Tackling HIV-Related Stigma and Discrimination in South Asia
OBJECTIVE: Although HIV prevalence in South Asia is low, vulnerable groups such as sex workers (SW), injecting drug users (IDU) and men who have sex with men (MSM) are at high risk for HIV. Widespread stigma impede efforts to reach those most in need of HIV prevention, care and treatment services. To tackle stigma, the South Asia Regional Development Marketplace (SARDM) partnership, led by the World Bank, launched a competitive grants program in 2008 to support innovative community approaches for reducing HIV-related stigma and discrimination (S&D) in the region.
METHODS: Twenty-six community groups in Afghanistan, Bangladesh, India, Nepal, Pakistan and Sri Lanka received funds to pilot innovations over a 12-18 month period. The interventions engaged a broad spectrum of groups in combating stigma, including transgender communities, MSM, IDU, SWs, people living with HIV, the media, local government authorities, health workers and religious leaders.
CONTENT: This book summarizes monitoring, evaluation and case study data, revealing that a number of strategies were particularly effective in raising awareness about S&D and shifting, albeit slowly, attitudes, norms and behaviors. The effective strategies engaged marginalized groups to design and lead the interventions, and facilitated contact between groups experiencing stigma and the general public to reduce fears and misconceptions about HIV transmission. Interventions that used traditional cultural mediums (e.g. song, dance, theatre) were successful in broaching taboo subjects.
CONCLUSIONS: Involving opinion leaders, such as local and religious leaders, the police and the media amplified the reach and effect of stigma reduction efforts. Projects that combined economic and stigma reduction interventions helped marginalized populations overcome internalized stigma and become empowered to advocate for their rights. This book is critical reading for all working on HIV prevention, care and treatment, from policy makers in national AIDS programs, to donors and program implementers, both within the South Asia region and globally.