HIV-related stigmatization and discrimination: Its forms and contexts

Abstract For more than two decades, HIV-related stigmatization, discrimination and denial have characterized the pandemic and presented a major challenge to the effectiveness of prevention, care and treatment programmes. Much of the societal and individual reaction towards people with HIV/AIDS may arise from stigma towards those most affected, where fear and blame are assigned and from which societal, political and behavioural responses are derived. Stigmatization and discrimination are reported to occur in a variety of forms–from societal level responses such as coercive government policies and laws, to apathy and denial of the HIV epidemic. At the individual level, the internalization of these societal responses may result in an individual's self-exclusion from information, treatment and care. Stigmatization and discrimination are explored through sociocultural understandings of illness and disease transmission and its manifestations at societal and invidividual level. Contexts of discrimination are briefly investigated and include employment, health care systems, travel and migration. Although there are widespread reports of HIV-related discrimination throughout the world there has also been significant progress towards reducing these practices. In addition to what is being done there is still much that we need to understand about the forms and contexts of stigmatization and discrimination if we are to succeed in our efforts to control the HIV epidemic.