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

Public Health & Infectious Diseases

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

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"HIV/AIDS is not merely a medical problem: the manner in which the virus is impacting upon society reveals the intricate way in which social, economic, cultural, political and legal factors act together to make certain sections of society more vulnerable. The epidemic exposes the method and the impact of marginalisation and inequality in clear terms.

Marginalised groups in our society have little or no access to basic fundamental and Human Rights such as food, medical services and information. Many of these groups are ostracised by society at large, and their lifestyles criminalized, making it practically impossible for them to participate in mainstream processes whereby they could demand their rights. Coupled with this dismal situation, there is minimal awareness about HIV and no real options for safer lifestyles. The stark reality of the HIV/AIDS epidemic is thus that people are becoming HIV positive because they have no access to basic fundamental Human Rights. For the same reasons, the impact of infection is a lot graver for those with no access to rights. It is time to recognise this link between marginalisation, Human Rights and vulnerability.

It is also time to recognise that the HIV/AIDS epidemic itself has given rise to a range of Human Rights violations. The refusal of treatment, denial of access to essential drugs including antiretroviral therapy, discrimination in the health care and employment sectors, women being deprived of their rights and thrown out of their homes etc are just some examples of these violations. Apart form having a serious impact on the lives of people living with HIV, these violations are pushing the epidemic underground. Unless these Human Rights violations are addressed, there cannot be the creation of an enabling environment, where people come forward to access health and other services, or even get tested.

There is also a need to understand the exact manner in which factors of gender, caste, region, class, sexual orientation influence the impact of these Human Rights issues for different sections of society. Along with social and economic factors, there are laws, which complicate the influence of these factors. To understand these different contexts would be the first step in addressing the problems they entail." Report of the National Conference on Human Rights and HIV/AIDS
 

ADDITIONAL ARTICLES:

Document Name & Link to Document Description

File Size /pdf

Marginalised Populations

India has 3.86 million people living with HIV/AIDS, the highest in any country after South Africa. HIV in India is mainly transmitted through heterosexual contacts placing large parts of the population at risk of infection. The stigma surrounding HIV/AIDS, and certain vulnerable groups affected such as injecting drug users, often leads to discrimination, which constitutes a serious obstacle to HIV/AIDS control and management.

 

Mobilising Media Activism and Community Participation in Stigma Reduction

the project aims to harness the capacity of the Nigerian media and communities as a potential force for change to reduce the high levels of HIV-related stigma and discrimination in the country

 

Neighborhood stigma and the perception of disorder Many Americans hold persistent beliefs linking blacks and other disadvantaged minority groups to social images, including crime, violence, disorder, welfare, and undesirability as neighbors. These beliefs are reinforced by the historical association of involuntary racial segregation with concentrated poverty—in turn linked to institutional disinvestments and neighborhood decline. Stereotypes about race, poverty, and disorder may loom especially large when residents have uncertain or ambiguous information about the neighborhood as a whole. In poor neighborhoods, many activities that in better-off neighborhoods occur in private (e.g., drinking or hanging out) necessarily take place in public. The resulting social structure of public places reinforces the assumption that disorder is a problem mainly in poor, African American communities. This stereotype may lead to actions by members of the stigmatized group that seem to confirm the statistical association between race and social disorder, usually inextricably linked, in a kind of developmental sequence. . . Pdf 392 kb
New challenges: HIV/AIDS and drugs
Misconceptions about HIV/AIDS have led in some parts of the 
world to an increased demand for young sex partners, including 
very young children.  In addition to the fallacy that children are 
less likely to contract and transmit HIV/AIDS, in some countries 
of Asia these are long-established myths about the rejuvenating 
powers of youth.
82 kb pdf

