The Role of Stigma & Marginalization

The role of Stigma and marginalization

Stigma and marginalization can have many negative effects on the health and well-being of women including those women living with, affected by or at risk of HIV.

What is Stigma?

In the context of HIV, stigma is defined by UNAIDS as ``a process of devaluation of people either living with or associated with HIV and AIDS ``.

Stigma can have many negative consequences for women such as discrimination, social isolation, increased stress and depression.  HIV stigma is perhaps the most important factor contributing to the prevention needs of women. Because of cultural gender roles and norms, women may experience stigma differently than men. For example, women living with HIV may be stigmatized or judged as promiscuous and therefore “deserving” of HIV.

Stigma has a negative impact on HIV prevention in a number of concrete ways (see Figure below).  It can prevent people from getting testing for HIV, prevent people from seeking care or support when needed, and contribute to the number of new HIV infections.

Stigma can prevent people from getting testing because individuals may not recognize or accept that they could be HIV positive (“that would never happen to me”, or “I won’t get it because I don’t do drugs”).  Attitudes such as these can contribute to new infections because people do not necessarily use protection or get tested if they do not realize they are at risk.

Connection between prevention, care and treatment, and stigma and discrimination

There are a number of situations where we can see stigma and discrimination in our day-to-day lives. Stigma can be evident in the language we use, the things we talk about, the assumptions we make, or the exclusion of certain groups.  For example (adapted from the HIVstigma.com campaign):

Language:  Terms like “clean” or “disease-free” being used to describe people who are HIV negative can make HIV positive individuals feel unworthy and ashamed.
Gossiping: talking about someone’s HIV status behind their back
Making assumptions: Believing that people who are HIV positive are reckless or deserving, and that they must have done something wrong to have HIV
Exclusion: People being excluded from social circles, public places, services or employment based on their HIV status is a form of discrimination.

Although illegal, exclusion and discrimination can still occur, especially when the affected individual lacks power or social capacity to seek justice. Furthermore, if the individual fears that addressing the issue may lead to the disclosure of her HIV status in the community, she may choose to keep silent about the discrimination.

 

What is marginalization?

Marginalization is when an individual or group is put into a position of less power or isolation within society because of discrimination. Marginalization can have a large impact on health and well-being, making individuals much more vulnerable to HIV infection. When an individual is marginalized, they are unable to access the same services and resources as other people and it becomes very difficult to have a voice in society.

Women are more likely to be marginalized than men, because of their gender. This is evident through the social, economic, and power imbalances that exist between men and women. For example, more women than men live in poverty, and men continue to have more secure, full-time jobs and higher income than their female counterparts.

A woman can also be marginalized because on her HIV status, or HIV risk. She may experience even more stigma if she is also a part of other marginalized groups in relation to her race or sexual orientation. For example, a woman is gay and an immigrant may also experience homophobia and racism.

 What can we do?

As long as there is a poor understanding of HIV and AIDS, the stigma and marginalization surrounding it will continue to exist. In order for HIV prevention to be successful, negative attitudes and discrimination towards those individuals living with, affected by or at risk of HIV should be challenged.  This can be tackled at a community level with you, as a service provider, playing a crucial role. An empowering environment where women feel comfortable and safe to talk about sex and their risk to HIV, where people are more willing to access testing or care or disclose their status is important for HIV prevention. We must work together to challenge the stigma surrounding not only HIV but also the sexual behaviour of women to make women living with HIV feel accepted, nurtured and respected.

 

Works Consulted

Leonard, L. (2007). Women and HIV prevention: A scoping review. Ottawa, ON: HIV Prevention Research Team.

Public Health Agency of Canada (2012). Population-specific HIV/AIDS status report: Women. Toronto, ON: Public Health Agency of Canada.


UNAIDS. (2003). Stigma and Discrimination Fact Sheet. Geneva: UNAIDS.

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