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Jumping over Two Hurdles: Caring for Addicts who live with HIV. Dr Ehab El Kharrat President of ISAAC International & Executive Director of Freedom Egypt. What is Stigma?. To stigmatize is to label someone. To see someone as inferior because of an attribute he or she has.
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Jumping over Two Hurdles:Caring for Addicts who live with HIV Dr Ehab El Kharrat President of ISAAC International & Executive Director of Freedom Egypt
What is Stigma? To stigmatize is to label someone. To see someone as inferior because of an attribute he or she has.
Types of HIV-Related Stigma • Self Stigma – Self-hatred, shame, blame (internal). • Felt Stigma– Perception or feelings toward PLHAs (external) • Enacted Stigma or Discrimination • Stigma by Association – The whole family can be affected by stigma. Stigma related to occupation.
A Double Stigma • Intra venous drug users are stigmatized: seen as selfish, criminals, fools and untrustworthy • People living with HIV are stigmatized: seen as perverts, should be avoided, may be contagious, magically harmful and should be avoided
Stigmatization and Condemnation • The roots of condemnation may be found in the attempt to preserve the majority (the upright) and preserve the purity of the moral message • Connecting HIV/AIDS to “committing adultery”, Drugs to “being selfish and callous” • The fear of appearing as a liberal or loose person leads religious people to exaggerated firmness • Lack of information and misconceptions
Roots of Stigmatization • With the rise in awareness of the facts the realization that confronting HIV/AIDS requires avoiding labeling, condemnations • Confronting • A call for love and compassion in action toward vulnerable groups and PLWHA • All human beings are sinners: The glory and the fall • The balance between affecting behavior change and avoiding stigma e.g. smoking, overeating
HIV status • If you do not get tested, you are not HIV negative you are only HIV ignorant • There is life after addiction • There is life after HIV • There is life after HIV and Addiction • You and Those whom you serve may well be HIV positive
Double Denial • It can not happen to me • I am not like this • I can not take it • If I am I should not know • It will not help me to know
Why our clients do not get tested • Stigma • Denial • Discrimination
History of Support Groups • Groups of friends or colleagues often develop naturally • HIV raises many difficult issues and questions • Many People living with HIV find support groups can provide information and reduce anxiety about questions
Benefits of Support Groups • Help individuals to become more confident and powerful • Provide a basis for activities organized by their members • Make links between people of different backgrounds and increase tolerance and understanding • Help share resources, ideas and information • Make others in the community aware of the situation faced by people in the group • Lead to the creation of a public or political voice for people living with HIV
Key benefits • Safe space • Reduced isolation • Providing optimism • Learning more • Action for change
Not Always Easy • People cannot have their HIV status known • People have economic and other issues that the group cannot meet • Group members have different needs and expectations which can lead to conflict and disappointment • Group founders/leaders move on, creating some weakness • Burn out
Ways to Positive changes for people living with HIV • Increase knowledge • More skills • Positive attitudes and beliefs • Helpful social and cultural influences • Supportive environment • Policy and issues/human rights • Access to materials and services • Economic opportunities • Open environment
Causes of Problems for People Living with HIV • Lack of Knowledge • Lack of Skills • Unhelpful attitudes and beliefs • Social and cultural pressures • Restrictive environment
Keys to care for PLWH • Regular intake of the medicines When the person needs it Avoid resistance The issue of priority Side effects Motivation Regular testing
Keys to care for PLWH • Stigma and Myths in and outside the recovery community: Dealing with the stigma • Nutrition • Healthy lifestyle • Discrimination