1. HIV/AIDS and STIGMA Sigrid Anderson, International Health Advisor USAID Regional Services Center Budapest, Hungary

2. WHAT IS STIGMA? a mark of disgrace deeply discrediting tainted, discounted contrary to a norm devalued undesirable victim us vs. them

3. Sexual relations and divisions Gender relations and divisions Race relations and divisions Class relations and divisions HIV/AIDS- related Stigma and Discrimination AIDS is a gay plaque AIDS is spread by sex workers AIDS is a womans disease AIDS is caused by men AIDS is a disease brought by White Men AIDS is an African disease AIDS is a disease of the rich AIDS is a disease of the poor sex workers Parker, Richard and Aggleton, Peter; 2002. HIV/AIDS-Related Stigma and Discrimination: A Conceptual Framework and an Agenda for Action, Horizons Program, pg. 3.

4. Herek, G., Capitanio, J. and Widaman, K. 2002. HIV/AIDS-Related Stigma and Knowledge in the United States: Prevalence and Trends, 1991-1999, to appear in American Journal of Public Health, 2002, 92 (3).

6. Regional Meeting Quick Survey n Belief that casual contact transmits HIV: (n=32) (percentage of those answering very likely, somewhat likely, or somewhat unlikely) n Sharing a drink from the same glass with someone how has the AIDS virus: 3% n Using public toilets: 12% n Being coughed on or sneezed on by someone who has the AIDS virus: 16%

7. Herek, G., Capitanio, J. and Widaman, K. 2002. HIV/AIDS-Related Stigma and Knowledge in the United States: Prevalence and Trends, 1991-1999, to appear in American Journal of Public Health, 2002, 92 (3).

8. HIV-Related Stigma and Knowledge in the U.S., 1991-1999: Conclusions n overt expressions of stigma appear to have declined over the 1990s n in 1999 one fifth of those surveyed still feared PWAs and one sixth expressed disgust or supported public naming of PWAs n more covert forms of stigma persist n the sorts of beliefs and opinions that provide a foundation for AIDS stigma continue to be widespread n although respondents understood how HIV is transmitted, they were much less clear about how it is not transmitted Herek, G., Capitanio, J. and Widaman, K. 2002. HIV/AIDS-Related Stigma and Knowledge in the United States: Prevalence and Trends, 1991-1999, to appear in American Journal of Public Health, 2002, 92 (3).

9. HIV/AIDS-related stigma comes from the powerful combination of shame and fearshame because the sex or drug injecting that transmit HIV are surrounded by taboo and moral judgment, and fear because AIDS is relatively new, and considered deadly. Responding to AIDS with blame, or abuse towards people living with AIDS, simply forces the epidemic underground, creating the ideal conditions for HIV to spread. The only way of making progress against the epidemic is to replace shame with solidarity, and fear with hope. -- Peter Piot, Durban, South Africa, 5 September 2001

10. HIV/AIDS STIGMA: KEY THEMES n People are largely unaware that their attitudes and actions are stigmatizing n Language is central to how stigma is expressed n Knowledge and fear interact in unexpected ways that allow stigma and discrimination to persist n Sex, morality, shame, and blame are closely related to HIV-related stigma n Disclosure of positive HIV status is advocated, but acknowledged as difficult and unusual n Widespread care and support for people living with HIV/AIDS co-exists with stigma and discrimination Understanding HIV-Related Stigma and Resulting Discrimination in Sub-Saharan Africa, International Center for Research on Women, June 2002 Research Update.

11. Discussion Questions 1. In what ways is HIV/AIDS-related stigma an issue in the communities where you live and work? 2. In what ways could you address the issue of HIV/AIDS-related stigma in your partnership communities?

12. For More Information… n Horizons (www.popcouncil.org/horizons)www.popcouncil.org/horizons n UNAIDS (www.unaids.org)www.unaids.org n International Center for Research on Women (www.icrw.org)www.icrw.org n Family Health International (www.fhi.org)www.fhi.org