On Stigma and its Public Health Implications

One of the curious features of literature concerning stigma is the variability that exists in the definition of the concept (Stafford and Scott 1986). In many circumstances investigators provide no explicit definition and seem to refer to something like the dictionary definition ("a mark of disgrace") or to some related aspect like stereotyping or rejection (e.g. a social distance scale). When stigma is explicitly defined many commentators turn to Goffman quoting his definition of stigma as an "attribute that is deeply discrediting" and that reduces the bearer "from a whole and usual person to a tainted, discounted one"

 

On The Road to Activism

(Large article, increase download time)
In order to understand how deeply rooted prejudice is in society, we can look at statements like “marijuana is a springboard to heroin, and heroin users are incurable and live a maximum of five years” – which are often pronounced publicly by politicians, reported in the media, and expressed by medical doctors, sociologists, teachers, and others. Pdf 1847 kb
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

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. This article addresses historical and contemporary issues concerning disability. Recent developments in the disability movement, including independent living, are discussed and compared to social work's approaches to disability

 

Philadelphia Settles Lawsuit Over Alleged Discrimination Against HIV-Positive Man by EMTs The city of Philadelphia on Monday settled a civil-rights lawsuit over alleged discrimination against an HIV-positive man who said that city emergency medical technicians provided inappropriate care after they leaned his HIV status  

Population Council: Annual Report 1999

An International Group that seeks to improve the well-being and reproductive health of current and future generations around the world and to help achieve a humane, equitable, and sustainable balance between people and resources

1,969 kb pdf

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
Prejudice from Thin Air: The effect of Emotion on Automatic Intergroup Attitudes Two experiments provide initial evidence that specific emotional states are capable of creating automatic prejudice toward outgroups.  Specifically, we propose that anger should influence automatic evaluations of outgroups because of its functional relevance to intergroup conflict and competition, whereas other negative emotions less relevant to intergroup relations should not. 162 kb pdf

Ramatex on Rack Again

A petition signed by nearly 700 employees cites poor wages, cramped living conditions and health concerns as their most pressing grievances. Their concerns peaked last week, when at least two employees were forced to return to the Philippines after being declared sick and unfit to work, assertions they dispute.

 

Reducing Stigma and Raising Awareness Beyond stigma’s immediate social and psychological effects, it also thwarts prevention efforts by raising the stakes of disclosure. If people fear they will lose their jobs or be shunned by friends and family if they are found to be HIV positive, they are less likely to test for HIV or make the changes necessary to protect themselves for fear of raising suspicion about their status. In many Kenyan communities the stigma surrounding HIV has made it difficult to discuss the facts of the disease, leaving people vulnerable to infection because of ignorance and misunderstandings. Though much effort has been made in recent years to educate the public about HIV, stigma and misconceptions remain prevalent. Pdf 545 kb

Report of the National Conference on Human Rights and HIV/AIDS

HIV/AIDS is not merely a medical problem: the manner in which the virus is impacting upon society reveals the intricate way in which social, economic, cultural, political and legal factors act together to make certain sections of society more vulnerable. The epidemic exposes the method and the impact of marginalisation and inequality in clear terms. Marginalised groups in our society have little or no access to basic fundamental and Human Rights such as food, medical services and information. Many of these groups are ostracised by society at large, and their lifestyles criminalized, making it practically impossible for them to participate in mainstream processes whereby they could demand their rights. Coupled with this dismal situation, there is minimal awareness about HIV and no real options for safer lifestyles. The stark reality of the HIV/AIDS epidemic is thus that people are becoming HIV positive because they have no access to basic fundamental Human Rights.

 

Resource Manual for Support of Dentists with HBV, HIV, TB and Other Infectious Diseases

Infected practitioners have various legal rights and responsibilities, as do persons with whom they associate. There are civil rights laws prohibiting discrimination against persons with disabilities, which afford numerous protections to infected providers and those who associate with them. These and other state laws (e.g., pertaining to confidentiality and practice restrictions) may bear upon an infected provider's practice.

