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“The only thing necessary for these diseases to the triumph is for good people and governments to do nothing.”

Impact on Relationships

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Main topics can be found within the left column; sub-topics and/or research reports can be found near the bottom of this page.  Thank you


"For Asians/Pacific Islanders (A/PIs), disclosure of HIV may be particularly difficult because of its association with death, illness, drugs, and homosexuality, topics deemed to be "taboo" in Asian cultures Indeed, some researchers have postulated that the stigma associated with HIV in Asian populations has inhibited the reporting of cases a contention supported by studies showing rates of risk behaviors and markers of risk behaviors among Asians to be roughly equal to those of other groups even though official tabulations of AIDS rates are much lower That A/PIs attribute their infection to blood transfusions-a more culturally acceptable source of infection-two to seven times more than other individuals a disparity with no apparent realistic basis, also speaks to the stigma of HIV within this population

For A/PI women infected with HIV, the issue of disclosure may be further complicated by cultural and gender values that emphasize sexual modesty, reticence regarding sex and sexuality and the fulfillment of family obligations and responsibilities). A declaration that one is HIV-positive may be viewed by the self and others as a rejection of these core values. Furthermore, because Asian cultures are predominantly collectivistic, where individuals are defined as part of groups such as families rather than as separate, independent entities being HIV-positive may be seen as a negative reflection not only on oneself but also on one's family or community. Therefore, the potential for shame and loss of face following disclosure is likely to be greater in this cultural context than in more individualistic cultures, making the concealment of one's seropositivity even more attractive.

The influence of cultural values on the decision to disclose has been suggested in previous studies. found that Spanish-speaking Latina women disclosed to fewer people, and in particular to fewer family members, than did English-speaking Latinas. A similar pattern of results was found for men, with Whites disclosing more than Latinos, and English-speaking Latinos disclosing more than Spanish-speaking Latinos. These authors suggested that these ethnic and cultural differences may be due to a difference in cultural values, specifically familism and simpatia, that inhibit disclosure. A desire to protect others was more frequently cited by Latino than White men as the reason not to disclose, consistent with the collectivistic orientation found in Latino cultures and therefore supporting the cultural hypothesis. " Disclosure of HIV Infection Among Asian/Pacific Islander American Women: Cultural Stigma and Support


Document Name & Link to Document


File Size /Type

A challenge for the Men in the Third Millennium

In all societies, men are known to engage in high-risk activities for acquisition of HIV. Often men have more sexual contact than women. Intravenous drug users are more often men than women. Due to the high risk behavior of men, their female sexual partners are at high risk of acquiring HIV infection. HIV is also more easily transmitted from the male to the female due to biological reasons

78 kb pdf


Social scientists have made significant research contributions by examining how individuals and groups perceive risk and how culture influences risk behaviours in a wide variety of settings. Unfortunately this knowledge has seldom been disseminated in fora directed to policy makers. To date, most prevention efforts are still focusing on increasing individual awareness about risks of transmission and promoting individual risk reduction. Few HIV prevention programmes have been designed where the socioeconomic and sociocultural contexts in which individuals live are taken into consideration.


Adolescent Girls and Young Women and HIV/AIDS Most at risk are those with a history of sexual abuse, poverty, violence, or limited educational and economic opportunities 152 kb pdf
Adolescent Women 
Face Triple Jeopardy: 
Unwanted Pregnancy,
New HIV infections and AIDS cases continue to increase in 
most developing countries, while the AIDS epidemic has most 
recently reached a plateau or shown signs of a slight overall 
decline in much of the developed world.  Where AIDS is 
increasing, new HIV infection is disproportionately
high among young women who contract the virus through sexual
 intercourse…This same group has the highest rate worldwide of 
unwanted pregnancy, pointing to a potentially significant 
epidemiological overlap of reproductive health risk.
AIDS: How a Killer Plague Can Be Stopped How bad is it? The president of one country in southern Africa told the recent international AIDS conference in Durban, South Africa, that in 10 years his country will not exist. With a third of its citizens infected with the human immunodeficiency virus (HIV), it's only a matter of time before virtually his entire country is wiped out by this modern plague.  
AIDS: The fear syndrome AIDS is not only an epidemic, but also a major crisis in public health with social, economic and political repercussions, as well as with important implications for human rights. At the level of the virus as such, that is, at the level of its microscopic structure and its modes of transmission and multiplication, we have often – and rightly – had the impression that, the more research progressed, the more elusive AIDS became. At a more general level, as a global epidemic, AIDS is also, unfortunately, defeating previous assumptions and posing new threats. AIDS has become a multidimensional challenge. Over and above the very real progress made in treating the disease, this is the main lesson learned from more than 20 years of struggle against AIDS: without a global response, it tends to spread out of control, as is in fact happening today in several regions of the world. Much too often, the struggle against AIDS is waged in a piecemeal, fragmented way, when what is required is, on the contrary, a high degree of coordination among all the social players – including trade unions, which have a key role to play. Today we know that, in order to be effective, an HIV-AIDS prevention programme must target, in the first place, all those who can act as intermediate links with the population: teachers, employers, trade unionists, local chiefs, religious leaders, healers, etc. In this respect, workers’ organisations have excellent credentials. “ Pdf 73 kb
AIDS Action testing An AIDS awareness counselor recently summed up her experience of society's response to AIDS: 'I believe that, although AIDS is a new disease, it is laying bare all the old prejudices and political injustices that already exist.' One area where this is most apparent is the misuse of testing for HIV infection.  

