Health and humanity: results from The People Living with HIV Stigma Index in four countries to overcome stigma and ensure universal access
L. Stackpool-Moore1, H. Akter2, L. Cairo3, F. Carceres4, S. Charensok5, F. Hale6, A. Luna7, T. Michael Gomes8, K. Osborne1, H. Patterson9, N. Schaay10, L. Sharp9, M.J. Vazquez11, A. Welbourn6, R. Wong-Grünwald12
1International Planned Parenthood Federation (IPPF), London, United Kingdom, 2Ashar Alo Society (AAS), Dakar, Bangladesh, 3Profamilia, Santo Domingo, Dominican Republic, 4Instituto de Estudios de Población y Desarrollo (IEPD), Santo Domingo, Dominican Republic, 5UNAIDS, Bangkok, Thailand, 6Salamander Trust Associates, London, United Kingdom, 7Red Mexicana, Mexico City, Mexico, 8UNAIDS, Dakar, Bangladesh, 9The Office for Psychosocial Research, Glasgow, United Kingdom, 10University of Western Cape, Cape Town, South Africa, 11Salamander Trust Associates, Barcelona, Spain, 12German BACKUP Initiative (GTZ), Eschborn, Germany
Background: Stigma creates barriers to testing and the uptake of health and other services. Stigma influences health-seeking behaviours, can delay testing and impacts the quality of life of people living with HIV. Stigma remains significant around the world and creates barriers to the full realization of human rights, to enabling a health-promoting society, and to achieving universal access.
Methods: Results from The People Living with HIV Stigma Index in 4 countries are presented. The peer-interviews documented experiences of living with HIV, accessing health and other services, experiences of stigma and living positively. The Index is an international community based research initiative and is one of the first systematic processes - driven by people living with HIV - that comprehensively documents the experiences of stigma and discrimination of people living with HIV.
Results: The results in each country indicate that participants have been denied access to health services in the last 12 months, fear that their medical records were not being kept confidential, and some participants reported having been coerced or denied family planning options or reproductive rights. Results also indicate that people living with HIV effect change and play a pivotal role in challenging stigma and providing peer-support. Qualitative results give insight into how stigma can be addressed to overcome barriers to testing and achieving universal access. The data has been analysed according to sex, age, group-identity, time-since-diagnosis and access to health services. Results indicate that gender differences exist between accessing health service and the internationalisation of stigma.
Conclusions: Stigma and discrimination remain a significant challenge, and people living with HIV continue to lead in the response to challenging and confronting stigma. The Index results show that physical and verbal harassment are a common reality and services need to be improved to meet the current and gender-specific needs of people living with HIV.
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