 

Rethinking AIDS as Social Responsibility

AIDS control efforts reflect the best and the worst face of globalization.  How are the dual sides manifest in relation to AIDS and how can we capitalize on the positive and counter the negative implications?  These are the central concerns while conceptualizing the workshop

 

Rooting Out AIDS-Related Stigma and Discrimination

"You have to recognize which kinds of stigma and discrimination are harmful for disease control," explains Dr. James W. Curran, an AIDS epidemiologist and professor at Emory University in Atlanta. "It depends on the country; it depends on the laws, the values, the particular subculture. The issues have to be identified and then they have to be combated. It's like weeds in a garden; you have to keep pulling."  Around the world, reactions to the AIDS epidemic have ranged from silence and denial to hostility and outright violence. Fear of being branded or socially outcast may prevent a person from being tested for the virus or from seeking treatment if he or she has HIV. People who have or are thought to have the virus may be shunned, abused, denied jobs and housing, or refused care and treatment at health care facilities. These reactions hamper prevention and treatment efforts and deepen the epidemic's impact.  
Sentenced to Stigma In Alabama, people in the visiting room recognize the armband worn by John S. and ask him if he has HIV. In South Carolina, Ronald B. was sentenced to 90 days in jail, but because he is HIV-positive he went to the maximum security prison that houses death row prisoners. In Mississippi, guards tell prisoners in the segregated HIV unit to “get your sick asses out of the way” when they pass them in the hall. Many prisoners with HIV will spend more time in prison because they are not eligible for programs that promote early release. These are some of the harsh consequences of HIV policies in Alabama, South Carolina and Mississippi, the only three states in the nation that have continued to segregate prisoners living with HIV. In March 2010, after reviewing the findings in this report, the Commissioner of the Mississippi Department of Corrections decided to terminate the segregation policy. The segregation and discrimination against HIV-positive prisoners continues to this day in Alabama and South Carolina, and constitutes cruel, inhuman and degrading treatment in violation of international law. Pdf 654 kb

Single-Motive and Multi-Motive Processing of a Threat Appeal: Promoting the Preventative Health Behavior of Influenza Vaccinations

This study considers the impact of behavioral commitment on the cognitive and affective processing of a persuasive message advocating influenza vaccination behaviors, and the resulting impact on the integration of information into attitudes, behavioral intention, and behavior.

 

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.  
Silence about AIDS is death We must keep AIDS at the top of our political and practical agenda. That is why we must continue to speak up openly about AIDS. No progress will be achieved by being timid, refusing to face unpleasant facts, or prejudging our fellow human beings -- still less by stigmatising people living with HIV/AIDS. Let no one imagine that we can protect ourselves by building barriers between ‘us’ and ‘them’. In the ruthless world of AIDS, there is no us and them. And in that world, silence is death  

Skills Development for
Multicultural Rehabilitation Counseling:
A Quality Of Life Perspective

This article focuses on a discussion of specific strategies usable in promoting the development of leadership capabilities in individuals with disabilities from minority groups. This paper states that rehabilitative success in counseling such persons depends on "the counselors understanding the life factors unique to consumers whose sociocultural experiences are different."

 

Social Stigma-A comparative qualitative study of integrated and vertical care approaches to leprosy Leprosy has been associated with stigma and social exclusion throughout history and on all continents, although there are wide variations in the ways in which this is worked out in different communities.  Stigma can be defined as an attribute that is deeply discrediting, and the stigmatized individual is one who is not accepted and is not accorded the respect and regard of his peers; one who is disqualified from social acceptance Pdf 78 kb
Stigma: A Paper for Discussion The origin of stigma related to government programs that provide health coverage appears to be linked to its negative association with the public welfare system. The stigma currently associated with Medicaid and SCHIP seems to break out into two components: the process and the product. The process end of stigma relates to the reportedly negative treatment of applicants by staff in welfare offices and the often intrusive nature of the personal information required upon application. On the product end, there is a prevailing perception that the delivery system does not provide the same level of care to holders of public coverage as it does to holders of private coverage. The stakes are high. Any success achieved with outreach, simplification, and coordination will be diminished if the stigma attached to these programs continues to prevent the enrollment of children into health coverage programs. Pdf 45 kb