AIDS Communication-an International view

What is an “international” perspective?


Aids orphans 'to double' A report compiled by aid agencies, presented to the International Aids Conference in Barcelona, said extended families often fail to cope, and many children are forced to live on the street  
AIDS-proof your marriage - use a condom

Thirty-four year-old Joan Gray has never led a dissolute life so she felt she had little need to worry about using a condom or being at risk for HIV/AIDS.

She was wrapped up in the security of a Christian marriage anchored on trust. Her husband Paul was also firmly rooted in the faith. "I trusted him because he was a child of God. And I know that if you are a child of God, you wouldn't do nothing to at all to hurt your wife or your husband," she said ruefully as she reflected on her ten-year marriage.

She is now HIV-positive - not as a result of her husband cheating on her but because he had had unprotected sex in a previous relationship. "Five years after we got married he learned that his ex-girlfriend had died of AIDS. He never went to get tested and he never told me," she said.

An analysis of the Policies, Pronouncements and Programmes on HIV-related Stigma and discrimination in Nigeria

More than two decades into the HIV/AIDS epidemic, stigma and discrimination against people who have HIV/AIDS (PLWH)1 or are affected by HIV continue unabated. Although the global pandemic has shown itself capable of triggering responses of compassion, solidarity and support, bringing out the best in people, their families and communities yet stigma and ostracism, repression and discrimination continue to be reported in both the rich developed and poor developing countries of the world. Herek et a reported that AIDS remain a highly stigmatized condition in the United States though the form of expression has changed over the years.


An ILO study on the socio-economic impact of HIV on infected persons finds that the HIV-positive face the maximum discrimination within their families

ILO (India) initiated a study to understand the socio-economic impact of HIV/AIDS on infected persons and their families, particularly women and children. The findings of this report, which was published recently, are both meaningful and significant because of the sensitivity with which the study was carried out.


An overview of HIV/AIDS-related stigma and discrimination

All over the world, the epidemics of HIV and AIDS are having a profound impact, bringing out the best and the worst in people. They trigger the best when individuals group together in solidarity to combat government, community and individual denial, and to offer support and care to people living with HIV and AIDS. They bring out the worst when individuals are stigmatized and ostracized by their loved ones, their family and their communities, and discriminated against individually as well as institutionally.


Analytical Review of Quarantine! : East European Jewish immigrants and the New York City epidemics of 1892


Howard Markel's Quarantine! examines the typhus fever and cholera epidemics that struck New York City in early and late 1892, respectively. Because typhus fever was traced to a boat load of Russian Jewish immigrants, Jews from throughout Eastern Europe were stigmatized. Only months after typhus fever struck the city, the cholera epidemic began. While the second disease appeared more widespread, the Eastern European Jews were once again blamed. A history of the political, health, immigration, and discrimination issues of the year, the book is aimed at a broad audience from high-schoolers to adults  
Big Issues-Scaling up responses to HIV/AIDS Stigma looms large and ominous, shadowing the HIV/AIDS pandemic.  It relates to every HIV intervention, including general prevention, the prevention of mother-to-child transmission, anti-retroviral treatment, and care and support for the patient and family, including children Pdf 206 kb
Breaking the silence - Stigma, discrimination and HIV/AIDS
Hers is not the sort of life anyone would wish on his or her
 worst enemy. To describe it as rough would be an 
Caregivers' Experiences Of Informal Support In The Context Of HIV/AIDS Social support is an important buffer for family caregivers of people living with HIV/AIDS (PLWHIV/AIDS). With limited formal support options, these caregivers have to rely increasingly on informal networks. Yet, accessing this avenue is also fraught with difficulty due to the stigmatising nature of HIV infection. Research in this area is not just not sparse, but focuses largely on sources of support and the circumscribing effects of stigma. To further our understanding, a qualitative study was conducted using various concepts from social support theory.  
China’s Growing AIDS Epidemic Increasingly Affects Women Increases in the heterosexual transmission of HIV in China are fueling concerns—including among senior Chinese leaders—that the epidemic may be moving from specific regions and at-risk groups into the general population, where the virus could more easily prey on women's vulnerabilities.  

