HIV-related stigma is a key barrier to testing and treatment. In October 2017, UNAIDS released a report stating that people living with HIV who experience high levels of HIV-related stigma are more than twice as likely to delay enrolment into care than people who do not perceive HIV-related stigma. Stigma plays a role in losses throughout the treatment continuum and remains a key barrier to improving HIV outcomes.
Often, people living with HIV seeking services for fear of unwanted disclosure, stigma, and discrimination based on their HIV status. Across 19 countries with available data, one in five people living with HIV avoided going to a clinic or hospital because they feared stigma or discrimination related to their HIV status. When people living with HIV wait until they are very ill before seeking treatment, they are less likely to respond well to antiretroviral therapy and have poorer health outcomes. Both perceived and actual stigma in communities leads to lower levels of HIV testing.
The report highlights that these fears are not unfounded. Across 19 countries with available data, one in four people living with HIV have experienced discrimination in health-care settings. Where programs have been put in place to respond to stigma and discrimination, access to services for HIV prevention, testing and treatment has improved. In one clinic in Namibia, a shift towards integrated health service delivery led to a 20% reduction in deaths among people with HIV.
In communities where isolation and mistreatment are evident, many are forced to live in the shadows out of fear and shame. In Mozambique, stigma has been shown to hinder adherence because PLHIV fear others finding out their status and those who disclose may become isolated due to the stigma and lose their support for treatment. That said, many countries have been tackling stigma and discrimination and normalizing HIV. There are several stigma reduction tools that may help program managers address this barrier.
This Trending Topic provides SBC tools and project examples created as part of efforts to help reduce HIV stigma. We welcome your suggestions for additional materials. Please contact the Compass Curator, Susan Leibtag, firstname.lastname@example.org.
Banner Photo – © 2017 Arturo Sanabria, Courtesy of Photoshare