Stigma/Barriers in Healthcare

1. Stigma/Barriers in Healthcare ADAP Advocacy Association Washington DC 2014 Jeff Allen – President Omar Mayes- Chair Mary Bennefield- Co-chair

2. Positive Champions Speakers Bureau Inc. • If you've been diagnosed with HIV (human immunodeficiency virus) or know someone who has, the need for support and compassion couldn't be greater. Too often HIV-positive people become targets of AIDS discrimination. On top of handling new health challenges, they sometimes face rejection by family, friends or work. They may be forced out of homes, lose their jobs or even become victims of violence.

3. The Positive Champions Speakers Bureau was created in a collaborative effort by our local planning consortia called Partnership for Comprehensive HIV/AIDS Planning (PCHAP) and the Health Planning Council of Northeast Florida. It was funded by a grant through AIDS United Southern Reach in 2011 and 2012. It is operated by an all volunteer group of HIV positive individuals or those affected by the disease. www.positivechampions.org ositivewww.positivechampions.org

4. Some Glaring Barriers….. • Racial Disparities • Housing (lack of and segregation) • Education • Employment • Healthcare • Incarceration • Stigma

5. Stigma • One of the biggest barriers to health equity surrounding HIV/AIDS is the stigma and relative silence associated with the disease. The stereotype of HIV/AIDS as the consequence of an individual’s deviant behavior has perpetuated shame and discouraged people from knowing their status and treating it.

6. Stigma • By expanding the discussion of HIV/AIDS to include structural factors that contribute to the high rates of HIV transmission, we can shift stigma away from individuals and extend the responsibility for addressing the crisis to the communities themselves. Moreover the psychosocial conditions that impact HIV rates are often the same ones that create health inequities in general. An integrated and holistic focus on health and wellness will reduce stigma.

7. How does stigma show up? • What are your thoughts? • What does it look like in your community? • What are you doing to address it?

8. Some ways stigma shows up are……… • A significant number of people are afraid to be associated with a place that provides HIV/AIDS services for fear of being found out that they are positive. • Some men don’t want to be tested because they fear being seen as gay.

9. Some ways stigma shows up are……… • Some women don’t want to be tested because they fear that they will be seen as promiscuous. In addition, they fear loosing their children, home, or partners.

10. If we continue to view HIV/AIDS as something separate from the rest of our community this stigma will continue to exist.

11. The challenges of disclosure • Disclosure of HIV status can be a difficult and personal decision. • What are the risks and benefits? • What is the impact on others? • What is the impact on self?

12. Benefits of Disclosure • Allows a person to receive trusted support from others • Reduces isolation and resultant anxiety, fear and worry • Helps a person feel more authentic with people they trust • Decreases the need to be secretive (e.g., hiding medications), which helps them to comply with adherence

13. Benefits of Disclosure……… • Helps reduce the isolating stigma associated with HIV • Fosters community with others who are HIV+ • Adheres to Legal Disclosure laws for some states

14. Assisting Client’s Disclosure • Identify risks and benefits of disclosure for clients • Develop strategies to assist clients in weighing the risks and benefits of disclosure • Develop strategies to support clients through the disclosure process • Self disclosure to clients, family, co-workers and community often enables clients with their own disclosure

15. Create a facilitated support group • Having it facilitated assures that everyone has a chance to share in a safe and confidential environment. • A facilitator can keep the conversation on topic while assuring that no one is cut off. • In our area we advertised at all HIV service providers. • We found a place not associated with any kind of CBO or Health Department which helped eliminate some of the fear of being associated with HIV sites.

16. The conversations within the group vary. We talk about: • Both HIV and non-HIV issues that affect out daily lives • The pro’s and con’s of disclosure/how to disclose • Drug reactions and complications • Sero-partners and fear of transmission • Prep (Pre-Exposure Prophylaxis) • Guilt and shame that some of us knowingly spread the virus for fear of disclosure • Issues specific to the newly diagnosed • Issues specific to growing old with the virus

17. Policies and interventions • Many HIV prevention programs and risk reduction interventions have focused on HIV knowledge, sex education and the promotion of condom use. Although such policies have effectively decreased sexual risk behaviors, conservatives have opposed to programs such as condom education in schools and distribution. In the past this has led to federal and state support for abstinence and abstinence-only programs.

18. Policies and Interventions • Policies that promote abstinence only and withhold important health information (condom education) place individuals at risk for making unhealthy choices. • While many prefer abstinence only as the sole solution for unmarried teenagers, the reality is that many young people are sexually active and at risk for contracting the virus and/or other STD’s.

19. Policies and interventions • In addition many policies provide a predominately heterosexual perspective, excluding the specific and focused health needs of gay, lesbian, bisexual, transgendered people, while indirectly stigmatizing them.

20. Questions?

21. Contact info: Jeff Allen jeffallen1961@aol.com 386-235-6796 ________________________________________ Omar Mayes trebon7@hotmail.com 386-295-4084 ________________________________________ Mary Benefield btflredrose@yahoo.com 386-307-7877 Positive Champions Speakers Bureau positivechampions@gmail.com www.positivechampions.org

22. www.positivechampions.org A collaboration with the Health Planning Council of Northeast Florida and the Partnership for Comprehensive HIV/AIDS Planning council . We are a premier model for a speakers bureau and we will gladly help you address stigma in your area.