Community Reaction to Person with HIV/AIDS and their Parents in Thailand

Stigma and discrimination against persons with HIV and AIDS (PHAs) are unfortunate and in some cases tragic consequences of infection that compound the suffering of some PHAs and their families. Whether such consequences are rare or common, they should serve to draw attention and response to the special burdens such families face

1,378 kb pdf


A stigmatized person possesses and exhibits an attribute that conveys a devalued personal and social identity within a particular social context Stigmatized individuals are commonly the targets of stereotyping, prejudice and discrimination



The purpose of this descriptive correlational study was to describe the differences in couples' perceptions of wives' Chronic Fatigue Syndrome (CFS) symptoms and to describe the relationship between changing symptoms and the marital relationship.


Deadly silence barriers to communicating HIV/AIDS in schools

An estimated 11.8 million 15 to 24-year-olds are living with HIV worldwide. Schools are the obvious place to teach young people about the risks of infection. But what is the best way to do this? Research by ActionAid identifies a number of silences in communication which are hindering efforts in the classroom.


Death a Result of Insufficient Care

Poor staffing was the reason cited for the death of Mike Hurewitz, the living liver donor at Mount Sinai Hospital, New York, who died after a portion of his liver was transplanted into his brother



Because HIV/AIDS carries so much stigma (qv) there are many pressures for denying a seropositive status or not seeking a test. Individuals may have a psychological aversion to hearing news of what is considered to be virtually a death sentence and there are more practical disadvantages such as the high chances of being sacked or difficulties in getting insurance as well as marital problems when serostatus is known.


Disclosure of HIV Infection Among Asian/Pacific Islander American Women: Cultural Stigma and Support

This decision may be particularly difficult for Asian/Pacific Islander (A/PI) women, owing to HIV's association with topics considered "taboo" in Asian cultures. This study explored the process, influencing factors, and consequences of disclosure among a sample of 9 HIV-positive A/PI women. On the basis of qualitative interviews and quantitative social network data, findings suggest that these women are acutely aware of and affected by the stigma attached to HIV and that the decision to disclose is influenced by fears about being stigmatized, concerns about disappointing or burdening others, and concerns about discrimination.


Discrimination Against Children Affected by HIV/AIDS Discrimination against people living with HIV/AIDS and their families is widespread in India.  People whose HIV status is known may lose their homes, their jobs, and their families, and may be denied medical care.77  Children who are HIV-positive, or whose caregivers are, may be denied access to school or treated badly there, kept at home to care for sick family members, or be unable to pay school fees because the family wage earner is sick or dead.78  Extended family members may refuse to care for children orphaned by AIDS, especially those who are also HIV-positive.  Institutions, including health care facilities and orphanages, may make improper disclosures of children’s test results and reject HIV-positive children.  Children already facing other forms of discrimination—sex workers, children of sex workers, Dalit and lower-caste children, and street children—suffer more.  Girls are especially vulnerable to HIV transmission if they are targeted for sexual abuse or have less access to information about HIV prevention and related issues.  They are also less likely than boys to be given adequate food, medical care, or education, and more likely to be pulled out of school to care for a sick family member or to take over domestic work.  This section documents discrimination HIV/AIDS-affected children face in health services and in education.  

Discriminatory attitudes towards people living with HIV/AIDS and associated factors: a population based study in the Chinese general population


Around 42% of the respondents exhibited discriminatory attitudes in at least five out of the 20 relevant items. For instance, about 42% would avoid making physical contact with PLWHA; 35% believed that all infected medical staff should be dismissed and about 47% would agree with enacting a law to prohibit PLWHA from visiting Hong Kong. A sizeable proportion of the respondents also hold negative perceptions about PLWHA (for example, 43.7% agreed that the majority of PLWHA are promiscuous, 20.7% thought that PLWHA are merely receiving the punishment they deserve, etc). Multiple regression analysis found that age, HIV related knowledge, the above mentioned negative perceptions about PLWHA, fear related to AIDS, and exposure to HIV related information were independent predictors of discriminatory attitudes towards PLWHA. About 30% would give PLWHA the lowest priority in resource allocation among five groups of patients with chronic diseases. Pdf 102 kb

Epidemic Ravages Caregivers; Thousands die from diseases contracted through needle sticks

Over the next 20 years, the epidemic would ravage the nation's medical workers. Thousands of needle stick victims would die of AIDS, hepatitis and other blood-borne infections. Tens of thousands more would contract devastating diseases. Hundreds of millions of dollars would be spent every year on replacing and treating dying and infected workers.


