Cross-cutting issues: Stigma and discrimination

HIV-related stigma has been defined as: “… a ‘process of devaluation’ of people either living with or associated with HIV and AIDS.” When HIV-related stigma (an attitude) turns into discrimination (an act) it becomes a human rights violation. Discrimination is the unfair and unjust treatment of an individual based on his or her real or perceived HIV status. Stigma and discrimination and the fear of them affect how people at risk of HIV infection consider their own risks and willingness to test.

Key barrier of an effective HIV response

Stigma and discrimination undermine HIV prevention efforts and the ability of people to access and adhere to treatment. Acts of discrimination deny people’s rights to information, to services to protect them against HIV infection, and to receive appropriate treatment, care and support when HIV-positive.

Internalised or self-stigma is felt by people living with HIV when they internalize the negative attitudes associated with the virus. Internalised ideas about AIDS can lead to denial of the HIV positive status to others, which in turn can lead to risk behaviour and not making use of treatment when necessary. Fear of stigmatization and discrimination discourages people from seeking information on HIV and AIDS, coming forward for counselling and testing, disclosing their status or accessing AIDS services. We will not achieve Universal Access without reducing stigma and discrimination.

Research has shown that causes of stigma and discrimination, as well as their manifestations, are remarkably similar across cultures. These causes include:

  • Lack of awareness of stigma and its harmful consequences;
  • Irrational fears and lack of sufficient knowledge regarding fear of HIV infection;
  • Social judgement, prejudice and stereotypes against people living with HIV and key populations;
  • Structural facilitators such as laws, policies, institutions.

Understanding the prevalence, causes and consequences of HIV-related stigma and discrimination, as well as understanding which interventions take place in the domain of stigma and discrimination and where the gaps are, is necessary for the successful development of anti-stigma strategies and programmes.

Integrating stigma and discrimination in our work

Aidsfonds (previously STOP AIDS NOW!) aims to integrate stigma and discrimination, as well as the other cross-cutting issues GIPA and gender, within all our programmes, as they are critical to the outcome and impact of all aspects of the AIDS response. A minimum requirement for integration is to conduct a thorough situation analysis with a focus on stigma and discrimination. Based on this, a well-founded decision can be made as to how and to what extent to integrate the cross-cutting issues in a particular project. Stigma and discrimination, for instance, play an important role in our work on linking SRHR and HIV, HIV prevention for youth, HIV and the workplace, and Treatment as Prevention.