Stigma, Race, and Disease in 20th Century America: An Historical Overview

The topic of the history of stigma, race, and disease is, of course, an expansive one – even if one confines the discussion to the 20th century United States.   In my own field of the history and sociology of medicine, the starting point for any such discussion of stigma must be Erving Goffman’s classic 1963 book, Stigma: Notes on the Management of Spoiled Identity  
Stigma and Discrimination Stigma is as old as history. While the word dates back to ancient Greek times and refers to the physical mark made by fire or with knives on individuals or groups considered outsiders or inferiors, the concept appears universal. In different cultures and at different times, slaves, criminals and adulterers – or those suspected of being slaves, criminals and adulterers – have been branded or otherwise physically marked.  
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 Global Health: Developing a Research Agenda

"Typically, miners who are believed to be infected are shunned. They sit alone in buses that carry workers to the pit. They eat alone in the company kitchens because their colleagues are afraid to share utensils or crockery with them."

 

Stigma and Social Control

 

Social interactions provide a set of incentives for regulating individual behavior. Chief among these is stigma, the status loss and discrimination that results from the display of stigmatized attributes or behaviors. The stigmatization of behavior is the enforcement mechanism behind social norms. This paper models the incentive effects of stigmatization in the context of undertaking criminal acts. Stigma is a flow cost of uncertain duration which varies negatively with the number of stigmatized individuals. Criminal opportunities arrive randomly and an equilibrium model describes the conditions under which each individual chooses the behavior that, if detected, is stigmatized. The comparative static analysis of stigma costs differs from that of conventional penalties. One surprising result with important policy implications is that stigma costs of long duration will lead to increased crime rates. Pdf 387 kb
STIGMA AND VIOLENCE Stigma is one of the most important problems encountered by individuals with severe psychiatric disorders. It lowers their self-esteem, contributes to disrupted family relationships, and adversely affects their ability to socialize, obtain housing, and become employed (Wahl, 1999). In December 1999, the Surgeon General’s Report on Mental Health called stigma "powerful and pervasive," and then-Secretary of Health and Human Services Donna Shalala added: "Fear and stigma persist, resulting in lost opportunities for individuals to seek treatment and improve or recover."  
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.  

Stigma of Hepatitis C and Lack of Awareness Stops Americans From Getting
Tested and Treated

Americans' misunderstanding of the potential dangers of hepatitis C is causing many with risk factors to forgo testing and treatment, according to a landmark survey commissioned by American Gastroenterological Association the


 

 

Stigma, Contagion, Defect Issues in the Anthropology of Public Health

Much of this research has been framed by his interests in questions of micro-social processes within which the self is created and maintained. Goffman applied the term (negative) stigma to any condition, attribute, trait, or behavior that symbolically marked off the bearer as “culturally unacceptable” or inferior, with consequent feelings of shame, guilt and disgrace.

 

Stigma, Discrimination and the Conspiracy of Silence

Stigma and discrimination fuel the HIV/AIDS epidemic by creating a culture of secrecy, silence, ignorance, blame, shame and victimisation, says the International Council of Nurses (ICN).  "Stigma prevents communities from addressing HIV/AIDS with the appropriate health care services, legal and educational strategies," declared ICN president Christine Hancock. "What stops them is HIV prejudice. And all that will stop HIV prejudice is speaking openly about the facts. It is past time for governments, civil society leaders and religious institutions to end the conspiracy of silence and shame surrounding HIV/AIDS."

