Stigma and Discrimination…
The same picture
as my first
presentation –
with a bit more
revealed
14
Themes of presentation…
Suggesting some entry points for both
Programmes
Advocacy
What we do
What we say
To counter Stigma and Discrimination , as well as reminding us
all of our agreed definitions , and showing some of the effects
researched effects of these two evils…
‫‪5‬‬
‫تعريف الوصم بالعار والتمييز‬
‫‪1/2‬‬
‫الوصم بالعار‬
‫مواقف أو معتقدات اجتماعية سلبية أو اإلزدراء تجاه ”اختالفات“ حقيقية أو وهمية‬
‫إزاء اآلخرين ‪ .‬وهو شعور ال يوجد بصورة طبيعية وإنما ينشأ لدى األفراد وفي‬
‫المجتمعات‪.‬‬
‫والوصم بالعار هو سلوك يحط من قدر اآلخرين‪ .‬ومرض اإليدز وفيروسه يولّد ويقوي‬
‫التحامل الموجود‪.‬‬
‫كما أن الوصم بالعار يعمل على تقوية المظالم االجتماعية خصوصا تلك التي ترتبط‬
‫بالنوع والجنس والعرق‪.‬‬
‫‪6‬‬
‫تعريف الوصم بالعار والتمييز‬
‫التمييز‬
‫‪2/2‬‬
‫تؤدي فكرة الوصم بالعار بالناس إلى القيام (أو عدم القيام) بشيء ينكر الكرامة الشخصية أو‬
‫االمتناع عن تقديم خدمة لشخص آخر أو حرمانه من حقوقه‪.‬‬
‫وكثيرا ما يتعرض المصابون بمرض اإليدز وفيروسه وأسرهم للتمييز وتنتهك كرامتهم وحقوقهم‬
‫ألنهم ببساطة مصابون أو يفترض أنهم مصابون بمرض اإليدز أو فيروسه‪.‬‬
‫ويمثل هذا تمييز‪.‬‬
5
Defining stigma and
discrimination
Stigma
1/2
Derogatory or negative social attitudes or beliefs towards the
perceived or real 'differences' of others do not naturally exist, they
are created by individuals and by communities.
Stigma is a process of devaluation. HIV/AIDS builds upon and
reinforces existing prejudices.
It also plays into, and strengthens existing social inequalities –
especially those of gender, sexuality and race.
6
Defining stigma and
discrimination
Discrimination
2/2
Stigmatising thoughts frequently lead people to do
(or not do) something that denies personal dignity, services or rights
to another person.
People living with HIV and AIDS (PLWHA) and their families are
frequently discriminated against and their dignity and rights violated
simply because they are known or presumed to have HIV/AIDS.
This is discrimination.
Stigma
• Does stigma enhance risk?
• Consistent evidence that people experience
discrimination and believe HIV is stigma bound. (Sherr & Sherr
99, 2000, Haour Knipe, Price 1992, Kraft 95, Altman 92, Leach 95, Young 94, Van der Ven 96,
Herman 95)
• Psychological effects of felt and enacted stigma is low
self esteem, depression, anxiety, isolation (Hall 92)
• Gold (2000) noted that negative mood and feeling bad
about themselves in a sample of gay men in Australia
was a predictor of risk
• Fear of disclosure linked with risk exposure
• But is it stigma or rejection that is the issue?
Some data from the European
Study (Sherr & Sherr 2001)
• Data collected from
108 HIV positive
individuals in UK
(83.2% male, 87.3%
UK born, x age 36.1
yrs, 30.6% minorities)
• 82.4% had fears or
concerns of
discrimination.
• Only 6.5% did not
hesitate telling
people their
diagnosis
• 19.4% told not to tell
at time of diagnosis
EXPERIENCE OF DISCRIMINATION
Subtle Discrimination
Mild acts of discrimination,
hard to quantify but hurtful
Obvious acts of discrimination
Acts of discrimination resulted in:i. Hurt feelings
ii. Exclusion
iii. Loss
iv. Physical damage
v. Mental damage
vi. Financial damage
57.4%
56.5%
47.2%
67.6%
49.1%
42.6%
12%
54.6%
40.7%
Impact of Discrimination
Emotional Trauma
Secondary Physical
Deterioration of health
Despair
Fear of recriminations
Reluctance to proceed
Stigma
Depressed
Confidentiality problems
Concern for dependants
Reluctance to seek help
Suicidal
63%
38%
44%
55%
50%
45%
48%
63%
46%
31%
59%
37%
Action taken
• 34.3% kept it to
themselves
• 31.5% report to
health care worker
• 25% seek formal
legal advice
• 11.1% note legal
action
• Only 5 people (4.6%
of the sample) had
gone to court on the
issue.
