Stigma and prevention HIV-related stigma also undermines

Stigma and prevention
HIV-related stigma also undermines
prevention efforts. The impact of stigma
and discrimination contributes to a
culture of silence and denial, in which it
is more difficult to take the actions
needed to respond to HIV. Stigma
associated with communities most at
risk of infection makes them more
vulnerable to HIV infection.
Vulnerability operates at both the
personal and societal levels. Various
factors such as an individual’s
knowledge, awareness and life skills will
make them more or less vulnerable to
HIV. However, it is impossible to
understand what makes someone
personally vulnerable to HIV without
addressing the contextual factors
related to social vulnerability. These
include the capacity to influence political
and power structures which impact on
people’s live, attitudes to sex and
sexuality, and religious beliefs.
HIV related stigma and
discrimination and gender inequality
There is for instance a very clear
correlation between HIV stigma
associated with sex, gender inequality,
the status of women, the violation of
their human rights and the growing
epidemic among women. Women are
disproportionately infected with and
affected by HIV. In Sub-Saharan Africa,
57 percent of those living with HIV are
female and young women aged 15 to
24 are two and half times more likely to
be infected than young men.
Human stories confront us with some
terrible realities. The following example
from a rape victim in the Democratic
Republic of the Congo1 clearly
demonstrates the relationship between
stigma, HIV, social exclusion and
discrimination:
My husband was angry; he said that
because I had slept with the enemy,
I would be punished and die of AIDS.
He said I was so dirty, that he did
not want to stay with me.
Addressing the impact of AIDS on
women requires us to address the
violations of women’s rights which give
rise to marginalization and increased
vulnerability, which contribute to the risk
of HIV infection. The interaction of
gender inequality and HIV-related
stigma and discrimination fuel the
epidemic and exacerbates its impact on
women, their families and communities.
Combating HIV-related stigma
Stigma thrives on misinformation and
denial. Even when people understand
how HIV is transmitted, that HIV can be
treated and that treatment is available,
stigma and discrimination persist.
Prejudices regarding sex, gender and
sexuality are difficult to change and
despite the high HIV prevalence in some
communities; blame and denial are
common and continue to contribute to
the stigmatization of people living with
HIV. The persistence of these beliefs
can in part be explained by the influence
of religious and moral beliefs and
cultural norms. Some religions continue
to teach that HIV is a punishment for a
moral fault. Cultural and religious norms
not just about sex but about social
expectations generally and gender
expectations in particular can also
reinforce specific HIV-related stigmatizing
attitudes.
In community workshops conducted for
a regional anti-stigma programme in
Southern Africa, participants cited many
examples of stigma in religious
institutions, including:
􀂄 refusal to sit next to someone who
is (or suspected to be) living with HIV;
􀂄 not visiting someone who is ill;
􀂄 being excluded or expelled from
church committees;
􀂄 preaching that AIDS is a punishment
from God for ‘the wages of sin’; and
􀂄 if pastors get sick, they lose the trust
of their congregation2 .