Population Council | 2004 Annual Report | Tackling Stigma and Discrimination Surrounding HIV/AIDS

2004 ANNUAL REPORT

HIV/AIDS
Tackling Stigma and Discrimination Surrounding HIV/AIDS

People living with HIV/AIDS may fear family rejection, loss of jobs, and public shunning. Stigma and discrimination discourage those who are infected with HIV/AIDS from obtaining needed services because doing so may reveal their HIV status.

Hospital staff reading the “Guidelines on HIV/AIDS care and management” developed for the pilot intervention in Indian hospitals to address AIDS-related stigma and discrimination.

Stereotypes about people living with HIV/AIDS contribute to a sense that HIV/AIDS is a problem that affects “others.” This attitude may prevent people from protecting themselves or seeking help if they develop symptoms. The Population Council has engaged in several studies focused on various aspects of stigma and discrimination surrounding HIV/AIDS. In India, for example, private, nonhospital physicians are generally the first contact for HIV patients, but most have no formal training in providing appropriate HIV care. With funding from the European Commission, the Council and several collaborating institutions developed a curriculum for physicians. The training improved physicians’ knowledge of HIV medications, understanding of universal precautions for preventing disease transmission, and awareness of opportunistic infections. Patients were treated more appropriately and considerately after the intervention, but physical contact during examination remained minimal, indicating lingering hesitation. Council researchers recommend establishing local facilities where more intensive and ongoing training can occur.

Investigators from the Council’s Horizons program, funded by the U.S. Agency for International Development, collaborated with an Indian organization, SHARAN, to introduce an intervention in public and private hospitals to reduce stigma and discrimination against people living with HIV/AIDS. The study tested a checklist to guide hospital managers in assessing their policies and practices so that people with HIV/AIDS receive the same quality of care as other patients and hospital staff are ensured a safe working environment. After the checklist was used to create action plans, the investigators found improvements in hospital staff attitudes and practices related to HIV testing and counseling, confidentiality and patient rights, and infection control.

Horizons is collaborating with South Africa’s Eskom power company and Development Research Africa, a South African research institute, to design and test Eskom’s workplace HIV/AIDS programs. Initial research revealed that workers are chiefly concerned about potential HIV-related stigma from co-workers, such as social isolation, and less about being fired from their jobs. As a result, the interventions that were implemented included educational materials that focused on stigma reduction as well as training on-site peer educators, managers, and medical staff about stigma and how to combat it.

The USAID-funded Horizons program is implemented by the Population Council in collaboration with the International Center for Research on Women, the International HIV/AIDS Alliance, the Program for Appropriate Technology in Health, Tulane University, Family Health International, and the Johns Hopkins University.

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