 

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 Interventions and Research for International Health Stigma has become an increasingly important priority for health policy and research. The topic encompasses a broad set of interests and specifies a field of study, however, that without critical rethinking may be too broad to contribute as much as we expect to health policy. The diversity of international health problems and the complexity of their social and cultural settings make questions of stigma even more challenging. Too little attention has been paid to the concept of stigma, distinct from its impact; careful consideration of the particular features of a useful formulation to guide public health policy and action is needed, especially with respect to the stigmatizing diseases of low- and middle-income countries. As we critically review of the topic, we begin by considering a few key points from the seminal contribution of the sociologist Erving Goffman  
"Stigma is Social Death" People described a number of sources of stigma. Major sources included family, friends and intimates, the job market and co-workers, neighbors, people at church and in school. They also described the practices of the housing market, insurance companies and the social security system as being 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.  
Stigma and Religion: An Inevitable Partnership?
"Stigma almost killed me" related one delegate who had been 
ostracized from her church because of her HIV status. Her statement 
underlined the continuing damage of HIV-related stigma, and the role 
of religious leaders in reducing discrimination
 
Stigma of Hepatitis C and Lack of Awareness Stops Americans From Getting Tested and Treated Hepatitis C is a potentially life-threatening viral disease of the liver transmitted through blood and blood products. Over time, chronic infection can lead to cirrhosis, liver failure, and liver cancer. The survey findings indicate the need for increased awareness and education about hepatitis C, the most common blood-borne disease in the US. While only about half of the general public believes it is a public health threat, more than 80 percent recognize HIV poses a serious threat. In contrast, physicians and hepatitis C sufferers surveyed view HCV as a threat on par with HIV.  

Stigma when there is no other option: “The poor even segregate the patient because there is nothing they can do to help”

Power Point Presentation 966 kb

Stigmas, Myths and Tuberculosis

Stigmatising Others is a basic human reaction when the person feels fearful for their own health or social status. In my opinion the history of Tuberculosis provides possibly the most complete basis for tracing the many ramifications of stigmatization of individuals, of women as a gender, of 'race' and classes of occupation.

 

Stigma Toolkit-AIDS stigma. Understanding and challenging HIV stigma—toolkit for action 9,937 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  

Strategies for working on the theme "stigma"

although there is widespread awareness of the extent and impact of stigma, we believe that the phenomenon as it relates to AIDS is still little understood. As a consequence, the responses to stigma, by policymakers, non-governmental organisations, the media and others are consequently ill thought out and ineffective. Stigma continues to represent a considerable obstacle to AIDS prevention and care efforts, even in regions such as Southern Africa where the epidemic is most widespread and one would have expected ubiquity to have led to tolerance and understanding

 

Striking Lack of Awareness

"People with hepatitis C infection deserve the same tools as those with HIV so that they can become experts about their virus," explains Michael Marco in the introduction to TAG's latest analysis of hepatitis C research and treatment.

 

Summary of HIV Prevalence and Sexual Behavior Findings This study compares levels and trends of behavioral indicators such as abstinence and age of sexual debut among youth, faithfulness in sexual relationships, multiple sexual partners, and condom use. 288 kb pdf

Table of AIDS Knowledge and Attitudes

Youth Indicators 1996—used in many US schools

 

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 seems to have marked the 1990s. This article provides a general overview of the important issues surrounding HIV-infected persons in the workplace, and provides recommendations for employee assistance professionals concerning both training efforts and the provision of accommodations for persons with HIV/AIDS

17 kb pdf

THE EFFECTS OF THE STIGMA OF LEPROSY ON THE INCOME GENERATION OF LEPROSY AFFECTED PEOPLE IN THE TERAI AREA OF SOUTH EAST NEPAL The issues surrounding leprosy are grounded in the attitudes and emotional reactions of both, the people affected by leprosy and the people with whom he or she comes into contact. The loss of income generation is one part of the overall leprosy related stigma issue, and is itself governed by the attitude of the employer. In the majority of cases, a lack of knowledge and understanding of the facts about leprosy, leads to the assumption that leprosy will be easily caught by anyone coming into contact with an affected person. In the work place this is obviously going to be a highly unwelcome problem, leading to the stigmatisation of the leprosy affected employee - colleagues refuse to work with the person, customers may refuse to be served, or will stop business altogether. This is all amplified by the appearance of visible deformity.  
THE EXPERIENCE OF SPECIFIC POPULATIONS This section of the Paper aims to describe stigma and discrimination as experienced by specific populations affected by the HIV epidemic in Canada. The differentiation of populations affected by HIV/AIDS is a social and cultural construction. Such differentiation may itself contribute to discrimination, as when drug users or sex workers are vilified as "vectors of disease." On the other hand, the failure to recognize and acknowledge publicly the experiences of a particular population in the course of the HIV/AIDS epidemic has also led to neglect and avoidance of that population's needs, as gay men have found in the "de-gaying" of AIDS  

