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What Stigma?

By Marc Kolman, M.S.P.H.

November 18, 2009

Two weeks ago we held a pastor's forum here in Durham, North Carolina. About 20 pastors came from both black and white Christian congregations. Stigma became the main topic. One of the things that surprised me most were the challenges of talking about health issues period -- let alone more controversial issues like HIV/AIDS.

One pastor shared that one partner of a couple in his congregation has a health issue that they won't talk about with anyone other than the pastor -- and this health issue is not even a stigmatized disease like HIV, but something like high blood pressure, diabetes, or cancer. But if the couple doesn't share their problem, the congregation can't effectively support them.

Another couple has a gay son who is HIV positive. The son has moved to NYC. Since the couple won't raise the issues with their church community, they are left alone to deal with the significant issues related to gay oppression and HIV. Because they don't talk about it, they don't get the benefits of support from their faith community. And in the Southern US as elsewhere, church communities are strong, numerous and influential.

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Stigma is the effect of oppressions and works both externally and internally. External oppression is the combination of forces working throughout our society to target individuals for who they are -- their life choices, identities, cultures, beliefs. Oppressions are ubiquitous. They operate throughout society and target everyone. Though oppressions towards a lot of groups, such as racism and sexism, are much more blatant, common-place, and egregious, no one is immune from oppression. Yes, there is oppression towards heterosexual, middle-age, Protestant, white men (the oppressor of last resort). The result is that everyone is saddled with the effects of oppression and can be targeted -- stigmatized -- if it serves at the time. Internal oppression is what people experience when they turn the external oppression on themselves -- they believe the messages about themselves and others in their group or constituency that can then be turned inwards on ourselves or outwards on those we love and cherish. Internal oppression serves to keep the external oppression functioning in the society.

Stigma serves to keep us separate, confused and feeling like potential victims. Stigma operates around HIV, but targets anything -- race, religion, class, etc. To end stigma would be to truly end the oppressions of all people -- to change the world to become a place where differences are respected and honored, where people care about others, where people can truly and safely be who they are.

Several of the pastors at our forum said they need ongoing dialogue in support of ending the stigmas in their congregations. They need education and information about HIV. They need support in addressing significant moral issues within their congregations. And they need help coordinating outreach and ministry activities. They also need their deacons, members of their congregations, and other pastors to back and support them. It takes courage to move forward against stigmas that are so prevalent and challenging.

Marc is Executive Director of the Piedmont Health Care Consortium in Durham, NC.

To contact Marc, click here.




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