Page 1 of 13

European Journal of Business &

Social Sciences

Available at https://ejbss.org/

ISSN: 2235-767X

Volume 07 Issue 01

January 2019

Available online: https://ejbss.org/ P a g e | 557

The Stigma and Discrimination of HIV/AIDS

DHYAN SINGH(RESEARCH SCHOLAR)

SINGHANIA UNIVERSITY

SUPERVISOR NAME: DR SUMAN(ASSISTANT PROFESSOR)

DISTRICT INSTITUTE OF EDUCATION & TRAINING(DIET),KURUKSHETRA

Abstract

Although stigma is considered a major barrier to effective responses to the HIV/AIDS epidemic,

stigma reduction efforts are relegated to the bottom of AIDS program priorities. The complexity

of HIV/AIDS related stigma is often cited as a primary reason for the limited response to this

pervasive phenomenon. In this paper, we systematically review the scientific literature on

HIV/AIDS related stigma to document the current state of research, identify gaps in the available

evidence, and highlight promising strategies to address stigma. We focus on the following key

challenges: defining, measuring, and reducing HIV/AIDS related stigma as well as assessing the

impact of stigma on the effectiveness of HIV prevention and treatment programs. Based on the

literature, we conclude by offering a set of recommendations that may represent important next

steps in a multifaceted response to stigma in the HIV/AIDS epidemic.

Keywords: epidemic,stigma,pervasive,multifaceted.

Introduction

The Human Immunodeficiency Virus (HIV) and the Acquired Immune Deficiency Syndrome

(AIDS), is the epidemic that has become the biggest threats to human survival, development, and

prosperity in the all parts of the world. HIV/AIDS related stigma (H/A stigma) is invoked as a

persistent and pernicious problem in any discussion about effective responses to the epidemic. In

addition to devastating the familial, social, and economic lives of individuals, H/A stigma is

cited as a major barrier to accessing prevention, care, and treatment services. Despite widespread

Page 2 of 13

European Journal of Business &

Social Sciences

Available at https://ejbss.org/

ISSN: 2235-767X

Volume 07 Issue 01

January 2019

Available online: https://ejbss.org/ P a g e | 558

recognition of the differential treatment of persons living with HIV/AIDS (PLHA) by society

and its institutions, over the first 25 years of the epidemic, community, national, and global

actors have only had limited success in alleviating the deleterious effects of H/A stigma. In

describing a sustained response to the HIV/AIDS epidemic, Peter Piot, Executive Director of

UNAIDS, identifies tackling stigma and discrimination as one of five key imperatives for

success. At the same time, Piot notes that stigma reduction efforts are relegated to the bottom of

AIDS program priorities, often without funding to support such activities.

In this paper, we systematically review the scientific literature on H/A stigma to document the

current state of research, with an emphasis on identifying gaps in as well as summarizing

existing knowledge on the four aforementioned challenges to effective intervention–defining,

measuring, assessing impact of, and reducing stigma. In assessing impact, we critically examine

the literature to elucidate the relationship of H/A stigma to the effectiveness of HIV prevention

and treatment programs. Finally, based on the available literature, we offer recommendations for

each of the four challenges that we believe represent critical next steps in ameliorating the

devastating effects of H/A stigma.

Defining Stigma: Conceptual Considerations

The conceptualization of H/A stigma that underlies most of the literature today mirrors the

stigma concept utilized for a broader set of health and social issues, such as mental illness or

unemployment. In the H/A stigma literature, the concept of stigma is often not explicitly defined,

but rather, is referred to cursorily as “a mark of disgrace”. The absence of an explicit

conceptualization of stigma precludes meaningful appraisal and comparisons of study findings

and limits the ability to design effective programs and interventions.

Early Work

Based on his work in psychiatric hospitals and among criminals and homosexuals, Erving

Goffman provided a seminal theorization of health-related stigma in the 1960s. Goffman defined

stigma as “an attribute that is deeply discrediting,” and that reduces the bearer “from a whole and

Page 3 of 13

European Journal of Business &

Social Sciences

Available at https://ejbss.org/

ISSN: 2235-767X

Volume 07 Issue 01

January 2019

Available online: https://ejbss.org/ P a g e | 559

usual person to a tainted, discounted one”. He established that society stigmatizes on the basis of

what is constitutes as “difference” or “deviance,” and results in a “spoiled identity”. The social

label of deviance compels stigmatized individuals to view themselves and others to view the

stigmatized as discredited or undesirable.

Socio-cognitive Approach

Goffman’s theorization of stigma was fruitfully adapted and extended by social psychologists

interested in how individuals construct categories and link these categories to stereotyped beliefs.

This body of work emphasized perceptions of individuals, the origins of stigma in human

cognition, and the consequences these individual perceptions have for social interactions. When

applied to HIV/AIDS, this socio-cognitive framework constrained the concept of H/A stigma to

an examination of how PLHAs are labeled and stereotyped by the public, based on their incorrect

beliefs and attitudes, and/or a focus on the specific emotions and cognition of PLHAs. This, in

turn, limited the scope of stigma reduction interventions to strategies that might increase the

empathy and altruism towards as well as reduce the anxiety and fear of PLHAs among the

general population or individual based interventions to assist PLHAs to cope with perceived or

experienced stigma. The great majority of articles on H/A stigma measurement and reduction

interventions identified in this review either implicitly or explicitly utilizes a socio-cognitive

conception of stigma. While important, these approaches exclude a detailed consideration of

structural aspects of stigma – the dynamic social/economic/political processes that

simultaneously produce and intensify stigma and discrimination.

Structural Understanding of Stigma

Recent work in the sociologic and anthropologic disciplines has broadened earlier conceptions of

stigma to encompass the structural conditions that contribute to stereotyping. One of the key

insights is that the process of stereotyping based on an attribute is not only a cognitive

phenomenon at the level of the individual but also is determined by a constantly changing social

process . Parker and Aggelton argue that “it is especially important to think of stigma as a social

and cultural phenomenon linked to actions of whole groups of people in the developing world,