All over the world, the AIDS epidemic is having a profound impact, bringing out both the best and the worst in people. It triggers the best when individuals group together in solidarity to combat government, community and individual denial, and to offer support and care to people living with HIV and AIDS. It brings out the worst when individuals are stigmatized and ostracized by their loved ones, their family and their communities, and discriminated against individually as well as institutionally.
An overview of HIV/AIDS-related stigma and discrimination
- Stigma and discrimination around HIV and AIDS continue to fuel the global AIDS epidemic. ‘Live and let live’, the World AIDS Campaign for 2003, explores how both individuals and organizations can help reduce stigma and discrimination.
- The campaign is working to tackle stigma and discrimination in a number of settings including: education, faith based organizations, health care settings, legal systems, the media, parliamentarians and the workplace.
What is HIV/AIDS-related stigma and discrimination?
- HIV/AIDS-related stigma can be described as a ‘process of devaluation’ of people either living with or associated with HIV/AIDS. This stigma often stems from the underlying
stigmatisation of sex and intravenous drug use – two of the primary routes of HIV infection.
- Discrimination follows stigma and is the unfair and unjust treatment of an individual based on his or her real or perceived HIV status. Stigma and discrimination breach
fundamental human rights and can occur at a number of different levels including: political, economic, social, psychological and institutional.
- When stigma exists people often prefer to ignore their real or possible HIV status. This can lead to the risk of faster disease progression for themselves and also to the risk of them spreading HIV to others.
The nature of stigma and discrimination
- HIV/AIDS-related stigma builds upon, and reinforces, existing prejudices. It also plays into, and strengthens, existing social inequalities - especially those of gender, sexuality and race.
- HIV/AIDS-related stigma and discrimination play a key role in producing and reproducing relations of power and control. They cause some groups to be devalued and others to feel that they are superior. Ultimately, stigma creates and is reinforced by social inequality.
Stigma, discrimination and human rights
- Prejudiced and stigmatizing thoughts frequently lead people to do, or not do, something that denies services or entitlements to another person. For example, they may prevent health services being used by a person living with HIV/AIDS, or terminate their employment on the grounds of their HIV status. This is discrimination.
- Discrimination occurs when a distinction is made against a person that results in their being treated unfairly and unjustly on the basis of their belonging, or being perceived to belong, to a particular group.
Tackling stigma and discrimination as a rights issue
- The human rights framework provides access to existing procedural, institutional and other monitoring mechanisms for enforcing the rights of people living with HIV and AIDS, and for countering and redressing discriminatory action.
- Appropriate reporting and enforcement mechanisms ranging from legal aid services to hotlines for reporting acts of discrimination and violence can provide powerful and rapid
means of mitigating the worst affects of HIV/AIDS-related discrimination.
The wider impact
- Stigma and discrimination can lead to depression, lack of self-worth and despair for people living with HIV. But people living with the disease are not the only ones at risk
from this fear and prejudice.
- Negative attitudes about HIV also create a climate in which people become more afraid of the stigma and discrimination associated with the disease than of the disease itself. When fear and discrimination prevail, people may choose to ignore the possibility that they may already be, or could become, HIV-positive – even if they know they have taken
risks. And people may decide not to take actions to protect themselves for fear that in doing so they are associating themselves with HIV and having been ‘at risk’. All of this
helps to create an environment in which the disease can more easily spread.
- The World AIDS Campaign seeks to break the cycle of stigma and discrimination by:
- Highlighting the harm of stigma and discrimination
- Promoting the benefits of tackling stigma and discrimination
- Using education to challenge ignorance, fear and denial
- Promoting hope and the contribution of people living with HIV and AIDS
- One of the most effective ways to break the cycle of stigma and discrimination is through ensuring people living with HIV can contribute to society. The best way to do this is to provide treatment to keep people healthier longer.
- The World Health Organization (WHO) and UNAIDS are spearheading a bold initiative to roll out antiretroviral treatment to 3 million people, in areas of most need, by the end of 2005. In addition a growing number of countries are setting up national comprehensive prevention and care programmes. These initiatives can help lift the pall of suspicion and secrecy that accompanies the epidemic.
- Only by confronting stigma and discrimination will the fight against HIV/AIDS be won.
Live and let live. Help us fight fear, shame, ignorance and injustice worldwide.
For more information, please contact Andy Seale, UNAIDS, Geneva, (+41 22) 791 4765 or Dominique De Santis, UNAIDS, Geneva, (+41 22) 791 4509. You may also visit our website, www.unaids.org, for more information about the programme.