This document discusses the role of HIV/AIDS stigma in access to care. It aims to examine how stigma impacts testing behavior, disclosure of status, and entry into care, particularly for women and minorities. The goals are to define key terms around stigma, discuss prevalence of HIV stigma in the US, and strategies to address stigma. HIV stigma stems from existing prejudices and negatively impacts individuals with HIV and those associated with them through discrimination and barriers to services. Racial minorities face disparities in access to HIV care due to the effects of stigma.

1. HIV/AIDS Stigma & Access to Care Carlos Velez, JD Director Technical Assistance, Training and Treatment Technical Assistance, Training and Treatment Division NATIONAL MINORITY AIDS COUNCIL

6. MODULE I KEY TERMS

22. MODULE II THE ORIGIN OF HIV/AIDS RELATED STIGMA

35. The Vicious Circle of Stigma & Discrimination Source: Parker, R and Aggleton, P. (2002) HIV/AIDS-related stigma and discrimination: A conceptual framework and an agenda for action. HIV/AIDS is associated with marginalized behaviors, and PLWH/A are stigmatized because they are assumed to be from a marginalized group. HIV/AIDS PLWH/A Marginalized Groups Ex.: GLB/T, IDU, Commercial Sex Worker Are seen as Are Seen as responsible for

36. The Vicious Circle of Stigma & Discrimination Source: Parker, R and Aggleton, P. (2002) HIV/AIDS-related stigma and discrimination: A conceptual framework and an agenda for action. Marginalized groups are further marginalized because they are assumed to have HIV/AIDS. HIV/AIDS PLWH/A Marginalized Groups Ex.: GLB/T, IDU, Commercial Sex Worker Are seen as Are Seen as responsible for

43. Negative Feelings Toward PLWH/A Source: Herek, G., Capitanio, J., & Widaman, K. 2002. HIV-related stigma and knowledge in the United States. American Journal of Public Health, 2002, 92(3), 1-14.

46. The Expression of HIV/AIDS Stigma Source: Herek, G., Capitanio, J., & Widaman, K. 2002. HIV-related stigma and knowledge in the United States. American Journal of Public Health, 2002, 92(3), 1-14. Q: “People who got AIDS through sex or drugs use have gotten what they deserve.”

47. The Expression of HIV/AIDS Stigma Q: “Most people with AIDS are responsible for having their illness.” Source: Herek, G., Capitanio, J., & Widaman, K. 2002. HIV-related stigma and knowledge in the United States. American Journal of Public Health, 2002, 92(3), 1-14.

48. Public's views on personal responsibility for contracting HIV Q:“In general, it’s people’s own fault if they get AIDS.” Source: Kaiser Family Foundation Poll Report

52. Public's views on discrimination against PLWH/A Q: “Do you think there has been a lot of discrimination against people with AIDS, or do you think their treatment has been generally appropriate?” Source: Kaiser Family Foundation Poll Report

56. MODULE III HIV/AIDS STIGMA AND IMPACT ON ACCESS TO SERVICES AND CARE

87. MODULE IV HIV/AIDS STIGMA AND MANIFESTATION IN SOCIETY

98. The MODE Model Person Sees Attitude Object (e.g., gay man, sex worker, drug user) Automatic Process -Object is evaluated-an unconscious process Homosexual/promiscuous Sex worker /immoral Drug user/criminal Cost/Benefit Process -person weighs the cost of a particular attitude-relevant behavior Attitude towards individual expressed

102. MODULE V THE PROCESS OF COUNTERING HIV/AIDS STIGMA

117. MODULE VI COUNTERING THE EFFECTS OF HIV/AIDS STIGMA WITHIN ORGANIZATIONS