STIGMA AND HIV//AIDS Definition: Stigma is undesirable or discrediting attribute that individual possesses thus reducing individuals status and/or worth in he eyes of the society. Highly stigmatized people never enjoy social and economic rights

Disease responsible for stigmatization include: Leprosy, Tuberculosis, Cancer, Mental illnesses HIV/AIDS is the latest in the above list HIV/AIDS stigma has negatively affected: Preventive behavior in relation to condom use HIV test-seeking behavior Care seeking behavior upon diagnosis Perception Rx of PLHA by communities, families and partners

HOW DOES STIGMA OCCUR Being a societal labeling of individual or group as different or deviant, stigma will occur in some or all of the following ways: Factors that distinguish and label to affirm difference The tendency to cultivate the ‘them’ and ‘us’ attitude The total erosion and loss of status through discrimination Stigma has the propensity to associate with disfiguring and incurable diseases especially where infection is wide attributed to result in personal behavior.

TYPES OF STIGMA: There are two types namely: FELT STIGMA Societal attitudes and potential discrimination arising from a particular undesirable attribute, diseases, (like HIV). ENACTED STIGMA This is the real experience of discrimination where disclosure of an individual’s HIV/AIDS status could lead to loss of job, health benefits or social ostracism. Military……….etc.

SOURCES OF STIGMA Fear of illness Fear of contagion Fear of death

Fears, anxieties etc. Are very patient issues surrounding HIV/AIDS stigma Fear of illness refers to the severity of the disease one has to go through Fear of contagion: have the culprits tend to be healthcare workers. There is ever-mushrooming attitudes and metaphors that indelibly equate HIV/AIDs to death, horror, punishment or shame. Many HCP (Heath care provider) tend to exaggerate the risk of HIV infection, this they do through contemporary etc………TB

CONSEQUENCES OF STIGMA This can be viewed along continuum from mild reactions of silence and denial to ostracism and ultimately violence. Research has revealed that AIDS stigma can have a variety of negative effects on: HIV test seeking behaviour Willingness to disclose HIV status Health care seeking behaviour Quality of health care received at the available health facilities

INTERVENTION STRATEGIES Evidence based interventions to reduce stigma vide Proper information based approaches Stringent counseling approaches Proper coping skill acquisition Increased contact with infected and affected groups

Creation of support and safe workplace There must evolve HIV/AIDS patients friendly hospitals Health care providers (HCP) need to be trained to improve contacts with patients, use of universal precautions and general approach Increased role playing, use of puppets drama, story, use of infected people as facilitators and teachers of health Breaking the conspiracy of silence and secrecy (will boost an atmosphere of openness and confidentiality, open discussion by HCP and public meetings.

What about TB? As we advocate for TB/HIV integration, we need to consider the human rights implications Confidentiality Vs Public health Act Consent Vs PITC Disclosure Vs Notification Does right to health cover patients with MDR TB (if tests can take up to 6 months) Can the HIV/AIDS Tribunal deal with cases of human rights abuse cases?