A systematic review of HIV/AIDS-related stigma and discrimination in India: Current understanding and future needs

Abstract

HIV/AIDS-related stigma is recognised as a major barrier to HIV prevention efforts and an impediment to mitigating its impact on individuals and communities. This paper reviews the existing research literature on AIDS stigma in India with the objective of documenting the current status of research, highlighting major findings and identifying key gaps remaining. Thirty publications were identified through a careful search of which a majority focused on stigma assessment and very few on stigma measurement, conceptual aspects of stigma or stigma reduction interventions. A few standardised stigma measures are available but more are required to assess causes of stigma among general population and compounded and internalised stigma among positive people. Research exploring linkages between stigma and HIV services uptake or the effect of HIV care and treatment programs on stigma levels are largely missing and need to be prioritised. In addition, more research is needed to advance conceptual understanding of stigma within the cultural context of the country including research on the neglected groups such as, transgender people. Context-specific (health care, community) interventions are needed to address various forms of stigma – enacted, perceived, internalised and layered – including structural approaches besides inter-personal and information-based approaches. A major gap relates to meager research on developing and evaluating stigma reduction interventions and needs priority focus. Overall, the review recommends developing a national agenda on AIDS stigma research and interventions to help realise the government's goal of stigma reduction.

HIV/AIDS-related stigmatization and discrimination and coping strategies among people living with HIV/AIDS (PLHIV) at the anti-retroviral (ARV) Clinic, University College Hospital Ibadan, Nigeria

“…Similarly, the study reported various forms of stigmatization and discrimination which were perpetrated against the respondents. This finding is in line with previous studies which showed stigma and discrimination perpetrated against PLHIV from colleagues, friends and the community (Ogbuji and Oke, 2010;Blackstock, 2005;Zierler et al, 2000;Bharat, 2011). Furthermore, the respondents also highlighted various forms of self-stigmatization they adopted primarily to conceal their HIV/AIDS status.…”

Knowledge and exercise of human rights, and barriers and facilitators to claiming rights: a cross-sectional study of female sex workers and high-risk men who have sex with men in Andhra Pradesh, India

“…Notably, knowledge of these rights was far from universal in both groups, but more so among FSWs; underscoring these findings, lack of awareness was also an identified obstacle to claiming rights in our study. An unexpected finding was that both FSWs and HR-MSM were least aware of the right to be free from stigma and discrimination (reported by one-fifth or less), although both groups face widespread discrimination and marginalization in multiple spheres [7–9, 19, 37]. Further, just 35% of FSWs and 55% of HR-MSM were aware of the right to dignity and equality.…”

HIV/AIDS-Related Stigma and Discrimination in Workplaces in Tanzania

“…Such exclusion has a significant impact on societies in which PLWHA live (Turhan, Inandi, & Inandi, 2006). Stigma and discrimination against PLWHA undermines the efficiency of national efforts to prevent and control the epidemic as noted in many papers (Bharat, 2011;Genberg, Kawichai, Chingono, Sendah, Chariyalertsak, Konda, & Celentano, 2008;Lau & Tsui, 2007;Maluwa, Aggleton, & Parker, 2002). Gari, Doig-Acuña, Smail, Malungo, MartinHilber, & Merten (2013) reviewed the literature on access to HIV/AIDS treatment in both low and high income countries, showing that stigma was among the barriers to HIV testing in both countries.…”