What Are the Issues?

Some of the most common situations that arise in the context of stigma and discrimination are listed below. However, this is not an exhaustive list.

Support for PLWHA and Their Families

PLWHA go through a process of grieving for their own lives -- a process that eventually should lead to an acceptance of their diagnosis. However, even when people do manage to find a balance in their own lives, society and institutions often perpetuate negative opinions and treat those affected by, and infected with, HIV as lesser members of the community. This produces ongoing limitations on the quality of life of PLWHA.

Health Care Settings

In many instances, the institution where people expect to obtain care and support is, in fact, the first place where people experience HIV/AIDS-related stigma and discrimination. This may be expressed in a lesser standard of medical care or, in the worst instances, in a complete denial of treatment -- often as a result of a misplaced fear of infection. Examples of the types of stigma and discrimination faced are: excuses and explanations about why a person cannot be admitted to a hospital (without admission being directly refused); isolation, name-tagging or other methods of identifying someone as HIV-positive; breaches of confidentiality, negative attitudes of staff, use of negative verbal and body language by health care workers; conditional treatment (e.g. patients will only be treated if they sign up for medical trials); shunting of patients between wards, doctors or hospitals; and restricted access to hospital facilities.

Access to Treatment

PLWHA often do not receive the same level of access to treatment as the general public and most do not have access to antiretroviral (ARV) therapies due to the high prices of these drugs and the lack of medical infrastructures in many developing countries to deliver good-quality medical care.

Even when ARV therapies are available, certain groups may be excluded -- for instance, because of reservations about their ability to follow a drug regime, as may be the case for injecting drug users.

Education

The right to education for PLWHA and vulnerable populations is often flouted through the refusal to enroll pupils in schools and universities, refusal to allow access to school facilities, negative treatment by peers and others in the school environment, segregation within the classroom, and an unwillingness to allow students to attend medical appointments, etc. Furthermore, the teaching of non-discriminatory attitudes about HIV/AIDS is often not part of the curriculum.

The World AIDS Campaign on stigma and discrimination brings attention to these identified, agreed goals and will advocate appropriate measures by States to reduce stigma, discrimination and human rights violations.

Judicial System

Negative attitudes or prejudice towards people living with HIV/AIDS can be reflected in denial or lesser access to the judicial system and in judgements involving issues such as confidentiality of HIV status and protection in rape/abuse cases. The judicial system can also inadvertently increase stigmatization -- e.g., when particularly vulnerable groups, such as sex workers and drug users, are penalized rather than being empowered to prevent HIV infections.

Politics

Executive inaction with regard to HIV/AIDS can legitimize stigma and discrimination, particularly when discriminatory attitudes towards people affected by, and infected with, HIV or marginalized populations are ignored in law reform processes, and those who discriminate are not held accountable.

Faith-Based Organizations

In some instances, faith-based organizations reinforce prejudicial attitudes towards people living with HIV and their families. This is particularly reflected in attitudes towards sexuality, sex and drug use, use of contraceptives, multiple sexual partners and the notion that HIV/AIDS is a punishment by God.

Media

Some journalists do not have the necessary knowledge or background information when reporting on situations involving vulnerable groups and PLWHA. Misinformation can lead to inappropriate comments, the use of negative terminology, sensationalism, breaches of confidentiality and the reinforcement of negative attitudes towards PLWHA and those affected, as well as towards vulnerable populations.

Workplace

The ability to earn a living and to be gainfully employed is a basic human right. HIV/AIDS-related issues arise concerning hiring and firing, employment security, unfair dismissal, medical leave, health insurance, absences from work for health purposes, work allocation, safe environment, pay and benefits, attitudes of employers and other employees, HIV screening for general employment, promotion and training. Often the thinking behind these issues revolves around the belief that it is not worth investing in someone who will die anyway. Disability employment policies (or lack thereof) are a complicated and often neglected area. In cases where someone falls ill, stigma against the disabled includes stigma against those disabled due to HIV/AIDS.

Culture/Social Norms/Practices

Cultural and social attitudes cover many practices within societies. Attitudes towards people with multiple sexual partners, sexually transmitted infections (STIs) and HIV, drug use, sex outside marriage, initiation rites, widow remarriage, orphans, single mothers, infertility, sex work, men who have sex with men, and death are often negative. These issues are ones that societies often have problems addressing and accepting, or are simply taboo. These groups are often already socially marginalized and ignored in their societies due to cultural and social 'norms'. In addition, HIV/AIDS is often prevalent among the poorest sectors of society.