Overcoming HIV Stigma: A Journey from Within
Stigma Can Be So Insidious
“Stigma can be so insidious. It cuts deep and affects all of us,” said Shaun Mellors, Director, Community Stakeholder Engagement, ViiV Healthcare who was speaking on Zero HIV Stigma Day during the opening plenary of LIVING2024. “Every day should be Zero HIV Stigma day,” rightly said Shaun.
A Legacy of Change
Shaun celebrated the inspiring legacy of Prudence Nobantu Mabele who was a force for change for a socially just world, and a noted South African activist. Shaun said that lessons from Prudence’s legacy are to “speak your truth”, “be brave”, “sing, even if you are a terrible singer, sing”, and “laugh and make others laugh.”
Breaking Down Barriers
All forms of HIV-related stigma and discrimination must end so that all people can access full spectrum of health and social services in a rights-based, people-centred and gender transformative manner.
The Impact of Stigma
People living with HIV who anticipate stigma are 2.4 times more likely to delay care until very ill.
Stigma – From the Inside Out?
“It is important to tackle stigma and discrimination at all levels of the socio-ecological level – individual, family and peers, community and structural level, to affect sustainable and transformative change. We need evidence-based multi-level interventions (to tackle all forms of stigma and discrimination – including internal stigma) for lasting change,” said Nadine Ferris France, CEO of Beyond Stigma and Certified Facilitator of Inquiry-based Stress Reduction (IBSR).
Internal Stigma
Internal stigma is a mindset of negative beliefs, thoughts, and behaviours about HIV, which manifests as shame, guilt, feelings of contamination, reduced self-efficacy, self-loathing, low self-esteem and self-rejection. “Internal stigma happens when we internalise external stigma and judgements and believe that they are true. Internal stigma also happens in the absence of external stigma and discrimination”, explained Nadine.
The Urgent Need to Address Internal Stigma
“84.5% of people living with HIV report internalised stigma or internal stigma or shame, according to the People Living with HIV (PLHIV) Stigma Index (December 2023)”, she added. The PLHIV Stigma Index is supported by the Global Fund to fight AIDS, TB and Malaria (The Global Fund) and US President’s Emergency Plan for AIDS Relief (PEPFAR) and the Global Partnership to Eliminate all Forms of HIV-Stigma and Discrimination. The PLHIV Stigma Index indicates that addressing internalised stigma is crucial for implementing community-led initiatives, improving treatment adherence, and accessing prevention services in focus countries.
Journey from Internal Stigma to Self-Love and Self-Worth
Through evidence-based interventions such as as the Wakakosha: I am Worth It peer-led intervention to support young people living with HIV improve wellbeing and improve self-worth, Wakakosha is layered within the existing Zvandiri CATS model and uses a cognitive-awareness approach called Inquiry-based stress reduction together with creativity such as music, poetry, writing and drawing. Currently being implemented in Zimbabwe and starting now in Rwanda, Ghana and elsewhere, results are promising.
Conclusion
Addressing internal stigma is essential for reducing HIV-related stigma and discrimination. By acknowledging the impact of internal stigma, we can work towards creating a world where people living with HIV can access the support and services they need to thrive.
FAQs
Q: What is internal stigma?
A: Internal stigma is a mindset of negative beliefs, thoughts, and behaviors about HIV, which manifests as shame, guilt, feelings of contamination, reduced self-efficacy, self-loathing, low self-esteem, and self-rejection.
Q: Why is addressing internal stigma important?
A: Addressing internal stigma is crucial for reducing HIV-related stigma and discrimination, and for improving treatment adherence, accessing prevention services, and implementing community-led initiatives.
Q: What evidence-based interventions are available to address internal stigma?
A: Interventions such as the Wakakosha: I am Worth It peer-led intervention, and Inquiry-based stress reduction, are being used to support young people living with HIV and promote self-love and self-worth.