HIV This Week

Mahajan AP, Sayles JN, Patel VA, Remien RH, Sawires SR, Ortiz DJ, Szekeres G, Coates TJ. Stigma in the HIV/AIDS epidemic: a review of the literature and recommendations for the way forward. AIDS. 2008 Aug;22 Suppl 2:S67-79.

Although stigma is considered a major barrier to effective responses to the AIDS epidemic, stigma reduction efforts are relegated to the bottom of AIDS programme priorities. The complexity of HIV-related stigma is often cited as a primary reason for the limited response to this pervasive phenomenon. In this paper, Mahajan et al systematically review the scientific literature on HIV-related stigma to document the current state of research, identify gaps in the available evidence and highlight promising strategies to address stigma. They focus on the following key challenges: defining, measuring and reducing HIV-related stigma as well as assessing the impact of stigma on the effectiveness of HIV prevention and treatment programmes. Based on the literature, the authors conclude by offering a set of recommendations that may represent important next steps in a multifaceted response to stigma in the AIDS epidemic.

Editors’ note: Stigma may be defined as a mark of disgrace, an attribute that is deeply discrediting, or a difference that taints and discounts a person. The conceptual framework presented here starts with the foundation of inequalities in social, political, and economic power that promulgate labelling, stereotyping, separation/status loss, and discrimination. Moving toward consensus on how best to define, measure, and diminish stigma is the first step. One component would be community organising among people living with HIV and their sympathetic supporters to ‘unleash the power of resistance on the part of the stigmatised’ but stigma will only be effectively reduced through an overarching multifaceted, multilevel approach.