HIV and stigma
"Stigma is a dynamic process of devaluation that significantly discredits an individual in the eyes of others. The qualities to which stigma adheres can be quite arbitrary - for example, skin color, manner of speaking, or sexual orientation. Within particular cultures or settings, certain attributes are seized upon and defined by others as discreditable or unworthy". - UNAIDS definition
Stigma is a mark of disgrace that sets a person apart from others. Stigma and discrimination impedes people's ability to access quality health services that respect the dignity of all users and contributes to spreading further HIV and AIDS and sexually transmitted infections.
It is incumbent upon governments, which should collaborate with health workers, civil society and members of stigmatised populations, to develop and implement comprehensive strategies to reduce and eliminate this stigma and discrimination; but also to all of individuals in society and at community level to put an end to social stigma.
"Listen to us! Learn from us! Join us!": Tanzania Women Living with HIV and AIDS sensitise the public aboutthe harm caused by stigma and discrimination during World AIDS Day celebrations.
Photo by Lokola Ndibalema
Progress has been made in addressing HIV and AIDS but some communities and groups have been left out and are still very much excluded hence most at risk of both spreading and suffering from the disease. ACORD has approached them as ‘hard to reach communities', or HTR.
They include commercial sex workers, pastoralists and communities that practise fishing, sexual and ethnic minorities, women survivors of sexual and gender-based violence, children heading households and internally displaced persons. These groups and communities are often marginalised and stereotyped; stigma must stop to leave space to inclusion and equal rights.If we do not address stigma and discrimination, HIV and AIDS will win!
ACORD's effort to fight HIV and AIDS affecting minorities is structured as follows:
- improving awareness among health care providers, community leaders and the general public on minorities and existing impeding factors violating their right to health;
- improving knowledge of health care providers, community leaders and the general public, on the linkages between stigma, minorities and health (in particular HIV and AIDS);
- reducing prejudice against minorities improving their access to health and prevention and reducing violence;
- reducing self-stigma among minorities through increased number of advocacy actions led by minorities groups themselves;
- ensuring availability of avenues in the media, the workplace and at community levels to discuss issues of stigma in comparison to social inclusion;
- improving collaboration between key stakeholders when addressing stigma-related issues at local, national and regional levels;
ACORD has been working on HIV and AIDS and on reducing stigma and discrimination for the past 15 years, and has successfully implemented the Stepping Stones methodology in several countries, as an efficient approach to influence positive attitudes and as a HIV and AIDS prevention tool.
Stepping Stones is a training and education process that involves working with people over a period of 12 to 18 weeks3 during which time they undergo a process of group exploration and develop the ability to look critically at the societal norms and values influencing their own attitudes and behaviours.
As the process moves on, they identify ways in which these attitudes and behaviours may need to be changed in order to protect themselves and others from HIV and associated risks and, to bring about more general life changes and improvements, such as improved communication with partners and children, more understanding and caring for others and increased self-respect.
Stepping Stones evaluations, ranging from personal testimonies provided by individual participants to rigorous large-scale surveys using scientific research methods, indicate that Stepping Stones has transformed the lives of many individuals and whole communities in very positive ways and has helped people and communities to be better equipped to face the challenges of HIV and AIDS and to work together to support each other and care for those already infected by the virus.
Social Exclusion Analysis
Additionally, ACORD has adopted the social exclusion analysis tool which has practical processes guiding communities to internalize stigma as well as analyse its manifestation within different communities. Based on their analysis communities can be facilitated to develop responses.In spite of the progress so far made in addressing HIV and AIDS in a number of countries to date.