Stigma and HIV

People who experience stigma are less likely to access the services and support they need to look after their health. Stigma and discrimination is one of the main reasons why people are reluctant to test for HIV, share their HIV status with others, go on HIV treatment or use PrEP.  

Stigma can be deadly. It can result in people with HIV getting diagnosed late, when the virus may have already progressed to AIDS. This makes treatment less effective, increases the likelihood of passing on HIV, and leads to unnecessary deaths. 

The effects of stigma are seen in:  

• Healthcare settings: Findings from the People Living with HIV Stigma Index suggests one in eight people with HIV have been denied health services. Stigma can lead to health providers delaying or denying treatment, demanding extra payment, and treating people in disrespectful and upsetting ways. 
• Social settings: People with or affected by HIV might be shunned by family, friends and the wider community and be treated badly at work or school. The fear of social isolation makes people reluctant to access HIV and sexual health services, even when they need them. 
• Mental health: Stigma can lead to low self-esteem, depression and other mental health issues. This can lead people to misuse alcohol and drugs and take risks with their health that make them vulnerable to HIV, like having sex without condoms. It also drives the silence and shame that stops people accessing services.  
• The law: Discriminatory laws and policies about HIV reinforce stigma. These laws can make people afraid to seek out healthcare or legal support. It can also stop people being honest if they’re a sex worker, have same-sex relations or inject drugs. This means they are less likely to access services to protect their health. 

Stigma-reduction dialogues, trainings and sensitisations can help people recognise and address the stigmatising attitudes they hold and change their behaviour. Running such sessions with healthcare providers, police, religious and community leaders, employers, journalists and politicians can help to change attitudes among these groups and in wider society. Enabling people with or affected by HIV to run (or co-run) these sessions is key for ensuring people understand the realities these communities face. These sessions should also address misinformation about how HIV is passed on. 

Enabling people with or affected by HIV to design and deliver programmes is key to creating stigma-free, friendly HIV and sexual health services and support that marginalised people feel willing and able to use.  

It is important to call out stigma whenever we see it – be that at work, in our communities or even at home. Public, community-led campaigns can provide information to challenge stigma, and show others that marginalised people are just like everybody else.  

Community-led advocacy to tackle discriminatory laws and policies is vital. It is also important to campaign for laws to protect people from HIV-related stigma and discrimination.

Providing mental health support can help people recognise and deal with the effects of stigma. It is also important to support people with HIV to understand more about the virus and their treatment. This can help people take a more active role in their care and reduce feelings of self-stigma. 

A human rights-based approach ensures that people with or affected by HIV are treated with dignity. A rights-based approach aims to create an environment that enables people with or affected by HIV to claim their right to health and to other rights, such as the right to live free from discrimination. Taking a rights-based approach to all HIV programming is essential.