Stigma! Stigma! Stigma!

Human Immunodeficiency Virus (HIV), which is transmitted sexually, by sharing needles or from mother to child, continues to greatly impact people of color. But it is not just the modes of transmission that is a problem, stigma continues to contribute to the high prevalence of HIV among this group. According to Merriam Webster, stigma is a mark of shame or discredit, and Stigma can present itself on an individual, community or structural levels. But the only way to know if our clients are impacted by stigma is to conduct a thorough assessment of your clientele, which can be useful in identifying individual level solutions for you clients and provide training for staff.

Individual stigma is a factor that impacts how an individual’s perceptions about living with HIV and the way(s) in which they access services. Individually, clients exhibit fear and stress towards the services or services providers. They may even see themselves at fault for their illness or others and may elect to cancel appointments or do not show up for other services. However, health care providers must assess barriers to care, treatment, provide assistance and support the client in their process towards optimum care. 

Another factor that impacts an individual’s perception about living with HIV and the way(s) in which they access services is community stigma. Community stigma involves the fear of being treated differently because of their HIV status. This could be in the form of being kicked out of their homes, being exiled from their community or an interruption of their social network due to their HIV status. However, communities must learn how to be supportive and create educational awareness events and activities that will elevate the awareness of its members to reduce community stigma. 

The last factor that impacts an individual’s perception about living with HIV and the way(s) in which they access services is structural (institutional) stigma. Structural (institutional) stigma are things like mis-gendering clients, not using preferred names, or utilization of systems or processes that prevent access to services. Such as requiring a driver license for HIV testing or requiring passports or immigration documentation to access health care services. However, structural/institutions can increase their capacity through ongoing training, workshops, and presentations. As well as continually accessing their systems and processes to ensure that there are no structural barriers to care and treatment. 

These types of stigma can be heightened by race, gender, sexual orientation, or religion. Therefore, it is imperative that health care practitioners continually and actively provide an educational platform that will enhance or bring about new ideas to eliminate or reduce stigma around HIV, particular among communities of color.

Richardo Jackson is a Public Health Practitioner and Director of Prevention and Community Engagements at Monarch Health Services, Inc. Partnering with individuals and communities to address the social determinants of health and improving health equity.