Presentation by John B. Pryor at 17th Texas HIV/AIDS Conference on May 25, 2010

1. HIV-Related Stigma John B. Pryor, Ph.D. Illinois State University Presentation at the 17 th Texas HIV/STD Conferences May 25 2010

3. Goffman (1963) defined stigma as “an undesired differentness from what we had anticipated.” “ By definition, we believe the person with a stigma is not quite human.” “ We construct a stigma-theory, an ideology to explain his inferiority and account for the danger he represents, sometimes rationalizing an animosity based upon other differences, such as those of social class (p. 5).”

5. A Dynamic Model of the Four Manifestations of Stigma Stigma-by- Association Public Stigma Self- Stigma Institutional Stigma

6. Applying the Stigma Model to HIV

8. Tri-Part Conceptual Model of Public Stigma Cognitive Component Behavioral Component Affective Component

12. What is self- stigma?

17. HIV African Americans MSM IV Drug Users Stigmas related to HIV in the US

18. HIV African Americans MSM IV Drug Users Societal responses to related stigmas in the US Sexual Prejudice Racism Criminalization of drug addiction

21. Research focusing upon one link in the model of stigma Stigma-by- Association Public Stigma Self- Stigma Institutional Stigma

23. Types of Stigmatizing Behavior Experienced

25. Stigmatizing experiences that uniquely predict psychological distress among 601 Dutch PLWHA Psychological Distress Told to Conceal Exaggerated Kindness Avoidance Awkward Social Interaction From Family From Health Care Sector Source: Stutterheim, Pryor, Bos, Hoogendijk, Muris, & Schaalma (in press, 2009)         Controlling for partner, educational & health status

26. Relationship of Endorsing Public Stigma to Manifestation of Self-Stigma Stigma-by- Association Public Stigma Self- Stigma Institutional Stigma

27. Relationships between Endorsing Public Stigma and HIV Testing Source: Kalichman & Simbayi (2003)

29. Evaluation Research of an Intervention Design to Reduce Public Stigma Stigma-by- Association Public Stigma Self- Stigma Institutional Stigma

30. Salud Es Cultura ¡Protégete! (Health is Culture, Protect Yourself) To reduce HIV/AIDS-related stigma within Latino communities through a portable promotores (peer education) program designed to provide accurate and culturally appropriate HIV prevention and outreach information.

32. Organization The National Council of La Raza Anti-Stigma Focus Public stigma Target Audience Selected Latino communities in California and Texas (N = 574) Method Peer education ( promotores ) programs Evaluation Quantitative: Pre/post assessment of public stigma in peer education sessions ( charlas ) Results Improvements in knowledge, communication intentions, testing comfort, & comfort with PLWHA

33. Stigma-by- Association Public Stigma Self- Stigma Institutional Stigma Evaluation Research of an Intervention Design to Reduce Self-Stigma

34. THRIVE! Weekend A program developed by the AIDS SURVIVAL PROJECT To reduce HIV/AIDS-related stigma among PLWHA as a barrier to prevention, care, and treatment in two rural areas of Georgia using a volunteer-based training run by and for those affected by and/or living with HIV/AIDS.

36. Organization The AIDS Survival Project Anti-Stigma Focus Self-stigma Target Audience PLWHA in rural & urban Georgia Method Weekend workshops led by teams of PWLHA, experts, and healthcare & social service providers Evaluation Quantitative: Pre/post assessment of self-stigma Results PLWHA felt less blame & shame following weekend workshops

38. Components of Effective Interventions