Use of the Law
Sherr L Sherr A Orchard et al JAMA 1999
• 76 Clients recounted
at least one
experience
• 35.5% believed not
actionable in law
•
•
•
•
•
22% lack of energy
17% time barrier
19% expense
22% exhaustion
20% confidentiality
worries
Accepting the challenge internationally
• Overall objectives accepted at the Federation's General
Assembly '01, agreeing to scale-up HIV/AIDS action
• Coalition being built with partners including UNAIDS, and the
Global Network of People living with HIV/AIDS (GNP+)
• Campaign design undertaken by Secretariat – presenting
message, graphics, actions, advocacy, tools, events etc.
in discussion with National Societies, and partners
• Subsequent role of the Secretariat to motivate, guide and coordinate work with National Societies, and globally
9
Accepting the challenge nationally
• Present and integrate the campaign into your National Society
programmes in accordance with the General Assembly decision,
co-ordinating regionally wherever possible
• Build partnerships for the campaign, including the national and
local networks of people living with HIV/AIDS
• Prepare national campaign strategy, adapting the global materials
as appropriate for your needs and sensitivities
• Motivate, guide and co-ordinate the campaign at national and
local levels
10
13
Building your campaign
• Establish your campaign task force, appoint a campaign coordinator, prepare your strategy
• Build partnerships especially with PLWHA
• Identify and provide direction on agreed advocacy issues
• Promote 'profile programmes' e.g. peer education, support
groups, and initiate or strengthen prevention and care
programmes
• Plan ongoing media campaign with peaks at key dates
• Organise and co-ordinate activities, events, seminars,
Red Cross/Red Crescent ambassadors and spokespersons at
national and local levels
14
Visibility and credibility
Keeping the balance
Programmes
What we do
Advocacy
What we say
Red Cross Red Crescent
visibility and credibility
• Ensure your Society is a 'safe' environment for your members and
volunteers living with HIV/AIDS. Put appropriate policies
in place
• Strengthen or initiate prevention and care/support programmes
organised by your society, making sure Red Cross/Red
Crescent is seen as a 'safe house' for PLWHA
• Cooperate, learn from, share ideas and initiatives with
other groups and organisations working with HIV/AIDS programmes and
advocacy
• Organise specific events, communications and activities to raise
awareness on stigma and discrimination among targeted groups and the
general public, and advocate for specific objectives wherever possible
15
Stigma and Discrimination…
All is now revealed !
This is me nearly 20 years ago.
Myself and 30 others dressed as
nuns, priests, monks formally
exorcised the spirits of
AIDSPHOBIA and HOMOPHOBIA
from the Anglican Church by
performing an excorcism ceremony
with PRESS coverage (TV, film
crews, photographers) outside the
official residence of the Head of the
Church of England .
I am not suggesting you do anything
like this – but do think creatively
please …remembering and aligning
to…
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Global campaign objective
Your action and communications will work to change
perceptions, attitudes, policies, behaviour in order to:
• ensure that those people who are already HIV+ or have AIDS are
able to receive the appropriate care and support, have access to
affordable drugs, and can live full and useful lives within their
communities
• prevent a further spread of the infection and increase every
individual's willingness to be tested, to protect him
or herself, and their loved ones
This might mean you getting it wrong occasionally, taking a few
risks ,…’ pushing the envelope’
An opportunity to partner at the
strategic level…
The criminalisation of HIV transmission in
Europe and Central Asia
We (GNP+ Europe) needs partners to help
map and monitor the existing situation ..
Aims of the Project
• To map the use of the criminal or state law in
prosecuting persons for the transmission of HIV.
Specifically to record the rate of
prosecutions/convictions and the type of laws used.
• To map who is being prosecuted and how this
compares to national epidemiology of HIV.
• To identify local organisations working on these issues.
• To examine the ease of access to this information.
Use of the Law
• At least 36 countries have laws that can be used to
prosecute individuals ‘transmitting’ HIV – and 14 of
these have created specific legislation or amended
existing legislation to ‘criminalise’ transmission in
certain circumstances
• Exceptions are:
• Albania, Bulgaria, Luxembourg, Slovenia
What is punishable?
Only actual transmission
punishable
Belgium, Bosnia &
Herzegovina, Croatia, Czech
Republic, Estonia, Finland,
Hungary, Ireland, Latvia,
Lithuania, Malta, Portugal,
Romania, Serbia and
Montenegro, Switzerland and
the UK
Exposing another person to the risk
of transmission also punishable
Armenia, Azerbaijan,
Denmark, France, Georgia,
Germany, Iceland,
Liechtenstein, Moldova, The
Netherlands, Norway, Poland,
Russia, Slovakia and Ukraine.
Punishments
• Differed widely
• From payment of medical treatment of the
person you ‘infected’
to
• Life imprisonment in four countries
• And deportation as well as imprisonment
Next Steps
•
•
•
•
We would like to finish off this research by
Filling in the gaps – for which we need your help
Publishing a brief overview of this report
Making the complete report – including the
country by country data – available electronically
• Want to get involved possibly? - contact me
7
Global campaign objective
Your action and communications will work to change
perceptions, attitudes, policies, behaviour in order to:
• ensure that those people who are already HIV+ or have AIDS are
able to receive the appropriate care and support, have access to
affordable drugs, and can live full and useful lives within their
communities
• prevent a further spread of the infection and increase every
individual's willingness to be tested, to protect him
or herself, and their loved ones
This might mean you getting it wrong occasionally, taking a few
risks ,…’ pushing the envelope’
And you know that you can do it …
So keep on doing it …but find ways of worker
SMARTER not HARDER and broaden what
you do …and involve all the objectives of the
global campaign at all levels