Stigma and Discrimination

This trainer's toolkit was developed to train health workers on HIV/AIDS, HIV stigma and discrimination, and universal precautions – and guide the process of developing new policy guidelines on these issues. The guide is written for facilitators of training workshops to transform hospitals into “safe and friendly health facilities.”

The demand for stigma indicators has continued to increase, particularly from USAID global missions and their partner agencies. Implementing agencies and donors need tested indicators by which they can reliably assess stigma in a given setting and measure progress in reducing it. In response to this need, USAID funded this first step of field-testing and validation of an initial set of stigma indicators at one site in Tanzania. This project builds on the findings of ICRW and its partners in a multi-country study on stigma, and on the Horizons and POLICY Project work on stigma. The specific aim of this project is to examine, test, and validate selected stigma indicators from the Blue Book and the 2004 stigma and discrimination interagency working group workshop. The results of this effort are included in this working report.

In this report, ICRW, Kara Counseling and ZAMBART combine the findings from a key study of children's experiences of HIV-related stigma in Zambia with a study of stigma in the wider community to arrive at a holistic picture of children's experiences of HIV-related stigma and discrimination from the perspective of adults and children within the same communities.

From August 2002 through January 2004, the Institute for Social Development Studies and ICRW conducted research on HIV and AIDS-related stigma and discrimination in two Vietnamese cities: Can Tho and Hai Phong. This report provides an overview of the key insights from the fieldwork phase of the project.

This document presents strategies, program examples and research findings about how governments, the UN system, donors and civil society can make the reduction of HIV-related stigma and discrimination central in national responses to HIV/AIDS. Development partners – as they support national authorities and civil society partners in scaling up toward universal access – can inspire greater political, financial and programmatic commitment to address stigma and discrimination in national AIDS responses.

Although there are a growing number of programs working to reduce stigma, few of these programs have been evaluated, particularly at the community level. Documentation and evaluation of these pioneering efforts is essential so that successful program elements can be replicated and scaled up. To help fill this gap, ICRW, the Muhimbili University College of the Health Sciences (MUCHS), the Horizons Program of Population Council, and Family Health International (FHI) conducted an evaluation of a community-based effort to reduce stigma in a peri-urban community in Tanzania.

This guide is designed for use by a wide variety of stakeholders working in Tanzania's grassroots organizations, program designers, donors, researchers, policy makers, media, and planners and implementers of HIV and AIDS activities at all levels to strengthen HIV stigma reduction efforts in their specific contexts. The guide first provides an overview of key concepts with respect to HIV-related stigma and discrimination.

In Kiswahili

As the impact of the HIV and AIDS epidemic deepens in Sub-Saharan Africa, and medical interventions to extend and improve the lives of people living with HIV and AIDS become more widely available, the need to understand and counter HIV and AIDS related stigma and discrimination has grown more urgent. It is widely acknowledged that stigma is one of the "greatest barriers" to HIV care and prevention. USAID recognized that there was a dearth of data to inform the design of interventions to reduce stigma and discriminatory practices and, in response, supported a three-country research study to be conducted by the ICRW, the CHANGE Project and local partners in Africa. This report synthesizes the findings of that study.

To address HIV-related stigma and discrimination, and improve the quality of care in the healthcare setting in Vietnam, the Institute for Social and Development Studies (ISDS), ICRW and the Horizons Program conducted intervention research in four hospitals. The study team conceptualized two fundamental causes of HIV-related stigma: 1) fear of casual transmission; and, 2) negative values/social judgments and associations between HIV and certain behaviors and groups, such as sex workers and injecting drug users. This report is a synthesis of the research.