HIV is not a virus that happens to "someone else" or to other 
communities - it is present everywhere in the world, including 
the United States. Stigma and discrimination contribute to the 
spread of HIV and compound the suffering of those who are living 
with HIV and their loved ones. Silence about HIV/AIDS 
has perpetuated ignorance about the facts, risky behavior
 and death
Evolved Disease-Avoidance Processes and Contemporary Anti-social Behavior: Prejudicial attitudes and avoidance of People with Physical Disabilities Drawing on evolutionary psychological logic, we describe a model that links evolved mechanisms of disease-avoidance to contemporary prejudices against individuals with physical disabilities.  Because contagious diseases were often accompanied by anomalous physical features, humans plausibly evolved psychological mechanisms that respond heuristically to the perception of these features, triggering specific emotions (disgust, anxiety), cognitions (negative attitudes), and behaviours (avoidance). 130 kb pdf


Mentally retarded and nonretarded perceiver children conversed by telephone with a child who was described as a special or regular education student. Perceivers reported that special and regular education telephone partners behaved differently during the conversation even though observers who were unaware of how telephone partners had been described did not detect behavioral differences between them. These same observers did detect differences in stereotype related social behaviors of mentally retarded and nonretarded perceivers, but only when perceivers thought they were speaking to a regular education student.


Fear and Stigma: The Epidemic within the SARS Outbreak Because of their evolving nature and inherent scientific uncertainties, outbreaks of emerging infectious diseases can be associated with considerable fear in the general public or in specific communities, especially when illness and deaths are substantial. Mitigating fear and discrimination directed toward persons infected with, and affected by, infectious disease can be important in controlling transmission. Persons who are feared and stigmatized may delay seeking care and remain in the community undetected.  


The potential destructive impact of AIDS is enormous. It can successively destroy individuals, families, communities and villages and is certain to affect both the national and household economies.


Hidden Battle-family & community

The AIDS epidemic will cause significant increases in illness and death in prime age adults.  This will affect both households and communities.  Prime age adult illness and death will manifest itself through negative social, economic and developmental impacts.  The economic impacts at the household level of the epidemic are decreased income, increased costs, decreased productive capacity and changing expenditure patterns

Pdf 76 kb



Currently, HIV/AIDS has been reported in virtually every racial and ethnic population, every age group, and every socioeconomic group in every State and most large cities in the United States. Initially identified among men who have sex with men on the East and West Coasts, the AIDS epidemic is composed of diverse multiple subepidemics that vary by region and community. By the end of 1998, more than 680,000 cases of AIDS had been reported, and nearly 410,800 people had died from HIV disease or AIDS.  
HIV/AIDS, STIGMA AND RELIGIOUS RESPONSES Religious groups, in general, have a reputation for responding to the issue of HIV in negative terms.    Factors that influence this perception have included judgmental comment from religious leaders; debate about condoms; and an obstructive stance towards policy development, particularly regarding drug use, commercial sex, and harm reduction approaches.   The religious sector has been largely unwilling to engage in any way that could imply dilution of moral standards.  As a result, people with HIV have experienced rejection by religious people, congregations or institutions.  

Holocaust as a Paradigm of Empathy


Since 1945 we have seen genocide repeated, in Cambodia and Uganda, in Rwanda and Bosnia. Modernity, with its access to science and technology, has perfected the killing of others in a way that makes the carnage exacted by religious wars of the past pale by comparison. In fact, the very question "Why be good?" challenges the assumption of modern Western thought that goodness is innate. If we have to ask the question, then perhaps we are not good; what we are trying desperately to do is to find reasons to keep at bay the chaos unleashed by seeing what we human beings really are. The Shoah is not an historical aberration, but a paradigm of human behaviour  
Home Care for PLWHA: The Power of our Community
The HIV/AIDS pandemic has created a crisis of unprecedented 
proportion that greatly impacts society as a whole, especially women 
and their reproductive health.  Communities everywhere are 
struggling to respond
410 kb pdf
Illness, Stigma and AIDS Imagine a disease that arouses great fear throughout the United States, especially in New York and other large cities where it is rampant.  Imagine that the disease has no cure and is fatal to most people who manifest its symptoms.  Physicians prescribe a variety of treatments but with little success Pdf 119 kb

Impact of AIDS on Older People in Africa: Zimbabwe Case Study

The main focus of the project is to "identify barriers that prevent older people from providing adequate & fulfilling care to their children dying from HIV/AIDS & subsequently, to their orphaned grandchildren".


Introduction to Beliefs, Attitudes, and Ideologies Certain opinions seem to go together. People who support affirmative action also seem likely to advocate stronger gun control, to oppose capital punishment, and to hold a pro-choice position on abortion. On the surface these diverse opinions do not seem to follow from one another logically--there are even some implied inconsistencies among them. And yet, knowing that a person holds one of the opinions often enables us to predict correctly that he or she also holds the others. This is possible, in part, because the opinions all appear to follow from a common set of underlying beliefs, attitudes, and values--from an ideology.  
Men of Quality are not afraid of equality. Besides deep changes in society, what we need is a deeply spiritual transformation in identity of men 2,619 kb pdf

Must-Tell Rules Would Keep Sexually Active Teens Away

Almost half of the adolescent girls who seek prescribed contraception and other sexual health services would cease doing so if they knew that their parents were going to be notified -- but most would continue to have sexual intercourse, indicate survey results published recently in JAMA


