The Oxford dictionary defines stigma as: “A mark of disgrace associated with a particular circumstance, quality or person”.
Stigma begins with the devaluing of a person because of a difference which is attributed with a negative connotation. Stigma and discrimination often go hand in hand, as discrimination often occurs as a result of stigma and stigmatising attitudes.
Stigma can disempower many people, but it is equally important to note that experiences with stigma have forced individuals into situations where they found new skills, strength, community and resilience.
Where does stigma come from?
Stigma can be experienced in a variety of ways. Some examples of HIV/AIDS stigma include:
- Ignorance or false information as to how HIV is transmitted
- False information that HIV is highly contagious
- Moral judgements about people and assumptions about sexual behaviour and or injecting drug use
- Fear of death and disease
Stigmatising behaviour can be embodied from a variety of sources including interactions between individuals, community and systemic stigma as well as internalised stigma.
Internalised stigma (or self-stigma) is where an HIV positive person places feelings of difference or inferiority or shame about their status on themselves. If you or someone you know is experiencing this, please contact QPP as we can help. You may also wish to check out the Need Help Talking part of our website.
What are some impacts of Stigma?
UN Secretary-General Ban Ki-moon stated that:
“Stigma remains the single most important barrier to public action. It is a main reason why too many people are afraid to see a doctor to determine whether they have the disease or to seek treatment if so. It helps make AIDS the silent killer, because people fear the social disgrace of speaking about it, or taking easily available precautions. Stigma is a chief reason why the AIDS epidemic continues to devastate societies around the world”
Ban Ki-moon op-ed(2008, 6th August), ‘The stigma factor’, The Washington Times
Stigma affects the entire community through perpetuating fear and false information about the HIV virus. Stigma discourages:
- People from accessing or getting tested
- Accessing treatment
- Disclosing their HIV status to friends and family
All of these impacts undermine and work against Australia’s efforts to realise the targets set in the Eighth National HIV Strategy 2018-2022. These targets are:
- Increase the proportion of people with HIV (in all priority populations) who are diagnosed to 95 percent;
- Increase the proportion of people diagnosed with HIV on treatment to 95 percent;
- Increase the proportion of those on treatment with an undetectable viral load to 95 percent;
- Increase the proportion of eligible people who are on PrEP, in combination with STI prevention and testing to 75 percent;
- 75 percent of people with HIV report good quality of life; and
- Reduce by 75 percent the reported experience of stigma among people with HIV, and expression of stigma, in relation to HIV status.
These targets are in alignment with the 2016 United Nations Political Declaration on Ending AIDS.
How can I reduce the effects of stigma?
“If we could change ourselves, the tendencies in the world would also change. As a [person] changes his own nature, so does the attitude of the world change towards [them]… We need not wait to see what others do.”
The 2012 HIV Stigma Audit described two ways in which HIV positive individuals can help reduce the impacts of stigma:
- Control your HIV disclosure. You control the who, what, when and where of your HIV disclosure.
- Developing resilience or ‘coping strategies’ in the face of stigma. These can include: seeking social support when needed (including from the HIV community); minimising the extent to which HIV is regarded as a key aspect of identity; and cultivating the capacity to bounce back from, or not take to heart perceived slights
For examples of coping strategies, please see attached article “Cloud 9: How to get there in the face of HIV stigma: A learning review of recent research in Queensland” below:
Recommendations from the NAPWHA Stigma Audit
- An initiative that aims to build resilience among people with HIV should be developed.This should include cultivating specific skills for combating HIV stigma and a broader set of life-enhancing skills that improve wellbeing.
- Opportunities for promoting resilience should be explored and exploited in the current body of education work occurring in the community-based response to HIV.
- Anti-stigma work, including campaigns and events, should avoid the idea that people with HIV are passive receptors of stigma or require sympathy. Such work should promote strong and positive responses that work to enhance wellbeing.
- The national HIV strategy should evolve to promote a more complex idea of PLHIV quality of life. The goal of improving quality of life is laudable and the strategy endorses a holistic approach to wellbeing. There remains, however, an emphasis on physical illness. Overcoming stigma and building resilience should be regarded as key activities in enhancing wellbeing. While anti-discrimination legislation is an essential element in our efforts to fight stigma, stigma is not an issue that is entirely dealt with under the heading of human rights and anti-discrimination.
- As HIV prevention evolves to include a range of risk-reduction strategies that may or may not include condom use, all such efforts should be reviewed to assess their effects on PLHIV. This includes strategies that encourage disclosure of HIV status and which may reinforce the sero-divide. Consideration should also be given to the different effects on PLHIV of such prevention efforts in settings outside large gay cities where sizeable PLHIV communities reside.
- As disclosure in sexual settings is highly fraught, legal requirements that require PLHIV to disclose their status in sexual settings should be reviewed. A requirement for a person living with HIV to take reasonable measures to avoid transmitting another person should be sufficient. Please see QLD’s legal requirements under HIV & the Law in QLD on our website.
Please read more about our programs online, or call toll free from a land-line on 1800 636 241, using the contact form provided or (07) 3013 5555 (nationally) to speak to one of our knowledgeable and kind staff about HIV stigma.