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A Global Framework for Action - Translating Theory into Practice Anne Stangl, PhD, MPH Senior Behavioral Scientist, ICRW July 26, 2012.

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Presentation on theme: "A Global Framework for Action - Translating Theory into Practice Anne Stangl, PhD, MPH Senior Behavioral Scientist, ICRW July 26, 2012."— Presentation transcript:

1 A Global Framework for Action - Translating Theory into Practice Anne Stangl, PhD, MPH Senior Behavioral Scientist, ICRW July 26, 2012

2 Background ICRW stakeholder consultation, November 2008 Lack of consistency in how stigma is measured globally –Question wording –Response categories –Domains assessed Lack of M&E Guidance related to S&D Limits ability to: –Evaluate stigma-reduction programming –Improve programs –Compare data across contexts –Use evidence to advocate for scale-up

3 Background (2) Initial Technical Consultation, Nov 2009 Development of Framework by 16 member GSDIWG

4 Adapted from: Stangl, A. V.Go, C. Zelaya, L. Brady, L. Nyblade, L. Stackpool-Moore, J. Hows, L. Sprague, L. Nykanen, B. DeZalduondo. Poster presented at IAS 2010; Vienna. PLHIV & key Populations Institutions & Structures Impacts Stigma Outcomes Stigma Manifestations Stigma “Marking” Intersecting Stigmas HIV Stigma Other Stigmas Actionable Drivers & Facilitators Family & Peers General Population Key areas for intervention development, scale-up & measurement

5 PLHIV & key Populations Institutions & Structures Family & Peers General Population Lack of Awareness Fear of HIV Infection Fear of Social Ramifications Fear of Economic Ramifications Social Judgment Prejudice & stereotypes regarding: HIV status Drug use Sexual behavior Sex work Gender Age Actionable Drivers & Facilitators Laws, Policies & Policy Environments Cultural Gender culture Sexual culture Health beliefs Ethics & morality Individual & Community Power Social support Social assertiveness Resilience

6 PLHIV & key Populations Institutions & Structures Intersecting Stigmas HIV Status Gender Sexuality Profession Drug Use Caste Actionable Drivers & Facilitators Family & Peers General Population Stigma “Marking”

7 PLHIV & key Populations Institutions & Structures Actionable Drivers & Facilitators Family & Peers General Population Stigma “Marking” Intersecting Stigmas HIV Stigma Other Stigmas Resilience Anticipated Stigma Perceived Stigma Internalized Stigma Experienced Stigma (outside legal purview) Discrimination (inside legal purview) Stigma Manifestations

8 PLHIV & key Populations Institutions & Structures Actionable Drivers & Facilitators Family & Peers General Population Stigma “Marking” Intersecting Stigmas HIV Stigma Other Stigmas Stigma Manifestations Stigma Outcomes Behaviors Uptake of HIV Services Uptake of Support Services

9 PLHIV & key Populations Institutions & Structures Actionable Drivers & Facilitators Family & Peers General Population Stigma “Marking” Intersecting Stigmas HIV Stigma Other Stigmas Stigma Manifestations Stigma Outcomes Stigma Impacts Quality of Life HIV Incidence & Prevalence Morbidity & Mortality

10 General Population Measures: How Far have We Come?

11 Measures Piloted in Rwanda: 5 Domains Cognitive Interviews of 18 questions in Rwanda (n=24) Selection and piloting of 8 questions in Rwanda DHS Pilot N=4669 9 questions found to be valid and reliable

12 General Population Measures

13 General Population Measures (2)

14 Next Steps Validate the measures in more countries Assess whether the measures predict key HIV-related behaviors and outcomes (i.e. HIV testing, condom use, etc.)

15 Thank You!

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