The Hidden Epidemic: Confronting Sexually Transmitted Diseases

There is a tendency to look on AIDS and HIV and other sexually transmitted diseases as issues largely of the developing world, particularly sub-Saharan Africa and Southern and South East Asia. However, some rich industrialised countries, particularly the United States, have an epidemic of sexually transmitted diseases (about 12 million new cases annually, of which 3 million occur in teenagers), and no national coordinated control programme of education and clinical services.

 

The Impact of Stigma on Service Access and Participation

A guideline developed for the Behavioral Health Recovery Management project

132 kb pdf

The Integrated AIDS Program: Decreasing Stigma through Quality Services In 1999, when the Integrated AIDS Program (IAP), run by the Assumption Sisters of Nairobi, began its home-based care activities, clients were hard to come by. Though in 1999 HIV prevalence in sentinel surveillance sites of Thika district, where IAP is located, was recorded to be 34 percent and there were few other organizations providing home-based care, IAP couldn’t find many clients. Because stigma against People Living With HIV (PLWH) was so high, people chose to suffer in silence, alone, rather than seek care if it meant disclosing their status. People avoided even testing for HIV, since in many people’s eyes just taking the test was an admission of “guilt.” 704 kb pdf
THE MEANING AND CONSEQUENCES OF PERCEIVED DISCRIMINATION IN DISADVANTAGED AND PRIVILEGED SOCIAL GROUPS The subjective meaning and consequences of perceived discrimination depends on the position of one's group in the social structure. For members of disadvantaged groups, attributions to prejudice are likely to be internal, stable, uncontrollable, and convey widespread exclusion and devaluation of one’s group. For members of privileged groups, the meaning of attributions to prejudice is more localized. Because of such meaning differences, attributions to prejudice are considerably more harmful for the psychological well-being of members of disadvantaged groups than they are for members of privileged groups. According to the Rejection-Identification Model (Branscombe, Schmitt, & Harvey, 1999), members of disadvantaged groups cope with the pain of attributions to prejudice by increasing identification with their disadvantaged group. We conclude with an exploration of the social contextual factors that can affect how the disadvantaged cope, and a discussion of the challenges facing future research on attributions to prejudice.  

The Most Vulnerable of the Epidemic—Orphans

One was a baby girl found by an orphanage in the garbage. When they realized she had HIV, they put her back in the garbage

 

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

Discusses 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

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 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
Through the Looking Glass One of the most difficult tasks of writing up any study is finding a title that accurately reflects the nature and major findings of the work. In this epidemiological study, the task is even more difficult, because this survey is so closely linked to the class action suit and the issue of monetary compensation of Hepatitis C positive transfusion recipients. All sides in this legal and economic struggle have taken considerable interest in our study's results, because so little is currently known about the health and socio-economic conditions of transfusion recipients. pdf

US to investigate impact of stigma on health

The US is planning an ambitious programme of research into the impact of stigma on human health, led by part of the National Institutes of Health in Bethesda, Maryland.

 

Violence and Public Health ; A case study of recent violence in Gujarat'

The discussion was centred on the break in confidence or trust of all institutions and that there is urgent need of rebuilding partnerships to prevent societies from fighting and breaking 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.  

Work Injuries and Illnesses Occurring to Women

Report on work injuries and illnesses occurring to women

43 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.  

 


 

 

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