HIV-AIDS Related Stigma in India

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In this youtube video, Anita an Indian woman talks about her experience of stigma living as an HIV+ person. UNAIDS estimates that India has approx. 2.4 million people living with HIV.  An important barrier to increased diagnosis and treatment of HIV-AIDS in India is the stigma attached to the disease (Report). Stigma has been defined by Irving Goffman as “an attribute that links a person to an undesirable stereotype, leading other people to reduce the bearer from a whole and usual person to a tainted, discounted one”. Several observers of Indian society, including its leading authors, have documented the stigma that is associated with HIV and its grave consequences for the persons living with HIV (PLHIV). One place where PLHIV face discrimination are hospitals where their experience might include denial of care; HIV testing without consent; disclosure of HIV status to family members, employers, non-treating health workers or other patients; and excessive use of barrier precautions for HIV-infected patients (USAID 2006). Patient advocacy groups like DNP+, NGOs like Sharan, CSR, and YRG Care (see video about the work of YRG care), groups of elected representatives like PFA, and government agencies like National AIDS Control Organization (NACO) are working towards reducing HIV-related stigma in India and to raise awareness about the disease, its prevention, and treatment. More work, however, is needed to reduce HIV-related stigma in Indian hospitals and clinics. Based on the USAID report cited above and the multi-level causal framework for stigma and discrimination shown in this table, following changes in the hospital practices can be recommended:

1. Safeguard patient confidentiality and institute institutional protocols that ensure that no one other than the health workers directly involved in patient care know about the sero status of the patients without patient’s explicit approval.

2. Empower and train health workers so that they feel confident caring for HIV+ patients

3. Legally prohibit public or private hospitals from denying care or unnecessarily referring away HIV+ patients

4. Improve the work environment in the hospitals so that the health workers are not at risk of accidental transmission of HIV.

5. Undertake educational campaigns to change the HIV-related attitudes of health workers away from blaming the victim  and towards a focus on providing adequate care and comfort to PLHIV

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2 Responses to “HIV-AIDS Related Stigma in India”

  1. janiepak Says:

    I am realizing more and more that there are few forces as powerful in influencing human behavior as that of social stigma. Being a social creature, it seems that humans have an innate desire to seek acceptance not only because of the psychologic impact but because we heavily rely on our social networks for things as small as having someone to chat with, to more serious matters such as receiving help in an emergency. When a social stigma is linked to a disease, such as HIV/AIDS, it is one of the greatest barriers because the very people with the disease refuse to accept treatment as it is seen as “publicizing” their disease status. But when the social stigma and prejudices infiltrate the healthcare professionals, then all patient with HIV/AIDS (even those who actively seek treatment) will receive poor care.

    I think policy changes suggested above are extremely important in ensuring protection of a patient’s privacy while educating health care professionals through education is crucial in minimizing discrimination within hospitals and clinics. However, to address the social stigma of HIV/AIDS within the healthcare setting, the awareness and education efforts need to reach far beyond the hospital and clinics to the general public. For it is the collective perspectives of the general public that is the driving force behind social stigmas in the first place and healthcare professionals are members of this general public too.

  2. janiepak Says:

    http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6VBF-3YS8DBM-4V&_user=75682&_coverDate=08%2F31%2F1995&_rdoc=1&_fmt=high&_orig=search&_sort=d&_docanchor=&view=c&_searchStrId=1430332668&_rerunOrigin=scholar.google&_acct=C000006078&_version=1&_urlVersion=0&_userid=75682&md5=29acf55bbce763932aecd1dd7c84dd55

    This article, by A. Alonzo and N. Reynolds, discusses in depth the types and phases of stigma experienced by people with HIV. It describes stigma not as something that is not “static” but “expansive, pervading all corners of one’s life space and identity,” yet still “controllable.”

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