Why Stigma and Discrimination?

Stigma often leads to discrimination and this, in turn, leads to human rights violations for people living with HIV/AIDS (PLWHA) and their families. Stigma and discrimination fuel the HIV/AIDS epidemic. They hamper prevention and care efforts by sustaining silence and denial about HIV/AIDS as well as reinforcing the marginalization of PLWHA and those who are particularly vulnerable to HIV infection. Since HIV/AIDS is linked to social taboos, such as sex, drug use and death, there are enormous levels of ignorance, denial, fear and intolerance about the disease in most communities. And it is partly because of these fears and prejudices that people stigmatize and discriminate.

Stigma is linked to power and domination throughout society. Ultimately, stigma creates, and is reinforced by, social inequality. It has its origins deep within the structure of society, and in the norms and values that govern much of everyday life. It causes some groups to be devalued and ashamed, and others to feel that they are superior.

Discrimination occurs when negative thoughts lead people or institutions to take, or omit to take, action that treats a person unfairly and unjustly on the basis of their presumed or actual HIV/AIDS status. Some examples of discrimination include hospital or prison staff denying health services to a person living with HIV/AIDS; employers terminating a worker from his/her job on the grounds of his or her actual or presumed HIV status; or families/communities rejecting those living with, or believed to be living with, HIV/AIDS. Such discriminatory acts, based on presumed or actual HIV status, are a violation of human rights.

Stigma and discrimination can occur anywhere and everywhere. They occur in the family, community, schools, place of worship, workplace, and legal and health-care settings. People can discriminate, both in their personal and professional capacities, while systems and institutions can discriminate through their practices and policies.

Another form of stigma arises through internalization by PLWHA of their negative perceptions of themselves. The stigma and discrimination associated with disease can have powerful psychological consequences for how people living with HIV/AIDS come to see themselves -- leading, in some cases, to depression, lack of self-worth and despair. Stigma and discrimination also undermine prevention efforts by making people afraid to find out whether or not they are infected, or may cause those who are infected to continue unsafe behaviours for fear of raising suspicion about their HIV-positive status. And they can cause people with HIV/AIDS to be erroneously seen as some kind of 'problem', rather than as part of the solution to containing and managing the epidemic.

In many countries, laws, policies and regulations have contributed towards the development of a supportive environment for HIV/AIDS prevention, care and support. But even in places where supportive policies and legislation exist, nonexistent or weak enforcement of these laws may facilitate the perpetuation of stigma and discrimination; this is because there is often little accountability for discriminatory action or redress for those who have been stigmatized and discriminated against. States and institutions can also create and reinforce stigma and discrimination through laws, regulations and policies that expressly discriminate against people living with or affected by HIV/AIDS.

With its focus on stigma and discrimination, the World AIDS Campaign hopes to encourage people to break the silence and the barriers to effective HIV/AIDS prevention and care. Only by confronting stigma and discrimination will the fight against HIV/AIDS be won.