The Impact of Stigma on HIV Care Access in the African American Community

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The Impact of Stigma on HIV Care Access in the
African American Community

• David P. Lee, MSW, MPH, LICSW
• African Americans Reach and Teach Health Ministry
• Northwest AIDS Education and Training Center
• Seattle, Washington

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About the Sponsors

• African Americans Reach and Teach Health (AARTH)
  Ministry.
• The Northwest AIDS Education and Training Center.

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PIFs and Evaluation Forms

• Please complete the Participant Information Form
  (PIF) which is used to track educational events
  conducted by AARTH NW AETC.
• Funding grants are based upon the type and
  quantity of educational events and the number of
  attendees!

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Introductions

• What is your name?
• What is your profession?
• What are you hoping to learn in this training?

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Learning Objectives

• Define stigma and discrimination.
• Identify the basis for HIV/AIDS stigma.
• Describe how HIV stigma manifest in the African
  American community.
• Discuss the impact of HIV stigma on care access
  for African Americans.
• Explore strategies to reduce HIV/AIDS stigma and
  stigmatizing practices in African Americans.

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QUESTION

• What is the definition of sigma?

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Definition of Stigma

• Stigma is a discrediting mark or attribute of
  shame. It is a feeling of undesirability that an
  individual possesses, thus reducing that
  individuals self-esteem and status both in their
  own eyes and those of society.

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Definition of Stigma

• Stigma often arises from a dynamic process in
  which community and/or society perceives that
  there has been a violation of shared attitudes,
  beliefs and values by the stigmatized individual,
  his/her group, significant others and associates.

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QUESTION

• What is the definition of discrimination?

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Definition of Discrimination

• Discrimination is a specific prejudicial act that
  is specific to a distinct stigmatizing mark,
  theory, fear or perception. It is a distinctive
  act based on prejudice, emanating from
  distinguishing features of stigma.

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Identify Basis for HIV/AIDS Stigma
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HIV/AIDS Stigma

• Homosexuality
• Substance use
• Sex workers
• Injection drug users
• Minorities

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Stigma Manifestations
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Institutionalized Stigma

• Institutionalized stigma is when an institution,
  such as a hospital or church, practices stigma
  either actively or passively.

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Example

• Give 2 examples of institutionalized stigma.

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Individualized Stigma

• The acting out of stigmatizing attitudes directed
  towards an individual. It can be done by one
  person or a group of people directed at an
  individual or done to oneself based on negative
  societal attitudes and perceptions.

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Example

• Give 2 examples of individualized stigma.

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Impact of Stigma on Care Access
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Impact of Stigma on care access

• Avoid HIV testing and treatment
• Less likely to disclose HIV status
• Access care late in disease process
• Refuse to take HIV medications

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Strategies to Reduce Stigma
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EXERCISE

• List 5 strategies to reduce HIV stigma and
  stigmatizing practices in African Americans.

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Summary

• Stigma is defined and differs from
  discrimination.
• HIV stigma manifests in the African American
  community in many ways.
• Stigma impacts the way that African Americans
  access HIV care.
• Several strategies are effective in reducing HIV
  stigma in African Americans.

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QUESTION

• How will you be able to use what we talked about
  today in your own work?

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Additional Resources

• David P. Lee 206-543-3319
• AARTH -- 206-850-2070
• black_social_workers_at_u.washington.edu

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Additional Reading

• NAPWA Facts At-A-Glance HIV/AIDS Stigma and
  Discrimination, National Association of People
  with AIDS, 2005.
• HIV, Stigma, and Rates of Infection A Rumor
  without Evidence, Daniel D. Reidpath, PLoS
  Medicine, October 2006.
• Stigma, Distrust, Fear, Kai Wright,
  HIVPLUSMAG.COM, 2007.
• HIV/AIDS Stigma An Impediment to Public Health,
  Ronald O. Valdiserri, American Journal of Public
  Health, 2002.