HIV Stigma Still Pervasive - NAPWA Qualitative Interviews
HIV Stigma Still Pervasive NAPWA Qualitative Interviews David Menadue Ronald Woods
Summary of findings <ul><li>Actual discrimination against HIV-positive people has declined ( HIV Futures : 10% experienced it in past two years cf 27% ever) </li></ul><ul><li>HIV still highly stigmatised in mainstream Australia– just not talked about except negative media eg criminalisation </li></ul><ul><li>Leads to major problems for positive heterosexuals, CALD, people with haemophilia, ATSI – including poorer health outcomes, mental health issues, isolation </li></ul><ul><li>Internalised stigma, lack of ability to disclose, feel safe in family and friendship networks </li></ul>
Positive Women <ul><li>Problems with health care workers: assumptions about drug use, sex work, promiscuity </li></ul><ul><li>Women often have first contact with with health professionals so, in couples, where both positive HIV is “seen as the woman’s fault” </li></ul><ul><li>Issues around having children,difficulties with GPs understanding latest information on maternal transmission. When to tell children if parent is HIV+? </li></ul>
A positive woman on disclosure to sex partners I think I’d prefer to be in front of 2000 A positive woman speaking about disclosure to sex partners I think I’d prefer to be in front of 2000 people speaking about HIV than I would having to tell a partner than I have HIV. It hasn’t got easier over the years as it’s not something generally discussed amongst the straight community Diane, Perth, WA
Positive ATSI <ul><li>Greatest fear is disclosure within your own community </li></ul><ul><li>Positive ATSI often prefer not to use Aboriginal Health Services because of family connections </li></ul><ul><li>ATSI often don’t get culturally appropriate service from mainstream practitioners </li></ul>
Cause of stigma: ATSI? Cause of Stigma: ATSI? ATSI experience an added stigma on top of racist views that many in Australia hold and the perception that “dirty black fellas” would get a disease like HIV because of high rates of promiscuity and STIs. The risk factors for HIV are much more complex and are better seen as coming from ATSI’s disempowerment from society Bev, PATSIN member, former ATSI health worker
CALD communities <ul><li>HIV not “culturally acceptable” or well understood in many CALD communities </li></ul><ul><li>Pos CALD very fearful of disclosure; won’t hire translators or child care workers from their own community </li></ul><ul><li>Excessive mental burdens on being HIV+ add to strain of being a migrant, qualifying for immigration; HIV exclusion criteria a looming threat. </li></ul>
People with haemophilia <ul><li>Fear of disclosure pervasive in community all these years on </li></ul><ul><li>Community don’t want to be associated as HIV-positive– burden on those who are </li></ul><ul><li>Families often don’t tell children they are HIV-positive until 16 yo </li></ul><ul><li>Difficulty living independent lives </li></ul>
Heterosexual Positive Men <ul><li>It’s the number one issue of concern for heterosexual positive men. Many have not had a relationship or sex in years. Many of the guys survive by not disclosing to sex partners and hoping things don’t get messy. </li></ul><ul><li>It’s partly a masculinity issue. These guys don’t want to put themselves in situations where they have to admit a weakness or face rejection </li></ul><ul><li>Wayne, HIV-positive man, Tasmania </li></ul>
Solutions? <ul><li>Most interviewees want to see a mainstream campaign to change attitudes towards HIV and people living with it. </li></ul><ul><li>Campaign should: </li></ul><ul><li>Identify stigmatising behaviour </li></ul><ul><li>Point out consequences for those affected </li></ul><ul><li>Include ordinary HIV-positive figures and community leaders </li></ul><ul><li>Include narratives of HIV-positive people who have successfully dealt with stigma or discrimination </li></ul><ul><li>Highlight lived realities of HIV in 2010 </li></ul><ul><li>Make clear the differences between HIV and AIDS </li></ul>
Solutions continued… <ul><li>A survey of training needs for HCW around HIV (including Aboriginal Medical Services) </li></ul><ul><li>Developing a workplace training module with anti-discrimination and equal opportunity boards around Australia </li></ul><ul><li>Conduct a “stigma audit” to better understand its impact on plhiv </li></ul><ul><li>Oppose HIV criminalisation, urge law reform – as clearly there is a link to stigma and discrimination </li></ul>
Solutions continued… <ul><li>Effort needed to overcome the internalised stigma experienced by HIV+ people: </li></ul><ul><li>Develop a program of activities to address HIV stigma in the workplace- incorporating the glbti “Pride in Diversity” model </li></ul><ul><li>Programs to develop resilience and reengagement, supportive social structures </li></ul><ul><li>Programs to help with disclosure skills </li></ul><ul><li>Use of HIV-positive role models in campaign </li></ul>
Thanks Thanks Interviewees and HIV sector agencies around Australia John Rule, Sean Slavin, NAPWA
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