Stigma and Discrimination

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Stigma and Discriminationof PLHA Dr.Daisy Dharmaraj TEST Foundation ACS Medical college

Stigma : 

Stigma A negative identity/connotation given to a person or a group of people Dalits /Untouchables Convicts Immoral people Women in prostitution Lepers

Definition of stigma : 

Definition of stigma Stigma has been defined as a process within a particular culture or setting, where certain person’s characteristics or attributes are looked upon by the surroundings as discreditable or unworthy. A process of devaluating and victimizing someone because of an undesired difference.

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Stigma is a powerful means of social control applied by marginalizing, excluding and exercising power over individuals who display certain traits. It also has important consequences for the way in which individuals come to see themselves

stigma : 

stigma Labelled by a higher or better person as perceived by the society or the person himself A sense of lowered status Stigmatised people tend to accept the label because they are ‘politically’ weaker Usually stigma is of long term and alters the quality of life of the affected person(s)

Discrimination : 

Discrimination Unfairness, inequity, intolerance, marginalisation Treated differently with negative bias Different dimensions - geographical, physical, emotional, economic, social, religious

Discrimination in relation to HIV/AIDS. : 

Discrimination in relation to HIV/AIDS. A distinction made against a person that results in his/her being treated unfairly and unjustly on the basis of the person belonging (or being perceived as belonging) to a particular group. Discrimination leads to a violation of the rights of the person exposed to discrimination, that the person would have had if not being discriminated.

Impact of stigma and discrimination : 

Impact of stigma and discrimination At the level of the individual, for example, it causes undue anxiety and distress- factors that are known in themselves to contribute to ill-health. At the level of the family and community, it causes people to feel ashamed, to conceal their links with the epidemic, and to withdraw from participation in more positive social responses. And at the level of the society as a whole, discrimination against people with HIV/AIDS reinforces the mistaken belief that such action is acceptable and that those infected with HIV/AIDS should be ostracized and blamed.

Self stigmatisation/ felt stigma” : 

Self stigmatisation/ felt stigma” Is the shame, guilt and blame that people living with HIV/AIDS experience, when they internalise the negative responses and reactions of their surroundings. the stigma that a person puts on him/herself in addition to e.g. self blame, guilt feelings and is the sense of loss of pride and worthlessness. depression, social isolation and withdrawal, feelings of worthlessness suicide

Why is there a stigma for HIV AIDS? : 

Why is there a stigma for HIV AIDS? Fear that HIV AIDS causes disfigurement and death it is an easily contractible disease because there is no treatment for it. they will be dis honoured,and labelled as immoral, as it is associated with aberrant sexual behaviour

Underlying Causes : 

Underlying Causes Ignorance Societal values related to gender and sexuality Peer influence Myths and misconceptions

Display of stigma: physical : 

Display of stigma: physical Not allowed to live with family Separate toilets/ baths Food, drink Not allowed in class rooms, work places Clothes, articles, not shared Not allowed iin the community Workplace marriage

Display of stigma: emotional : 

Display of stigma: emotional Blamed for living a reckless life Women accused of bringing in the disease Taunted for being a burden to family Cursing fate and God for infection Abused for bringing dishonour to family Guilt of infecting family Guilt of leaving behind orphans / burdening relatives

economic, : 

economic, retrenchment from work Deny loans Denial of property Larger economic burden to society

Display of stigma: social, : 

Display of stigma: social, Non acceptance by society Alienation Direct insult and cruelty Unable to keep/ be considered for public responsibilities Stigma on entire family- future of children

Display of stigma: religious : 

Display of stigma: religious Judged on morality Not included in church activities Denied communion Ex communicated Denied burial Alienated in training institutions/ pastoral ministry

Society and community reacts negatively through : 

Society and community reacts negatively through Laws / legislation / rules / policies/ procedures Ex: compulsory HIV screening and testing of groups and individuals, including groups “at risk” prohibition of PLHA from certain occupations and types of employment reluctance to provide medical examination and care, practise of isolation, detention compulsory treatment of HIV infected individuals restriction of certain behaviours, e.g. IDU and prostitution

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Stigma and discrimination works differently for different people …..for some time Gender Haves and have nots

Effects of such measures : 

Effects of such measures increase and reinforce the stigmatisation of PLHA and at risk groups, provide misplaced sense of security in society restrict a person’s right to anonymity, confidentiality and movement, promote underground culture under utilization of health services harassment, victimizing and acts of violence

Stigma and discrimination lead to : 

Stigma and discrimination lead to . fear, avoidance . denial . isolation . suicide, . increased HIV transmission Increase in other related communicable diseases . human suffering and marginalization . increased poverty . family and social disruption

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Lack of Access to food, shelter, medical care Burden to family, who also have to give up jobs to care for them

Ways to counter stigma : 

Ways to counter stigma . dissemination of HIV/AIDS information and other IEC activities . improving coping mechanisms – by skills acquisition . counselling approaches with different types of counselling . programs promoting greater involvement of people living with HIV/AIDS .monitoring violations of human rights and creating a supportive legal environment to enable people to challenge discrimination . showing examples of non-discriminative and non- stigmatising behaviour towards PLHA in communities, e.g. through home based care, in health care centres, in social support groups, etc. . peer education and youth programs

Involving stakeholders : 

Involving stakeholders Legal and civil administration, religious and traditional leaders People Living with HIV/AIDS NGOs and Community Based Organizations (CBO)s business community workers places/industries and their management health personnel police military teachers, youth leaders, women leaders community leaders and workers

What should be our response : 

What should be our response Break the ignorance Build opinion that HIV AIDS is like any other communicable disease Deal with sexuality issues Keep the youth with you Counsel couples on parenting today’s children Protect the vulnerable

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Deal with discrimination, sensitively Include PLHA in church Advocate their causes Do not use derogatory terms- AIDS patients, Positives, innocent victims, immoral

Biblical Examples : 

Biblical Examples Leprosy and Jesus Menstruating woman and Jesus Tax collector and Jesus Thieves on the cross and Jesus Adulterous (wo)man and Jesus

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Inclusion Look out for best practices Identify vulnerable factors and deal with them Speak up

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THANK YOU