1. 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

2. 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

3. 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.

4. 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.

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

6. 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

7. 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

8. 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

9. 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.

10. 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?