Overcoming the stigma of chronic illness-Strategies for ‘straightening out’ a spoiled identity This paper addresses the concept of chronic illness as a socially constructed experience of stigma.  The stigma of having a chronic illness affects the person’s self-concept, capacity to adapt to the illness and the quality of his/her social networks.  Social stigma is a de-legitimizing social process derived from both popular and medical views of chronic illness.  Based on research into the coping strategies of a range of people with long-term, serious chronic illnesses, the paper argues that Government health policies and services in Australia can best help people with chronic illness by supporting their self-help groups and community-based activities. 106 kb pdf
Peer influence groups: identifying dense clusters in large networks Early social network theorists argued that the power of social networks lies in large-scale connectivity.  The extended effects of social networks are clear when we consider the spread of diseases, such as HIV/AIDS, that have crossed the globe through an intimate but far-reaching social network. 743 kb pdf

People with Disabilities and Social Work: Historical and Contemporary Issues

From the earliest recorded history, people with disabilities have been ostracized, rejected, and discriminated against in society. Although social work has a history rich in advocacy for oppressed people, the profession has been hesitant to become involved with people with disabilities.


Positively Abandoned: Stigma and Discrimination against HIV-positive Mothers and their Children in Russia Russia is home to one of the fastest-growing and potentially massive AIDS epidemics in the world, but the government has done little to address the problem.  As a result, the Russian public today, though highly educated, is almost as ignorant of HIV and how it is spread as it was ten years ago, when AIDS was hardly known in Russia Pdf 303 kb

Preventing Discrimination and Reducing Stigma and Isolation

In order to provide better access to health services for people with hepatitis C, it is particularly important that the discrimination common in health care settings is acknowledged and actively challenged

413 kb pdf

PSYCHIATRIC STIGMA follows you everywhere you go for the rest of your life A problem you should think about before consulting a mental health professional, or encouraging someone else to do so, is the stigma of having received the so-called therapy.  If you seek counseling or "therapy" from a psychiatrist or psychologist, how are you going to answer questions on job applications, applications for occupational or professional licenses, a driver's license, applications for health or life insurance, and school and college applications, such as "Have you ever had psychiatric or psychological therapy?" When you apply for a job or occupational license or a driver's license or apply for an insurance policy or admission to an educational program you will often be required to answer this or a similar question.  When you answer such questions candidly and admit having received psychiatric or psychological "help", the result often will be loss of important opportunities  
Rooting Out AIDS-Related Stigma and Discrimination A debate over how best to weed out AIDS-related stigma and resulting discrimination is growing within international health circles, as experts try to address these stubborn obstacles to HIV/AIDS prevention and treatment. While there is increased consensus that HIV/AIDS programs must tackle these issues directly, researchers have yet to find an effective means of tracking changes in attitudes toward infected people  

Sacred lives

Previous studies have shown sexually exploited Aboriginal children and youth form a disproportionately high percentage of the sex trade

Pdf 818 kb

School-related Issues Among HIV-Infected Children

Only 3% of school-age children were too ill to attend school, and almost all were enrolled in public schools. The number of HIV-infected children reaching school age will continue to grow, and public schools will bear the responsibility for educating these children. Health care providers will increasingly be called upon for guidance by both educators and families to assure that HIV-infected children receive the best education possible.


Shaking off 'shame' In a civilized society, people should not be scared to talk about their ailments -- especially when the illness may have been contracted from medical product infected with a potentially fatal virus. Yet in Japan, between 1980 and 2001, an estimated 10,000 people may have been infected with the hepatitis C virus (HCV) after being injected with a tainted blood coagulant during labor or surgery -- but most choose to keep their condition secret.  

Socio-economic Impact of HIV/AIDS on Children in a Low Prevalence Context: the Case of Senegal

WE examine the socio-economic impacts of HIV/AIDS on children in Senegal as well as the impacts of the response policies implemented by the different actors

92 kb pdf


As the world enters the third decade of the AIDS epidemic, it has spread with great speed. The epidemic has claimed more than three million lives in 2003, and an estimated five million people acquired HIV, bringing to 40 million the number of people globally living with the virus (United Nations Joint Programme on AIDS (UNAIDS, 2003). According to UNAIDS and the World Health Organization (WHO) report (2002:16), the annual number of new infections has remained steady, but it hides dynamic trends in the economy and population. Pdf 237 kb

Spotlight Fades on AIDS in Town, But the Disease and Stigma Remain

News reports branded Belle Glade as the AIDS Capital of the World. High school football teams refused to play here, visitors drove down Main Street wearing surgical masks and residents who shopped out of town reported the humiliation of having their personal checks sprayed with Lysol. Fight Against AIDS Continues  

STD Screening, Testing, Case Reporting, and Clinical and Partner Notification Practices: A National Survey of US Physicians

STD screening levels are well below practice guidelines for women and virtually nonexistent for men. Case reporting levels are below those legally mandated; physicians rely instead on patients for partner notification. Health departments must increase collaboration with private physicians to improve the quality of STD care

