Stigma and discrimination related to HIV/AIDS discourage people from seeking prevention and treatment services. Stigma includes social isolation, shaming, blaming, and discrimination through unfair treatment in access to healthcare, employment, and social services. Stigma occurs through isolation, gossip, name-calling, and refusal of services in health facilities, communities, homes, and workplaces. Health workers should address stigma by treating all patients equally and involving people living with HIV in service delivery.

1. National Centre for AIDS
and STD Control
Stigma and Discrimination Related to MTCT
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2. National Centre for AIDS
and STD Control
Objectives
By the end of this session participants will be able
to:
• Explain the definition of Stigma and
Discrimination
• Identify HIV-related stigma and discrimination.
• Identify forms of stigma that discourage women
from enrolling for PMTCT or completing the full
treatment for themselves and their babies
• Discuss strategies to address stigma and
discrimination in the delivery of PMTCT services

3. National Centre for AIDS
and STD Control
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7. National Centre for AIDS
and STD Control
Stigma: Definition
• Stigma: unfavourable attitudes and beliefs
directed toward someone or something (s'g}
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• HIV-related stigma: unfavourable attitudes
and beliefs directed toward people living with
HIV, their family and friends, social groups, and
communities

8. Examples of stigma
• Family or village rejects wife and children of man who died
from AIDS
• PLHIV loses job because people learn of HIV-infected
• HIV infected and affected children are rejected to get
admission in school/ or forced to leave school

9. National Centre for AIDS
and STD Control
Discrimination: Definition
• Discrimination: the treatment of an individual
or group with prejudice (JolQm jf ;d"xnfO{
k'jf{u|xL b[li6sf]0fn] x]g'{)
• Discrimination includes the denial of basic
human rights such as health care,
employment, legal services and social welfare
benefits

10. National Centre for AIDS
and STD Control
Forms of Stigma
The main forms of Stigma includes:
• ISOLATION AND REJECTION – based on ignorance and
fear about HIV transmission or about the behaviors of a
marginalized group. The person stigmatized is forced to
sit alone and others avoid contact with them.
• SHAMING AND BLAMING – gossip, name calling,
insulting, judging, shaming. Stigmatized people are
“blamed and shamed” for assumed “bad behavior”, for
breaking social norms.

11. National Centre for AIDS
and STD Control
Forms of Stigma
• DISCRIMINATION (ENACTED STIGMA) – unfair treatment
such as refusing to provide health services to HIV positive
clients, treating them last, or testing clients without their
consent.
• SELF-STIGMA – PLHIV stigmatize themselves in reaction
to stigmatization from society. They accept the blame
and rejection of society, and withdraw from social
contact or exclude themselves from accessing health
services out of fear of having their status revealed.

12. National Centre for AIDS
and STD Control
Forms of Stigma
• STIGMA BY ASSOCIATION – The families of PLHIV are
stigmatized by others in the community. Some health
workers are stigmatized for working with HIV clients.
• LAYERED STIGMA – Marginalized groups (e.g., sex
workers, men who have sex with men, people who use
drugs, etc) are already stigmatized. When they get HIV
they are doubly stigmatized – getting another layer of
stigma.

13. National Centre for AIDS
and STD Control
Stigma in different settings
• In health facility
• In community
• At home
• At workplace

14. National Centre for AIDS
and STD Control
Examples of stigma
• HIV positive patients are kept waiting a long time.
• Unfriendly looks. Gossip. Name calling. Blame
HIV+ patients for “immoral behavior”
• Blaming and shaming - “You deserve to get this,
because of your immoral behavior.”
• Some health workers refuse to treat the clients,
or refer them to other staff.
• Use gloves and masks for routine tasks which
don’t involve the handling of bodily fluids
• HIV-infected clients receive poor care at a clinic

15. National Centre for AIDS
and STD Control
Key Points
• Health Care Workers are role models. PMTCT staff
should treat PLHIV equally without bias
• PLHIV can become involved in PMTCT services in any
number of ways, as volunteers or paid staff,
depending on their skill level and interests.
• PMTCT staff should encourage partner participation
in PMTCT interventions and community support of
PLHIV and their families.