WORLD AIDS DAY 2012

ZERO Discrimination
Presented by Rick Meriwether, Program Manager UAB Department of Medicine Division of Infectious Diseases meriwether@uab.edu 205-975-9380

WHY DISCUSS STIS/HIV?

Raise awareness Open DIALOGUE

More awareness equals less stigma, equals better prevention and care. from an article on HIV/AIDS in Africa by Enid Vazquez, Positively Aware, March/April 2006 issue

STIGMA AND SHAME

ENACTED STIGMA
I am going to Selma. Talk about a place thats underground. The clinic wont put its name on it. No signage, and its supposed to be the testing center. (HIV physician, April 2010)

DISCRIMINATION

Original meaning of discriminate was to note differences

In contemporary society, it means to perpetuate an unjust action against individuals who belong to a particular group, in particular stigmatized groups

THEORIES ABOUT WHY PEOPLE DISCRIMINATE

Need for social control of a problem

Need to exercise power over individuals who show unworthy characteristics

Need to set people apart

WHY HIV DISCRIMINATION?

Lack of knowledge/understanding about HIV

Disassociation ( us and them ) Someone must have done something wrong or been bad

WIDELY HEALTH BELIEFS ABOUT HIV

Nice (normal?) people do not get HIV If you are not promiscuous you will not get HIV, unless your partner betrays you Testing for HIV is warranted primarily for persons with risks for HIV When HIV is present, its obvious

Discussion of the need for HIV testing is offensive to patients

CONVENTIONAL WISDOM REGARDING STDS

STDs are the result of inappropriate behavior
People with STDs will know they have them Efforts to control STDs should focus on women Sex is not an appropriate topic for conversation

Part of a series of posters and other materials produced

by PAHO to raise awareness of the problem

STIGMA IS MULTI-FACETED
HIV/STI stigma is not just about having a bodily affliction. Stereotypes about race/ethnicity, gender, poverty, and social deviance shape public attitudes toward STIs and HIV. According to Erving Goffamn (1963) there are two types of stigmatizing attitudes:

FELT STIGMA = shame ENACTED STIGMA = discrimination

Source: presentation made by Browen Lichtenstein, PhD, 28th Annual Update in STDs/HIV, October 30, 2012

HOW DO WE REDUCE DISCRIMINATION?

Education:
I am disturbed, I am uneasy about men because we have no guarantee that when we train a mans mind, we will train his heart; no guarantee that when we increase a mans knowledge, we will increase his goodness. There is no necessary correlation between knowledge and goodness.
Benjamin May, past President, Morehouse College

HOW DO WE REDUCE DISCRIMINATION?

normalizing HIV testing all Americans age 15 65 should be offered screening as part of routine health care 2012 U. S. Preventive Services Task Force showing PLwHIV (People Living w/HIV) as active & contributing members of society: putting a face to the infection

HOW DO WE REDUCE DISCRIMINATION?

Issue of DISCLOSURE: encourage, and assist, PLwHIV to speak out when discrimination occurs/disclose their sero-status
Work with community leaders/gatekeepers Mobilize political representatives, religious leaders, health providers; the media

HOW DO WE REDUCE DISCRIMINATION?

Avoid stigmatizing words/phrases/language related to HIV or PLwHIV Discourage, and correct, misinformation when appropriate
Educate PLwHIV about their rights as patients (ADA) and about how to challenge discrimination

WE ARE ALL IN THE SAME BOAT:

There is no separation between us and them We are all facing and living w/HIVall are affected We have all taken risks and made mistakes at one time in our lives All of us are at risk of contracting HIV so there is no point in stigmatizing or blaming those who already are living w/infection

SPEAK UP. SPEAK OUT

Three conversations You need to Have:

Sexual Partner(s)/Get Personal Health Care Providers/Ask to be Tested. Friends/Start the Conversation

A FINAL QUOTE:

Change your thoughts and change your world

Norman Vincent Peale