115 kb pdf

Stigma and Acceptance of Persons with Disabilities We explore this critical aspect of the social context by investigating employee acceptance of a coworker who has a disability.  We conceptualize acceptance specifically in terms of an incumbent employee’s attitude toward a coworker who has a disability, perceptions, of fairness of accommodations the coworker receives, and employment judgments about that coworker (with respect to hiring, promoting, and retaining. 144 kb pdf
Stigma and Discrimination Defined [Erving] Goffman defined stigma as an "attribute that is deeply discrediting" that reduces the bearer "from a whole and usual person to a tainted, discounted one." Since Goffman, alternative definitions have varied considerably. Two reasons for this variation are that the concept has been applied to an enormous array of different circumstances -- from schizophrenia to exotic dancing -- and that it has been studied from the perspective of many disciplines. We attempt to advance the study of stigma by proposing a definition that encompasses these differences and that attends to important critiques noting that much theory about stigma is uninformed by the lived experience of the people being studied and that research on stigma has an individualistic focus, viewing stigmas as something in the person rather than a designation that others affix to the person.  

Stigma and Discrimination: Field Experiences and Research from Africa, Asia & Ukraine

“A woman will never decide to do the testing. If she finds herself HIV-positive she is signing three deaths: psychological death, social death & physical death. Don’t you think that is a lot?”


Stigma in our Schools and Communities Stigma is fundamentally different from discrimination.  Most people understand what discrimination is, but many are not clear what stigma means.  Discrimination focuses attention on the producers of rejection and exclusion—those who discriminate against others for any number of reasons.  Stigma directs attention to the people who are the recipients of these behaviors. 136 kb pdf

Stigma Intervention & Research for International Health

The concept of stigma is rooted in history and social science, but the historical concept of physical stigmata and the sociological framework of deviance and social interactions fall short as a guide to public health interventions and research to eliminate or mitigate undesirable stigma. A wide range of social phenomena, usually undesirable but not necessarily so, may be considered under the heading of stigma.


Stigma, HIV/AIDS and prevention of mother-to-child transmission

HIV/AIDS-related stigma has been a major stumbling block in addressing all aspects of HIV prevention, treatment and care across the globe,

148 kb pdf

Stigma, Threat, and Social Interactions The chapters in this and many other volumes attest to the importance of stigma as a construct in psychology, sociology, and related disciplines.  Not surprisingly, stigma enjoys a long history as a central construct in social psychology investigated by both psychological and sociological social psychologists.  Many theorists have explicitly or implicitly woven stigma into their explanations of stereotyping, prejudice, social justice, and social identity. Researchers have accumulated a wealth of information regarding the impact of stigmatized others (or “targets”) on affective and cognitive processes of perceivers and a more modest but substantial amount of information regarding the impact of a stigma on the bearer.  Researchers have also accumulated much knowledge on the social identity of the stigmatized, the consequences of membership in stigmatized groups, and coping with stigma  
Stigma is Social Death While respondents cited a variety of sources of stigma, most frequently mentioned were the attitudes and practices of the mental health system and its workforce. Following are attitudes, beliefs and practices within the mental health system thought to be stigmatizing. Issues relating to power and control were most often mentioned. These included the practice of forced treatment as well as threats of forced treatment or of no treatment. People also cited lack of involvement in treatment planning or other aspects of decision-making about their lives. In addition, restrictions on the freedom to come and go; being "placed" in a house or apartment, and other examples were given. The experience of having lower status than staff within the mental health system was commonly mentioned. Many examples were given, including cues within the physical environment such as separate staff-client bathrooms and eating areas, demeaning and infantilizing interactions between staff and consumers/survivors, differences in status embedded in program policies, and discriminatory treatment in employment of people with psychiatric disabilities as mental health workers.  
Strategies for working on the theme “stigma” Often stigma is not due to the presence of the Human Immunodeficiency Virus. Instead it is due to a whole series of assumptions about what the presence of the virus implies. These assumptions can relate to class-status, sexual morality, hygiene, gender, ethnicity and so on. So when a woman living with HIV is refused a job in Johannesburg, this may be as much to do with the employer’s social prejudices, as it has with the fear of the virus, and the workers long-term health prospects.  
Survey Suggests Lack of Awareness Heightens Risk for Sexually Transmitted Diseases New survey results unveiled today by the American Social Health Association (ASHA) - an organization dedicated to preventing sexually transmitted diseases (STDs) -- suggest that lack of awareness may put Americans at risk for contracting STDs.  

Swapo Man Proposes 'Disclosure' of HIV When Person is Buried

A TOP Swapo official yesterday proposed that the globally respected norm of "no disclosure" of illness should be relaxed when it comes to HIV.


