Understanding

Stigma and Discrimination Related to MTCT : 

Stigma and Discrimination Related to MTCT M O D U L E 5

Module 5: Objectives: 

Module 5: Objectives Define and identify HIV/AIDS-related stigma and discrimination. Better understand international and national human rights issues. Clarify personal values and attitudes with regard to HIV/AIDS prevention and care. Know how to address stigma and discrimination in the context of providing PMTCT services.

Stigma and Discrimination Related to MTCT: 

Session 1 Introduction to the Concepts of Stigma and Discrimination and International Human Rights Stigma and Discrimination Related to MTCT

Introduction to Stigma and Discrimination: 

Introduction to Stigma and Discrimination HIV/AIDS-related stigma is increasingly recognized as the single greatest challenge to slowing the spread of HIV/AIDS. HIV/AIDS – a threefold epidemic HIV AIDS Stigma, discrimination and denial

Stigma versus Discrimination: 

Stigma versus Discrimination Stigma refers to unfavourable attitudes and beliefs directed toward someone or something. Discrimination is the treatment of an individual or group with partiality or prejudice.

Stigma versus Discrimination: 

Stigma versus Discrimination Stigma reflects an attitude. Discrimination is an act or behaviour.

Human Rights: 

Human Rights Freedom from discrimination is a fundamental human right. Discrimination on the basis of HIV/AIDS status is prohibited by human rights standards.

PMTCT Programmes and Human Rights : 

PMTCT Programmes and Human Rights Women have a right to: Determine the course of their reproductive lives Access information about HIV/AIDS and infection prevention Access testing and counselling services

PMTCT Programmes and Human Rights : 

PMTCT Programmes and Human Rights Women have a right to: Know their HIV status Decide not to be tested or to choose not to know the result of an HIV test Make informed decisions about infant feeding

Stigma and Discrimination Related to MTCT: 

Stigma and Discrimination Related to MTCT Session 2 Values Clarification (Individual Perspective)

Themes Related to Stigma: 

Themes Related to Stigma Attitudes and actions are stigmatising. Choice of language may express stigma. Lack of knowledge and fear foster stigma

Themes Related to Stigma: 

Themes Related to Stigma Shame and blame are associated with stigma and HIV. Stigma makes disclosure more difficult. Stigma can exist, even in a caring environment.

Stigma and Discrimination: 

Stigma and Discrimination Media Health services Workplace Religion Family and local community

Effects of Stigma: 

Social isolation Limited rights and reduced access to services Secondary stigma (stigma by association) Effects of Stigma

Consequences of Stigma in PMTCT Programmes: 

Consequences of Stigma in PMTCT Programmes Discourages access to ANC services Prevents access to HIV testing, counselling and PMTCT services Discourages disclosure of HIV test results to partner(s) Discourages acceptance of PMTCT interventions Inhibits use of safer infant-feeding practises Confers secondary stigmatisation on child

Stigma and Discrimination Related to MTCT: 

Stigma and Discrimination Related to MTCT Session 3 Dealing with Stigma and Discrimination in Healthcare Settings and Communities

Addressing Stigma: 

Addressing Stigma Interventions addressing HIV-related stigma take place at all levels National Community and social/cultural PMTCT site/facility Individual

National Level Interventions: 

National Level Interventions For national HIV/AIDS initiatives addressing human rights of PLWHA Enlist political support. Encourage high-profile individuals to serve as leaders and role models.

National Level Interventions : 

National Level Interventions Support Human rights legislation National efforts to scale up ARV treatment Funding for PMTCT services Share PMTCT success stories

Community Level Interventions: 

Community Level Interventions In the community, promote HIV awareness and knowledge PMTCT activities as integral to health care and HIV/AIDS prevention and treatment Referrals to and from PMTCT services Awareness of PMTCT interventions

Community Level Interventions: 

Community Level Interventions Partnerships with churches, schools and community organisations PLWHA in implementing initiatives Networking with needed linkages Ongoing training

PMTCT Programme Level Interventions: 

PMTCT Programme Level Interventions Integrate PMTCT into antenatal care services. Encourage partner involvement. Enlist partner and family support to decrease HIV transmission.

PMTCT Programme Level Interventions: 

PMTCT Programme Level Interventions Educate and train healthcare providers in HIV transmission Activities to address stigma Awareness of language that describes PLWHA PMTCT-related policies Counselling and safer infant feeding practises

PMTCT Programme Level Interventions: 

PMTCT Programme Level Interventions Educate and train healthcare providers in Controlling infection Maintaining confidentiality and obtaining informed consent Serving as role models and advocates Facilitating community support and linkages

Role of PMTCT Programme Managers: 

Role of PMTCT Programme Managers Enlist managers’ help to ensure policies and procedures are in place and implemented for Non-discrimination Confidentiality Universal Precautions Post-exposure prophylaxis (PEP)

Module 5: Key Points: 

Module 5: Key Points While stigma reflects an attitude, discrimination is an act or behaviour. Discrimination is often defined in terms of human rights and entitlements in health care, employment, the legal system, social welfare, reproductive, and family life. Stigma and discrimination are often interlinked. Stigmatising thoughts can lead to discrimination and human rights violations.

Module 5: Key Points : 

Module 5: Key Points International and national human rights declarations affirm that all people have the right to be free from discrimination on the basis of HIV/AIDS status. PMTCT programme staff have a responsibility to respect the rights of all women and men, irrespective of their HIV status.

Module 5: Key Points : 

Module 5: Key Points HIV/AIDS-related stigma and discrimination may discourage PLWHA from accessing key HIV services. It may also: Discourage disclosure of HIV status Reduce acceptance of safer infant-feeding practices Limit access to education, counselling, and treatment even when services are available and affordable

Module 5: Key Points : 

Module 5: Key Points PMTCT programme staff can help reduce stigma and discrimination in the healthcare setting, community, and on the national level. Encourage PMTCT staff to serve as role models by treating PLWHA just as they would treat patients assumed to be HIV-negative.

Module 5: Key Points : 

Module 5: Key Points Involve PLWHA in every aspect of the PMTCT programme. Promote partner participation and community support.