Stigma and discrimination
Effective responses impossible so long as stigma goes unaddressed
In 2006, at the High Level Meeting on AIDS, the UN General Assembly committed to scale up towards the goal of universal access to comprehensive HIV prevention, treatment, care, and support by 2010 for all those who need it. This has the potential to be a momentous turning point in the AIDS response – but a target that may also remain unmet because of the barriers that stigma and discrimination present.
The global consultation process on universal access, facilitated by UNAIDS, highlighted that services need to be accessible to people where and when they need them, without fear of prejudice or discrimination. It showed that prevention, treatment, care and impact mitigation must be planned and delivered with the full inclusion of people living with and affected by HIV. And information and services must be equitable – available regardless of age, sex, wealth, or vulnerability[1].
Some of the case studies and testimonies that you can access from these pages show that this model is still a long way off. Many people are frightened of disclosing their HIV status and of participating in HIV programmes or using HIV services. They are experiencing violence and aggression within families, violence and extortion by the police, and discriminatory treatment accessing health services. They are often unaware of their rights, and confidentiality is being breached. They are being shunned by families, friends, and communities.
HIV-related stigma is based on fear and ignorance about HIV and AIDS. It can also be based on fear, ignorance, or prejudice about the groups most affected by HIV – for example, men who have sex with men, sex workers and injecting drug users.
HIV-related discrimination is the unfair treatment of people based on their actual or suspected HIV status. It is linked with and reinforces other forms of discrimination, such as racism and homophobia.
Whilst stigma and discrimination disproportionately affect groups that engage in behaviours that put them at a higher risk of HIV infection – such as sex workers, men who have sex with men and injecting drug users – the resources devoted to HIV prevention, treatment and care for these groups is inadequate. Only 5% of injecting drug users[2], 11% of men who have sex with men and 16% of sex workers[3] have access to basic HIV prevention services.
Human rights abuses continue to undermine the effectiveness of HIV interventions, both fuelling and following infection. Those most in need of HIV information, prevention, and treatment are being driven underground, while people living with HIV experience stigmatisation and discrimination, including at work, and in accessing government services.
Stigma and discrimination impacts on people’s ability to network, organise, and cooperate to respond to HIV and AIDS. Already under-represented in decision-making processes, marginalisation creates a vicious cycle for populations key to the epidemic, rendering their experiences invisible to policy and decision makers and leaving them without access to adequate or appropriate services. Yet when involved in responses to the epidemic, these communities are often the most effective actors, bringing the expertise of lived experience, and the ability to reach people who are hard to reach.
The examples on these pages aim to give an overview of different approaches the Alliance and partners are taking to address stigma and discrimination – from one-on-one support right through to working with national governments. The examples are also feeding into a global review of evidence of stigma-reduction programming by the International Centre for Research on Women, commissioned by the UK Department for International Development.
[2] Report on the global AIDS epidemic 2006, UNAIDS
Related resources
Anti-stigma and discrimination work in action
A trainer’s viewpoint
26 June 2007
The Africa regional stigma training project
20 June 2007
Facing up to official fears - in China
20 June 2007
Learning not to judge - in Mexico
20 June 2007
Voices of change: Diana Quispe Pari
31 January 2007
Voices of change: Freddy Cahuina Ramos
31 January 2007
Unheard Voices, Hidden Lives: a participatory photography project
The individuals in this project – people living with HIV, men who have sex with men, and sex workers – invite us to share, in their own images and words, their experiences, hopes, and fears of living in a world irreversibly touched by HIV.
A trainer's viewpoint
Trainers who have attended stigma-reduction training of trainers workshops in Kenya describe some of the ways the training has affected their lives and their communities.