The burden of stigma Few people with HIV/AIDS escape the stigma and discrimination that often comes with the disease. When those who are infected live on the fringes of society, their misfortune is perceived by many people as punishment for errant lifestyles. Drug addicts, sex workers, men who have sex with men bring the virus on themselves, say those who deny our shared humanity. HIV-positive people are driven underground as a consequence, fearing the prejudice and intolerance of communities which are not prepared to accept them. The epidemic continues unabated and soon becomes everyone's problem.  

The Components and Impact of Stigma Associated with EAP Counseling

The economic and social impact of workers with HIV/AIDS on businesses has not waned with the increased public complacency regarding the virus that seem to have marked the 1990s/ As we approach the beginning of the third decade of the AIDS pandemic, increasing numbers of businesses can expect to be faced with the reality of infected employees.

17 kb pdf

The Impact of Relationship Violence, HIV, and Ethnicity on Adjustment in Women

Results indicated that HIV-positive women reported significantly more depressive symptoms, slightly more anxiety, but no differences on posttraumatic stress disorder (PTSD) symptoms than HIV-negative women. Women victimized by relationship violence also reported more depressive symptoms and anxiety and evidenced significantly more PTSD symptoms than nonabused women. Indeed, 58% of victimized women evidenced significant PTSD symptoms.


THE INVISIBILITY OF LESBIANS WITH AIDS There is very little medical documentation of woman-to-woman sexual transmission of AIDS. But a significant number of women who identify primarily as lesbians have contracted AIDS through intravenous drug use or heterosexual sex.  
The Social Epidemiology of Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome Social epidemiology is defined as the study of the distribution of health outcomes and their social determinants. It builds on the classic epidemiologic triangle of host, agent, and environment to focus explicitly on the role of social determinants in infectious disease transmission and progression. These determinants are the "features of and pathways by which societal conditions affect health". Early studies of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) focused on individual characteristics and behaviors in determining HIV risk, an approach that Fee and Krieger refer to as "biomedical individualism." Biomedical individualism is the basis of risk factor epidemiology; by contrast, the social epidemiology perspective emphasizes social conditions as fundamental causes of disease. Social epidemiologists examine how persons become exposed to risk or protective factors and under what social conditions individual risk factors are related to disease. Social factors are thus the focus of analysis and are not simply adjusted for as potentially confounding factors or used as proxies for unavailable individual-level data. Social factors are indeed critical to understanding nonuniform infectious disease patterns that emerge as a result of the dependent nature of disease transmission or the idea that an outcome in one person is dependent upon outcomes and exposures in others  

The Most Vulnerable of the Epidemic—Orphans

It’s no wonder that when protecting orphans, advocates go back to the basics—stop the stigma. Promote education and awareness. As Archbishop Bonifatius Haushiku declared at the opening of Catholic AIDS Action in Namibia, an organization that helps orphans, HIV/AIDS is a disease, not a sin.


The role of stigma in reasons for HIV disclosure and non-disclosure to children Given that approximately 80% of women with AIDS are within their reproductive years uncertainty about the future can include concern about who will take care of their children should they become incapacitated or die This additional stress can directly impact both the family and children, particularly when women must ‘hide’ their illness to protect their children. Relatedly, mothers with HIV infection may also face the realities of the stigma associated with HIV.  
The Scope of Injuries as Public Health and Research Problems It is interesting that notions of fault and negligence of individuals immediately involved in damaging transfers of mechanical, thermal, chemical, and radiation energy have seldom been applied to interpersonal transfers of harmful biologic organisms. In medieval times, persons thought to be carriers of the plague, but who actually were not, were persecuted and in some instances murdered.(2) But in modern times people seldom if ever think of suing someone who conveys bacteria or viruses that result in disease. Surely the person who knowingly has a disease that is transmitted by sneezing in crowds, kissing, sexual intercourse, or whatever and who then infects others by engaging in those activities is no less negligent than the alcoholic who drives while intoxicated and injures someone. Why do we believe that the latter is somehow more subject to control by legalistic fault finding and punishment than the former? Infectious-disease epidemiologists seldom if ever concern themselves with blame assignment, although carriers of the more serious diseases may be pursued by public-health physicians for the purpose of treating the disease and stopping the chain of transmission. Yet the primary purpose of police and often of expert investigation of car crashes is to assign fault in reports or to testify in lawsuits for damages.  
The tendency to stigmatise This time-honoured propensity has probably served humankind and its ancestors well in the service of species and related personal survival. Such biological mechanisms as those subserving immediate survival, the quest for food, reproduction and related territorial needs are presumably its foundation. Moreover, the crudity of categorisation and labelling of related perceived possible threats needs, constitutionally, to be safely over-inclusive, before juggling the consequent options of relating to, coming to dominate, fleeing from or ignoring the source  

The third phase of HIV pandemic: Social consequences of HIV/AIDS stigma & discrimination & future needs

