The Stigma Faced by People Living with HIV/AIDS

1
The Stigma Faced by People Living with HIV/AIDS

• Joanne A. Cyr, PsyD
• Clinical Health Psychologist
• August 9th, 2006, Journalist to Journalist
  Training on HIV/AIDS, In collaboration with the
  XVI International AIDS Conference in Toronto
• A Project of the NATIONAL PRESS FOUNDATION

2
Health Canada report on HIV?AIDS

• HIV is transmitted through
• Unprotected sexual intercourse (vaginal, anal,
  oral)
• Shared needles or equipment for injecting drugs
• Unsterilized needles for tattooing, skin piercing
  or acupuncture
• Pregnancy, delivery and breastfeeding (from an
  HIV-infected mother to her infant)
• Occupational exposure in health care settings

3
Health Canada report on HIV/AIDS

• HIV CAN NOT be transmitted through
• Casual, everyday contact
• Shaking hands, hugging, kissing
• Coughs, sneezes
• Giving blood
• Swimming pools, toilet seats
• Sharing eating utensils, water fountains
• Mosquitoes, other insects, or animals

4
Social Determinants of HealthWHO 2003 Report

• 1. The Social Gradient
• 2. Stress
• 3. Early Life
• 4. Social Exclusion
• 5. Work

5
Social Determinants, contd

• 6. Unemployment
• 7. Social support
• 8. Addiction
• 9. Food
• 10. Transport

6
Vulnerable Groups

• Aboriginal population
• Migrants Refugees
• Women
• People of Colour
• Youth
• Mentally Ill
• Homeless
• Sex trade Workers
• Intra-venous drug users (IVDUs)
• Men who have sex with men (MSM)
• Trauma Survivors

7
HIV-Related Stigma

• Fear of life-threatening illness
• Fear of infection (instrumental)
• Fear of lifestyle associated with taboo
  behaviours (ie. IVDU, MSM)
• People being seen as responsible
• Religious/moral beliefs about punishment (shame
  blame)
• Misperceptions of other groups

8
Consequences of HIV-related stigma

• Refusal to seek HIV testing or treatment
• Deterioration in personal, social and familial
  relations
• Negative emotions such as fear, guilt, grief,
  depression and anxiety
• Loss of support, SOCIAL ISOLATION
• Lack of trust in health care providers
• At the extreme discrimination, persecution,
  ostracization and violence

9
Secondary Consequences

• Restriction in ones rights
• Diminished capacity to advocate or negotiate for
  oneself
• Employment and housing problems
• Healthcare access issues
• Even, access to foreign countries
• Denial and avoidance of self-care and
  self-responsibility

10
The US vs. THEM dilemna

• HIV/AIDS is a global issue affecting millions of
  people largely for financial and social reasons
• Where consistent access to HAART is available,
  HIV-related stigma is reduced

11
Interventions

• Understanding and Challenging HIV stigma
• A Toolkit for Action
• Naming the Problem
• More understanding and less fear
• Sex, morality, shame and blame
• Living and caring for PLHAs within family
• PLHAs coping with stigma
• Stigmatized children
• Planning for Action
• www.changeproject.org/technical/hivaids/stigma.htm

12
UNAIDS (2002)Conceptual Framework for Basis of
Action HIV/AIDS Stigma and Discrimination

• Legal and Policy Decisions
• Program and Service Interventions
• Give accurate information about how HIV is and is
  not transmitted
• Give people reliable tools and resources for
  overcoming fear and avoidance
• Highlight the positive, and illustrate the
  destructive aspect of stigma

13
In Style and Delivery

• Be aware your own prejudices
• Convey messages in fact-based, neutral, non-value
  laden manner
• Encourage thought, discussion, questions,
  feedback. List resources where people can find
  accurate information or seek support

14

• PROMOTE NON-STIGMATIZING PRINCIPLES LIKE
  COMPASSION AND EQUAL RIGHTS FOR ALL

15

• Respect confidentiality
• Appreciate the cultural framework
• Integrate Primary and Secondary Intervention