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AIDS
and Stigma: Cultural Discontents and Social Manifestations
Ken Morrison
Senior HIV
Advisor
POLICY Project
Mexico
Stigma and discrimination have, since the end of the 90s, been
identified as major obstacles to effective responses to the AIDS
epidemics. But little substantive work has been undertaken in terms of
identifying causes, characteristics, and consequences or in terms or
providing a means of measuring HIV-related stigma. Based on the results of
two years of investigation of HIV-related stigma in Mexico and Ecuador,
this talk will discuss the construction of HIV-related stigma and
discrimination and some of the key results especially in terms of internal
stigma of persons living with HIV and persons from key populations to the
dynamics of epidemics in Latin America.
Methodology includes both qualitative and quantitative tools: focus
groups and in-depth interviews with key populations (persons living with
HIV, gay and other men who have sex with men MSM, sex workers SW),
behavioral surveys with MSM and SW, a health survey with health
professionals and a media scan. Results highlighted a cycle of
inter-related and mutually-reinforcing elements: stigma causes
discrimination which leads to the internalization of stigma which, in
turn, reinforces the original stigma.
Stigma, divided into pre-existing, HIV-specific and enacted stigma, can
provide important insights into both fear-based and moral-based stigma.
Enacted stigma shows clear patterns of identification, distancing and
exclusion. Internal stigma, the result of the acceptance and
internalization of stigma and discrimination, analyzed as both process and
product shows that disdain and social pressures can lead to a sense of
loss of control and auto-perceptions related to shame, guilt and
discomfort with self. Subterfuge, isolation and avoidance are key results
which are crucial constituents to increased vulnerability.
The work shows clearly that pre-existing stigma related to gender and
sexuality are predominant aspects of stigma in Latin America. Implications
for this work include outlining a means of analyzing stigma and
discrimination as well as providing clear avenues for stigma reduction. It
illustrates the cultural implications of a machistic society in terms of
feeding a concentrated epidemic and providing a base for the
generalization of the epidemic. |