An overview of social responses to AIDS, characterized by high levels of stigma, discrimination central to the global AIDS challenge, as related to human dignity is described. Stigma is conceptualized as a problem of ‘they’ and ‘us’, or interactions perspective. Causes and consequences to enable the varied perspectives in understanding this third epidemic of social impact of HIV/AIDS are described. In the absence of an effective medical intervention, the social factors like stigma and discrimination attached to HIV/AIDS are a major obstacle in the curtailment of the disease requiring urgent action. The different forms of stigma associated with other diseases are compared. Ignorance about the disease, fear of discrimination and consequent denial for testing and treatment, contribute to spread of the disease. The disease status adds to vulnerability especially in women. The disease is often identified with groups like intravenous drug users (IDUs), and homosexuals who face a double stigma as a result of HIV. Research scenario on stigma associated with HIV/AIDS is reviewed to understand the future needs. Initiatives of ongoing intervention to reduce stigma exist globally. Emerging issues in research priorities have been highlighted to counter consequences of pandemic from social perspective of human dignity and rights. Pdf 71 kb

The National Mental Health Consumers: Fighting Stigma

The Random House Dictionary defines "stigma" as "a blemish on one's record or reputation." Such a stigma affects anyone who has a psychiatric history. There are myths that have become part of American "folklore" that contribute to this stigma.


The spread of HIV/AIDS within families brings up an interesting concern 
with addressing inconsistencies between intent and experience within the 
family: How do certain family structures create greater vulnerability? The first 
part of this presentation will look at an interesting paradox: the family, that
 institution through which human beings expect and receive their greatest 
nurturing, is the same institution that can create the greatest vulnerabilities 
in the spread of HIV/AIDS for women and children. When the structure of 
family itself causes vulnerability, critical examination is even more in order
 to construct ways that civil society can empower family members to challenge 
the abuses that occur within families. However, some see the very idea of 
challenging “family” as a disruption in social well being. Ultimately my question
 is: How can families empower all members equally despite vulnerability due 
to age or gender.
Western Values blamed for AIDS The rapid spread of HIV/AIDS as well as the increase in the number of street children in Tanzania and Africa in general have stemmed from the tendency by many people to abandon positive cultural values and adopt western culture  
What Protects Teenagers from Engaging in Early Unprotected Sex, Violence, Drug and Alcohol Use and Suicide? Power point presentation  
What protects Teenagers from Risk Behaviours. Applying a resiliency approach to adolescent reproductive health in Jamaica 682 kb pdf
What we know about the impact of HIV-for instructors #1 Power point presentation 936 kb
What we know about the impact of HIV-for instructors #2 Power point presentation 458 kb

When Family Members just Can't Understand

There are probably few things in life that are more hurtful than being rejected by family members when we need them most. Unfortunately, many patients find that a diagnosis of hepatitis C not only causes friends to scatter, but also contributes to some families literally splitting apart.


Which Came First: Social Prejudice or Fear of Disease?


"Survey of Canadian dentists reveals that 16% would refuse to treat HIV+ patients," reads a story reported in the April issue of the American Journal of Public Health.[1] The only good news in the survey is that people with HIV infection are better off than those known to be injecting drug users (35% would refuse to treat them) or infected with hepatitis C (36% would not treat). Access to care has been a core policy concern in the HIV epidemic since the disease was first recognized nearly 20 years ago. Early on, we were moved to impassioned public advocacy by stories of dinner trays left undelivered outside hospital rooms; dying patients surrounded by what looked like lunar exploration teams in full protective gear; reports of dozens of calls made to secure one appointment for dental care; nursing homes saying "we can't manage care that complicated." The pain of the disease was magnified by the pain of rejection, not only on the part of an uninformed public but also by those supposedly committed to the care of all those in need.  

Who cares for family and friends?: providing palliative care at home

"Care in the community is good and care at home is even better". While this may be true for patients, it is not necessarily true for the families and friends who provide most of the care when death is imminent. Recently, the carers' perspective has tended to be overlooked and they have often been referred to as the "hidden patients". This project sought to reinstate carers as clients of palliative care.


Why focusing on stigma is important Reasons to focus on Stigma and discrimination 46 kb pdf

Why Reach Out to Persons with AIDS?


Leprosy was a disease of unparalleled implications in first-century Palestine. It was a horrible disease; it spread slowly until it made the body ugly and robbed it of vitality. It was a dreaded disease; it meant separation from social life and from contact with all non-lepers. Leprosy was a deadly disease. Because it was incurable and eventually fatal, it made its victims the living dead. And leprosy was a “sinners’” disease—not in that it was contracted through personal sin, but because it formed an apt metaphor for the nature of sin.  

Widow's death by Stoning

Widow with AIDS allegedly stoned to death in India


Women and Girls Bear the Burden in ZIMBABWE “I first knew of my HIV status when my husband got ill. We both went for HIV testing and we were counseled and given our results. We were both found HIV positive,” recalls the 35-year-old mother of three. “My husband got worse and finally died late last year. His relatives insisted that I should be inherited by one of his brothers. This is when I decided to tell them that I was HIV positive and that my husband had died of AIDS.”  




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