HIV/AIDS-related stigma and discrimination: a conceptual framework and an agenda for action

HIV/AIDS-related stigma and discrimination maintains social inequalities

The purpose of this paper is to propose a new conceptual framework to help inform thinking about the processes of stigma and discrimination (S&D) about the way these processes relate to HIV/AIDS, and about potential interventions to address S&D and minimise their impact.

This paper analyses the sources of S&D, the ways in which HIV/AIDS-related S&D manifests itself, and the contexts in which HIV/AIDS-related S&D take place. It highlights the limitations of current thinking and argues that S&D need to be understood as social rather than individual processes and identifies an agenda for research and intervention.

Findings:

it is important to acknowledge the way in which HIV/AIDS-related S&D interact with and reinforce pre-existing S&D associated with sexuality, gender, race, and poverty, and to locate HIV/AIDS-related S&D within a broader social, cultural, political, and economic framework
S&D should be viewed as a social process, used to create and maintain social control and to produce and reproduce structural inequalities, rather than as individual actions. It plays a key role in transforming difference into social inequalities. Enacted stigma (or discrimination) helps to perpetuate these inequalities

Recommendations for new approaches to research:

exploratory studies to identify and assess concepts that take account of the social, cultural, political, and economic determinants of S&D and contribute to our understanding of the processes of change
investigative studies to explore these processes in a range of contexts and evaluate the potential of interventions intended to reduce S&D
strategic and policy-oriented studies to inform implementation of effective responses

The paper concludes that challenging S&D requires social action to change the context within which individuals and communities respond to HIV/AIDS rather than just individual action. Creating a climate in which S&D are no longer tolerated therefore requires environmental interventions, in particular, social and community mobilisation and empowerment of marginalised groups to resist S&D, and structural interventions, especially laws and policies that protect the rights of PLHA and those affected by the HIV/AIDS epidemic.

Related content

Document
Transactional sex and risk for HIV infection in sub-Saharan Africa: a systematic review and meta-analysis
Joyce Wamoyi, Kirsten Stoebena, Natalia Bobrova, T. Abramsky, Charlotte Watts / 2016
Young women aged 15 to 24 years in sub-Saharan Africa continue to be disproportionately affected by HIV. A growing number of studies have suggested that the practice of transactional sex may in part explain women's heightened risk, but evidence on the association between transactional sex and HIV has not yet been synthesized.
Document
Income-generating activities for young peoplein southern Africa: Exploring AIDS andother constraints
Flora Hadju, Nicola Ansell, E. Robson, Lorraine van Blerk, Lucy Chipeta / Wiley Online Library, 2010
This paper reports on a study with rural young people (aged 10–24 years) in Malawi and Lesotho, focusing on their opportunities to learn skills and access capital and assets to engage in income-generating activities (IGAs).
Document
Ending child marriage and stopping the spread of HIV ...opportunities and challenges for action
End Child Marriage Now (African Union), 2016
AIDS is now the number-one killer of adolescents in Africa. What is more worrying is that seven of every 10 new infections of HIV among adolescents are girls, which shows how vulnerable girls are to acquiring HIV.
Document
Averting 'New Variant Famine' in Southern Africa: building food-secure livelihoods with AIDS-affected young people
N. Ansell, E. Robson, L. van Blerk, F. Hajdu / Economic and Social Research Council, UK, 2009
Numerous reports have linked AIDS’ impacts on young people and their long term food insecurity, through, for instance, orphans’ failure to inherit property and resources; inability to retain rights to land which they are too young or inexperienced to farm; or interruption of intergenerational knowledge transfer following parental deaths.
Document
Averting ‘New Variant Famine’ in Southern Africa: building food-secure rural livelihoods with AIDS-affected young people
N. Ansell / Department for International Development, UK, 2009
Southern Africa is experiencing the world’s highest HIV prevalence rates alongside recurrent food crises. This has prompted scholars to hypothesise a 'New Variant Famine' in which inability to access food is driven by the effects of AIDS. In line with this, it has been suggested that the impacts of AIDS on young people today is likely to diminish their prospects of food security in adult life.

Eldis

HIV/AIDS-related stigma and discrimination: a conceptual framework and an agenda for action