Horizons Projects | Moving Forward: Tackling Stigma in a Tanzanian Community

HORIZONS PROJECT
Moving Forward: Tackling Stigma in a Tanzanian Community

Stigma and discrimination pose critical obstacles to curbing the HIV/AIDS epidemic. HIV-related programs are increasingly addressing these issues. Standard indicators that measure stigma and discrimination across sites and over time are needed in order to monitor and evaluate these efforts.

An initial set of stigma indicators was created and reviewed by the US Agency for International Development. These indicators were then field tested in Tanzania. Indicators were tested in four key domains: avoidance of contact with people living with HIV and fear of casual transmission; values and attitudes; enacted stigma (discrimination); and disclosure. This field test led to refined and validated indicators.

Further field testing and refinement of these indicators was needed. The indicators were initially tested in the Kimara ward of Kinondoni district prior to the introduction of a community based stigma reduction intervention. An endline survey in this community along with qualitative data collection was conducted, to evaluate the intervention and to analyze the indicator’s performance in detecting changes in stigma over time.

Key findings include:

People recognize stigma.
Both fear and value drivers of stigma remain high.
Fear-driven stigma is hard to shift despite high knowledge of HIV.
Individuals exposed to intervention activities reported less stigmatizing attitudes.
Community members observed more instances of discrimination/enacted stigma.
Community leaders are a promising entry point for intervention.
The intervention did not reduce stigma community wide.
The stigma indicators performed solidly over time.

The findings of this study present a mixed, but hopeful, picture for a way forward in tackling stigma at the community level.

Location

Kinondoni Municipality, Dar Es Salaam, Tanzania

Duration

December 2005–May 2007

Horizons and Population Council researchers

Julie Pulerwitz

(For more information about this study, please contact horizons@popcouncil.org.)

Non-Council collaborators

Gideon Kwesigabo and Lusajo Kajula (Department of Psychiatry and Institute of Public Health, Muhimbili University College of Health Sciences)

Fausta Philip and Jessie Mbwambo (Muhimbili National Hospital)

Kerry MacQuarrie and Laura Nyblade (International Center for Research on Women)

Lisanne Brown (Tulane University)

Kimara Peer Educators and Health Promoters Trust

Family Health International

Donor

US Agency for International Development

Publications/Resources
Horizons and Population Council researchers' names appear in boldface type.

2008
Nyblade, Laura, Kerry MacQuarrie, Gideon Kwesigabo, Aparna Jain, Lusajo Kajula, Fausta Philip, William Henerico Tibesigwa, and Jessie Mbwambo. “Moving forward: Tackling stigma in a Tanzanian community,” Horizons Final Report. Washington, DC: Population Council. (PDF)