIV/AIDS, such as TB prophylaxis or counselling on how to live healthily with the disease, can be highly effective in extending lives. But many depend on easy access to healthcare, and HIV-related stigma could be a major barrier to access in many areas across the world.
Dealing with stigma is not easy, however, because it is much more than just a “bad” attitude or fear of infection. Stigma is a socially constructed phenomenon that, according to Peter Aggleton of the University of London, is “not random, but systematic – reinforcing existing divisions” in society. Stigma reduction is therefore not about passing on information, though this may play a small part. Instead, it requires a significant conceptual and cultural repositioning.
But the news was not all bad this week, and attempts to reduce stigma at the personal level are clearly taking into account social context. A number of skills workshops have been held, a common theme to them all is the need for people to “know thyself” as a preliminary step to disentangling the knots of stigma and discrimination. The greater personal understanding that results helps people identify with, rather than exclude people with HIV/AIDS.
Other sessions looked at ways of “measuring” stigma. Some tried to locate the origin of stigma in national or institutional settings.
The fight against stigma will be protracted, but to continue is vital. Because if stigma and discrimination remain at their current levels, adequate healthcare and social support for people living with HIV and AIDS will be incredibly difficult to provide.
Can we afford another 20 years of this?
HDN Key Correspondent
Email: correspondents@hdnet.org
(July 2004)
Stigma and discrimination have been shown at this conference to be alive and well, and continuing to trouble the lives of people living with HIV/AIDS.
Stigma and discrimination against people with HIV/AIDS is seemingly entrenched in many areas across the world. A report published recently by the Asia Pacific Network of People Living with HIV/AIDS (APN+) – “AIDS Discrimination in Asia” – suggests 26% of people living with HIV experience some degree of stigma and discrimination in the community. The study also found women experience significantly more stigma than men, including twice the levels of violence. This raises the spectre of a strong gender component to stigma.
Other studies presented during the conference confirm that negative perceptions of PLWHA are as endemic as the virus itself. This is not news to many, of course.
But as talk of “scaling-up” and “mainstreaming” continues, initiatives will be seriously compromised if stigma and discrimination remain as common as they are now. Any healthcare initiative designed to improve the lives of HIV-positive people or to expand testing must consider the difficulties presented by current levels of stigma.
The situation is further complicated by stigma and discrimination experienced in the health sector – the subject of many papers presented at this conference. The APN+, for example, found that 26% of PLWHA experienced healthcare-related stigma. This is a clear disincentive to treatment, and could reduce the effectiveness of otherwise well-designed programmes.
For example, treatments intended to extend the lives of people with HIV/AIDS, such as TB prophylaxis or counselling on how to live healthily with the disease, can be highly effective in extending lives. But many depend on easy access to healthcare, and HIV-related stigma could be a major barrier to access in many areas across the world.
Dealing with stigma is not easy, however, because it is much more than just a “bad” attitude or fear of infection. Stigma is a socially constructed phenomenon that, according to Peter Aggleton of the University of London, is “not random, but systematic – reinforcing existing divisions” in society. Stigma reduction is therefore not about passing on information, though this may play a small part. Instead, it requires a significant conceptual and cultural repositioning.
But the news was not all bad this week, and attempts to reduce stigma at the personal level are clearly taking into account social context. A number of skills workshops have been held, a common theme to them all is the need for people to “know thyself” as a preliminary step to disentangling the knots of stigma and discrimination. The greater personal understanding that results helps people identify with, rather than exclude people with HIV/AIDS.
Other sessions looked at ways of “measuring” stigma. Some tried to locate the origin of stigma in national or institutional settings.
The fight against stigma will be protracted, but to continue is vital. Because if stigma and discrimination remain at their current levels, adequate healthcare and social support for people living with HIV and AIDS will be incredibly difficult to provide.
Can we afford another 20 years of this?
HDN Key Correspondent
Email: correspondents@hdnet.org
(July 2004)
posted by AIDS-Care-Watch at 7:05 pm
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