1. Addressing Stigma and Discrimination
HIV Care, Support, and Treatment

2. Introduction and Definition
HIV-related stigma and discrimination is a process of devaluation of people living with or associated with HIV.
Stigma is linked to power and domination in society as a whole and reinforces inequality.
When stigma is acted upon, the result is discrimination.

3. Causes of HIV-Related Stigma and Discrimination
Blame: “PLHIV did something wrong”
Moral judgments or biases
Fear: Life-threatening illness, death, visible debilitation
Misinformation: HIV transmission, treatment efficacy
Existing social inequalities: race, gender, ethnicity, profession, sexuality

4. Forms of HIV-Related Stigma and Discrimination
Those infected or suspected to be infected
Stigma-by-association
Self-stigma/internalized stigma
Discrimination
Arbitrary distinction, exclusion, restriction
Takes place in family, community, institutional, national settings

5. Causes of TB-related Stigma and Discrimination
Perceived risk of transmission
Association with HIV, urban poverty, overcrowding, physical frailty, low social class, malnutrition, “disreputable behavior”
Impact on women, poor, less-educated
High death rate

6. Stigma and Discrimination and Care, Support, and Treatment
Major barrier deterring PLHIV from
Voluntary testing
Access and retention in care and support services across the Continuum of Care
Treatment adherence
Non-disclosure
Self-stigma

7. Stigma and Discrimination and Care, Support, and Treatment
At the same time, despite challenges, CST helps address HIV stigma and discrimination:
Care and support acknowledges reality of HIV; demonstrates shared concern and that close and sustained contact does not pose risk of infection
Recruiting and training PLHIV
Access to treatment enables PLHIV to live positively and productively; encourages testing for HIV

8. Analyzing and Taking Action
Social Ecological Model

9. Evidence-based Practices to Address Stigma and Discrimination
Training and involvement of PLHIV as advocates and role models
Mobilization of influential community leaders, especially religious leaders
Community engagement through participatory, nonformal education (community dialogue, local radio, and other media, forum theatre that engages the audience, etc.)