The Stigma Faced by People Living with HIV/AIDS: 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


Health Canada report on HIV?AIDS: 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


Health Canada report on HIV/AIDS: 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


Social Determinants of HealthWHO 2003 Report: Social Determinants of Health WHO 2003 Report 1. The Social Gradient 2. Stress 3. Early Life 4. Social Exclusion 5. Work


Social Determinants, cont’d: Social Determinants, cont’d 6. Unemployment 7. Social support 8. Addiction 9. Food 10. Transport


“Vulnerable Groups”: “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


HIV-Related Stigma: 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


Consequences of HIV-related stigma: 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


Secondary Consequences: Secondary Consequences Restriction in one’s 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


The US vs. THEM dilemna: 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


Interventions: 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


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


In Style and Delivery: 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


Slide14: PROMOTE NON-STIGMATIZING PRINCIPLES LIKE COMPASSION AND EQUAL RIGHTS FOR ALL


Slide15: Respect confidentiality Appreciate the cultural framework Integrate Primary and Secondary Intervention