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Stigma and HIV

  • There is a two-way relationship between stigma and HIV. People who experience stigma are more vulnerable to HIV, while people with HIV often experience stigma.  
  • Misinformation and fear increases the stigma surrounding HIV and AIDS.  
  • One in eight people with HIV are denied health services because of stigma and discrimination.  
  • Providing clear information about HIV, plus public awareness campaigns and stigma-reduction sessions for healthcare professionals and others can help people recognise and address the stigmatising attitudes they hold. 

What is stigma?

Stigma refers to the negative attitudes and judgements people have about others, based on an aspect of their identity. Stigma leads to discrimination, social isolation and abuse. 

People with HIV are often stigmatised. This stigma is linked to fears about HIV, which emerged at the beginning of the epidemic when little was known about how HIV was transmitted. Although there is now a lot of more information about this, HIV-related stigma persists. 

People from groups most affected by HIV also experience HIV-related stigma, whether they have HIV or not. They can also experience stigma relating to their sexual orientation or gender identity (homophobia), their gender, race, profession, age, or on other grounds. 

What links HIV and stigma?

People who experience stigma are less likely to access the services and support they need to look after their health. Stigma and discrimination is one of the main reasons why people are reluctant to test for HIV, share their HIV status with others, go on HIV treatment or use PrEP.  

Stigma can be deadly. It can result in people with HIV getting diagnosed late, when the virus may have already progressed to AIDS. This makes treatment less effective, increases the likelihood of passing on HIV, and leads to unnecessary deaths. 

The effects of stigma are seen in:  

  • Healthcare settings: Findings from the People Living with HIV Stigma Index suggests one in eight people with HIV have been denied health services. Stigma can lead to health providers delaying or denying treatment, demanding extra payment, and treating people in disrespectful and upsetting ways. 
  • Social settings: People with or affected by HIV might be shunned by family, friends and the wider community and be treated badly at work or school. The fear of social isolation makes people reluctant to access HIV and sexual health services, even when they need them. 
  • Mental health: Stigma can lead to low self-esteem, depression and other mental health issues. This can lead people to misuse alcohol and drugs and take risks with their health that make them vulnerable to HIV, like having sex without condoms. It also drives the silence and shame that stops people accessing services.  
  • The law: Discriminatory laws and policies about HIV reinforce stigma. These laws can make people afraid to seek out healthcare or legal support. It can also stop people being honest if they’re a sex worker, have same-sex relations or inject drugs. This means they are less likely to access services to protect their health. 

What can we do to tackle stigma?

Addressing misinformation and changing attitudes and behaviours

Stigma-reduction dialogues, trainings and sensitisations can help people recognise and address the stigmatising attitudes they hold and change their behaviour. Running such sessions with healthcare providers, police, religious and community leaders, employers, journalists and politicians can help to change attitudes among these groups and in wider society. Enabling people with or affected by HIV to run (or co-run) these sessions is key for ensuring people understand the realities these communities face. These sessions should also address misinformation about how HIV is passed on. 

Putting people with HIV at the centre

Enabling people with or affected by HIV to design and deliver programmes is key to creating stigma-free, friendly HIV and sexual health services and support that marginalised people feel willing and able to use.  

Challenging every day stigma

It is important to call out stigma whenever we see it – be that at work, in our communities or even at home. Public, community-led campaigns can provide information to challenge stigma, and show others that marginalised people are just like everybody else.  

Tackling stigmatising laws

Community-led advocacy to tackle discriminatory laws and policies is vital. It is also important to campaign for laws to protect people from HIV-related stigma and discrimination.

Counselling, information and support

Providing mental health support can help people recognise and deal with the effects of stigma. It is also important to support people with HIV to understand more about the virus and their treatment. This can help people take a more active role in their care and reduce feelings of self-stigma. 

A rights-based approach

A human rights-based approach ensures that people with or affected by HIV are treated with dignity. A rights-based approach aims to create an environment that enables people with or affected by HIV to claim their right to health and to other rights, such as the right to live free from discrimination. Taking a rights-based approach to all HIV programming is essential. 

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