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Stigma-Reduction Programs. Principles , Tools, Successful Programs and Resources. A Basic Framework . Immediate Actionable Causes Lack of awareness Fear of casual contact Values linking HIV with immoral behavior . Structural Polices, laws, and systems. Individual Address attitudes
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Stigma-Reduction Programs Principles, Tools, Successful Programs and Resources
A Basic Framework • Immediate Actionable Causes • Lack of awareness • Fear of casual contact • Values linking HIV with immoral behavior • Structural • Polices, laws, and • systems • Individual • Address attitudes • and behaviors • Environmental • Meet needs for information, • training, and supplies Nyblade, L. Stigma Reduction: Evidence and Tools for Action. Presented at IAS 2008.
Key Programmatic Principals for Successful Stigma-Reduction Programs
1) Raise Awareness: Close the Intention-Action Gap • Foster understanding and motivation for stigma reduction by: • Creating recognition of stigma • The benefits of reducing it • Safe space to reflect and gain skills for change
2) Address HIV Transmission Fears and Misconceptions • How it is and is not transmitted • In-depth information • Interactively: Allow for • “Yes I know that, but why…?” • Listen, learn & respond to specific fears related to daily living context
3) Discuss and Challenge the ‘Taboo’ • Provide safe spaces to discuss, reflect, understand and question: • The values and beliefs that underlie stigma and discrimination • Where they come from • What they do • Gender, inequity, sexuality, violence, drug use
4) Role for People Living with HIV • Empowerment and capacity building • Building networks, strengthening Civil Society groups • Address internalized stigma • Skills building • Delivering programs
5) Start at ‘home’ • Space/support to reflect on, evaluate & change • Organizational level • programs, practices and policies • Individual/Personal level • Build skills • Provide on-going support for learning and change
Intervention Approaches • Involve gatekeepers and multiple change agents to promote understanding and ownership • Facilitate interaction, reduce ‘distance’ • Advocacy campaigns • Model and uphold desirable behavior • Create alliances and form new partnerships
Intervention Approaches • Use a Range and Combination of Approaches • Participatory learning • Community meetings • Cultural Mediums • Written Materials of Local Relevance • Media Channels
Addressing intersecting stigmas • Key populations experience stigma related to multiple sources: • Drug use, sexuality, gender, sex work, HIV, violence
Effective efforts engage marginalized communities • Address self-stigma • Develop & Support Networks • Capacity strengthening • Training: new knowledge and skills • Access to prevention and treatment services • Income generation
A Toolkit for Action • Based on 4 country study • Participatory development • Successfully used with wide range of audiences • 40+ countries • 7 languages • Living document
Tools for Reducing Stigma among the General Population • Link to the Following Tools in the SAN E-library: • Understanding and Challenging HIV Stigma: Toolkit for Action • Youth Manual on Anti-Stigma messages • HIV & AIDS - Stigma and Violence Reduction Intervention Manual • Ending HIV/AIDS-Related Stigma and Discrimination - Methodological Workbook for Raising Awareness and Training
Tools to Reduce Stigma in Health Care Settings • Link to the Following Tools in the SAN E-library: • Reducing Stigma and Discrimination Related to HIV and AIDS: Training for Health Care Workers • The PLHA - Friendly Achievement Checklist • Reducing HIV Stigma and Gender Based Violence Toolkit for Health Care Providers in India • HIV Principles and Stigma Reduction Training Curriculum: Addressing HIV and Stigma in the Healthcare Setting in the Middle East and North Africa Region
Additional Resources For more information • View presentations giving an overview of HIV and stigma, and outlining principles for stigma reduction program design, resources and tools Two additional key resources: • SAN advocacy brief • Stigma measurement brief
Measuring the Results of Stigma & Discrimination-reduction Efforts Current Stigma Measures:1,2 • Assess the underlying ‘immediately actionable’ drivers of stigma: • Lack of awareness of stigma • Fear of infection through casual contact • Values linking HIV with immoral behavior (shame & blame) • Assess the manifestations of stigma: • Experiences of stigma and discrimination 1Nyblade et al. 2005. Can we Measure HIV/AIDS-related Stigma and Discrimination? http://www.icrw.org/files/publications/Can-We-Measure-HIV-Stigma-and-Discrimination.pdf 2UNAIDS 2007. Reducing HIV stigma and discrimination: a critical part of national AIDS programmes: a resource for national stakeholders in the HIV response. http://data.unaids.org/pub/Report/2008/JC1521_stigmatisation_en.pdf