Fighting Stigma in South Asia

Community-led efforts to reduce HIV-related stigma and discrimination can achieve a great deal with relatively small investments, according to a new report by the International Center for Research on Women (ICRW) and the World Bank.

The report, “Tackling HIV-Related Stigma and Discrimination in South Asia,” synthesizes lessons from a World Bank regional competition to find innovative, grassroots programs that reduce stigma and discrimination. The grants program totaled $1 million and funded 26 projects in Afghanistan, Bangladesh, India, Nepal, Pakistan and Sri Lanka; the maximum grant size was $40,000. ICRW’s team of experts collaborated with grantees to design and evaluate the programs, and analyze their outcomes.

Grantees embraced many approaches to address stigma, ranging from training for radio journalists to food and catering services for people living with HIV. Each effort was led by or engaged key populations at risk, including sex workers, injecting drug users, men who have sex with men and transgender communities. In South Asia, the prevalence of HIV is low overall but the epidemic is growing among high-risk groups, partly due to the failure to respond to HIV stigma and discrimination.

One intervention, Project Baduku in Bangalore, India, led a series of more than 200 campaigns to sensitize the public about the issues female sex workers and people living with HIV face and to encourage change in societal attitudes and biases. As a result, sex workers living with HIV reported that they felt more confident after participating in the campaigns.

 “Being a part of Project Baduku gave me the mental stamina I needed to resist stigma and discrimination and deal with my disease,” one woman said. “It made me strong. When you are better mentally, you are better physically.” Additionally, the percentage of sex workers living with HIV who regularly sought care and treatment at antiretroviral therapy centers increased from 30 percent before the project to 60 percent after.

“These results suggest that minimal investments in stigma reduction can maximize investments in HIV prevention, treatment and care,” said Anne Stangl, behavioral scientist and stigma specialist at ICRW and lead author of the report. “This report provides lessons for AIDS funders and community groups to replicate and scale up similar initiatives.”

Sandy Won is ICRW's strategic communications manager.

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