Stigma and Intervention Structures

This 3-page discussion paper explores the subject of stigma and the authors' wish to approach HIV/AIDS in the context of working within "wellness," a broader context of health. The authors ask, "If stigma is a set of ‘isolate and separate’ perceptions and behaviours, then are we not perpetuating stigma by having ‘separate’ structures such as HIV policies, HIV programs, HIV Champions, HIV peer educators, HIV NGO’s, public officials with HIV portfolios, HIV awareness campaigns, HIV condom distribution, ABC, and AIDS day talks?" The premise of this paper is that it is time to normalise HIV/AIDS by striving to include HIV/AIDS functions within existing health, policy and service structures.

One of the questions that the authors explore is: "To what extent is the method of delivery of HIV and AIDS services contributing to the perpetuation of stigma?" The authors suggest that there is a failure to recognise that a state of separation is perpetuated by setting HIV/AIDS on its own platform, particularly in delivered interventions. They believe that those living with the disease are unintentionally isolated in spite of people trying to help them.

The authors describe the conundrum behind HIV/AIDS awareness campaigns this way, "How do we get people to attend? If you attend, you are concerned. Then people wonder why you are concerned. The stigma begins." Some ways to help combat this issue are through revising social marketing and delivery structures. The authors suggest for example that when individuals are tested for HIV/AIDS it should be in the broader context of "wellness/health." They offer an example. When potential HIV/AIDS patients go to a clinic the clinic should be one where a variety of people with chronic or life threatening illnesses are being treated. If a patient were to receive disturbing news, then he or she could exit through a back door.

The authors ask, "is it not more effective to remove the term ‘HIV AIDS’ from awareness efforts, and rather include it as one of a range of modules in ‘Wellness’ efforts, where other issues include hepatitis, malaria, TB, breast-feeding, nutrition, and other common concerns? How many more people would we reach this way?"