WECC0101

HIV-Stigma Research & Action What We Know Gaps and Next Steps : 

HIV-Stigma Research & Action What We Know Gaps and Next Steps Laura Nyblade XVI International AIDS Conference

What We Know: 

What We Know HIV-stigma is: Barrier to universal access Universal Prevalent Differentially experienced by women and men Actionable Measurable

Research to Action Program: 

Research to Action Program Disentangling HIV-stigma: Ethiopia, Tanzania, Zambia, Vietnam (2001-2003) Development & Adaptation of stigma reduction tools Understanding and Challenging HIV-stigma: Toolkit for action Measurement of stigma Develop stigma indicators & field-test for validity & reliability (Tanzania Indicators Field Test Group) Evaluation of stigma-reduction interventions

HIV-Stigma is Prevalent: 

HIV-Stigma is Prevalent

Differentially experienced by Women and Men: 

Differentially experienced by Women and Men

Underlying Causes : 

Underlying Causes Fear of casual infection of HIV remains high 46.6% of survey respondents in Tanzania feared HIV infection through one of 12 channels Stigmatizing attitudes remain high 50.4% agreed with 1 of 3 Shame items e.g. I would feel ashamed if someone in my family had HIV/AIDS 65.7% agreed with 1 of 4 judgment and blame items e.g. HIV/AIDS is a punishment for bad behavior

Anti-Stigma Tools and Intervention Models Exist: 

Anti-Stigma Tools and Intervention Models Exist

Anti-Stigma Toolkit : 

Anti-Stigma Toolkit Understanding and Challenging HIV-stigma: Toolkit for action Developed through a participatory process Based on research findings Available in English, French, KiSwahili, Amharic, Vietnamese, Portuguese (in progress) Adaptations and second edition in process Practical interventions in multiple settings using toolkit Community, government & faith leaders, health providers, PLHA, media Regional TOT program based out of Zambia (International HIV/AIDS Alliance)

Interventions: Key Lessons learned: 

Interventions: Key Lessons learned Start at ‘home’ Recognition of stigma & discrimination Building skills Listen; Let go; Learn Open the Gate and build capacity among leaders Policy makers Community & religious leaders

Interventions: Key Lessons learned: 

Interventions: Key Lessons learned Involve groups experiencing stigma: People Living with HIV or AIDS, MSM, sex workers, transgendered people, Injecting Drug Users, Carers Enhance visibility and raise awareness of S&D Address self-stigma Skills building for advocacy, defence of human rights, education of others Networking between stigmatized populations for joint solidarity

Interventions: Key Lessons learned: 

Interventions: Key Lessons learned Target the media, police and healthcare workers Participatory approach: use the toolkit Diversified activities; use positive images of PLHA Sustained activities over time Incorporation into existing activities (e.g. HBC, Peer education, counseling) Ongoing support and refresher training

Remaining Gaps and Next Steps: 

Remaining Gaps and Next Steps

Gaps and Next Steps: 

Gaps and Next Steps Studies to examine the relationship between: Reducing HIV-stigma and uptake of HIV services, treatment and prevention Availability of ART and prevalence of HIV-stigma Nexus between Gender, Stigma and Violence Layered (compounded) stigma Operations research to rigorously evaluate stigma- reduction programs

Gaps and Next Steps: 

Gaps and Next Steps Standardized set of stigma indicators Sharing best practices and collective learning Adaptation of successful tools and practices Scaling up Increased advocacy

HIV Stigma Can Be Reduced: 

HIV Stigma Can Be Reduced We understand enough to act We have practical anti-stigma tools We have measures to evaluate Each of us can a make a difference

Acknowledgments: 

Acknowledgments Muhimbili University College of the Health Sciences and Kimara Peer Educators and Health Promoters Trust, Tanzania Miz Hasab Research Center, Ethiopia Zambart Project and Kara Counseling and Training Centre, Zambia Institute for Social Development Studies and Commission for Ideology and Culture, Vietnam USAID, GlaxoSmithKline’s Positive Action Programme, DFID, SIDA, AED/Change, Synergy Project, PACT, FHI, Horizons

Toolkit, Research & Measurement Reports: 

Toolkit, Research & Measurement Reports WWW.ICRW.org