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Key Text HIV-related Stigma, Discrimination and Human Rights Violations: Case Studies of Successful Programmes

Author: UNAIDS
Date: 2005
Size: 74 pages (957 KB)

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Summary

Stigma and discrimination have fuelled the transmission of HIV and increased the negative impact of the epidemic. How can HIV-related discrimination be addressed in order to achieve public health goals and overcome the epidemic? UNAIDS examines this question, drawing on a range of case studies from all over the world. Stigma, discrimination and human rights violations are intimately linked, reinforcing and legitimising each other. Multi-faceted action, sustained over time, is needed to prevent stigma, challenge discrimination and promote and protect HIV-related human rights.

Stigma is the dynamic process of devaluation that 'significantly discredits' an individual in the eyes of others. Discrimination is actions or omissions that are derived from stigma and directed towards those individuals who are stigmatised. With HIV/AIDS this can occur in family/ community/ institutional/ national settings. Discrimination is a violation of human rights.

There are a range of ways in which these issues can be addressed. Some cases deal with stigma at collective and community levels. Others address the development and implementation of laws and policies to protect against discrimination and support the rights of people living with HIV/AIDS (PLWHA).

The negative effects of stigma and discrimination can be seen during prevention, care and treatment:

  • A non-supportive environment undermines the ability of individuals and communities to protect themselves and to receive care and support.
  • 'Internalised' stigma can also prevent PLWHA from seeking treatment, care and support or working/attending school.
  • Stigma reinforces pre-existing prejudices and inequalities, including gender, racial, and ethic stereotyping.
  • Discrimination occurs through ostracisation at family and community level. In institutional settings it may result in reduced access to health care, loss of work or denial of access to school. Some countries explicitly restrict the rights of PLWHA through the absence of laws to safeguard their rights.
  • Violations of rights therefore worsens the impact of HIV and increases vulnerability to infection (for instance, if women do not have the legal power to make choices in their lives and to refuse unwanted sex). It hinders positive responses to the epidemic, restricting civil society from mobilising effectively.

There are now examples of successful programmes that have begun to address these issues:

  • Home-based care programmes significantly improve the quality of care provided to PLWHA and can reduce discrimination. Involving PLWHA in prevention and care encourages greater community acceptance, reduces self-stigma and encourages further disclosures of seropositive status.
  • Mobilising the community (particularly religious leaders) in prevention and care can be very effective. Participatory training empowers communities to be aware of and challenge stigma.
  • Multisectoral programmes target the multiple contexts of stigma and discrimination, and should address other forms of inequality and exclusion that are further disempowering. This includes gender.
  • The media, especially radio and television drama, can promote positive attitudes towards PLWHA. Supportive and confidential spaces for discussion of sensitive topics are needed, such as telephone hotlines, counselling centres, and support groups. Counselling and support to families and children is vital.
  • Workplaces and health-care centres should adopt rights-based anti-discriminatory policies and legislation. Mechanisms for redress where violations do occur are necessary, such as legal aid institutions and lawyers' collectives specialising in AIDS.
  • Access to treatment (to treat opportunistic diseases and antiretroviral therapy) can also help reduce stigma.


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Source: Aggleton, P. et al, 2005, ‘HIV-related Stigma, Discrimination and Human Rights Violations: Case Studies of Successful Programmes’, UNAIDS Best Practice Collection, Geneva
Author: UNAIDS, http://www.unaids.org


 
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