20th International AIDS Conference - Melbourne, Australia

TUAD03 Stigma: Contexts, Intersections and Responses
  Oral Abstract Session : Track D
Venue: Plenary 2
Time: 22.07.2014, 16:30 - 18:00
Co-Chairs: Li Li, United States
Venkatesan Chakrapani, India

#Retweet this: HIV stigma in the twitterverse
M. Vega Dabbah1, A. Dabbah2, E. Klukas1
1Latino Commission on AIDS, Research and Evaluation, New York, United States, 2America Online (AOL), New York, United States

Poverty, intersecting stigmas, and health outcomes among HIV-positive African, Caribbean and Black women in Ontario, Canada
C. Logie1, W. Tharao2, M. Loutfy3
1University of Toronto, Factor-Inwentash Faculty of Social Work, Toronto, ON, Canada, 2Women's Health in Women's Hands Community Health Centre, Toronto, Canada, 3Women's College Research Institute, Toronto, Canada

Children's poverty and poor health override AIDS-related orphanhood in predicting stigma and bullying
M. Pantelic1, L. Langhaug2, F. Moonga3, K. Wespi4, P. Ammann4, A. Gschwend4,5
1Oxford University, Oxford, United Kingdom, 2REPSSI, Harare, Zimbabwe, 3Mulungushi University, Kabwe, Zambia, 4Swiss Academy for Development, Basel, Switzerland, 5University of Bern, Dept of Psychology, Bern, Switzerland

HIV-related stigmatized attitude among health care providers in Aceh, Indonesia: new findings from an Islamic and very low HIV case-load region
H. Harapan1,2,3, S.A. Khalilullah1, S. Anwar4, R.P. Putra1, M. Zia1, F. Novianty1, S. Nesya1, T.N. Putra1, I.S. Kumalasari1, R. Pratama1, E.B. Joris1, H. Kurniawan5,6, M.B. Hossain7, M. Yani5
1Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Indonesia, 2Tropical Disease Center, School of Medicine, Syiah Kuala University, Banda Aceh, Indonesia, 3Postgraduate Study, Infectious Diseases, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia, Crawley, Australia, 4Department of Applied Mathematics, National Dong Hwa University, Taiwan, Taiwan, Province of China, 5Department of Public Health, School of Medicine, Syiah Kuala University, Banda Aceh, Indonesia, 6Epidemiology Unit, Faculty of Medicine, Prince of Songkhla University, Songkhla, Thailand, 7Department of Population Sciences, University of Dhaka, Dhaka, Bangladesh

Discrimination among men who have sex with men in Nigeria: assessment of the immediate HIV-related impact of anti-gay laws
S. Schwartz1, I. Orazulike2, R. Nowak3, S. Kennedy3, S. Ketende1, K. Ugoh4, B. Keshinro5, J. Ake5, O. Njoku5, M. Charurat3, W. Blattner3, S. Baral1
1Johns Hopkins School of Public Health, Epidemiology, Baltimore, United States, 2International Centre for Advocacy on the Right to Health, Abuja, Nigeria, 3University of Maryland, Insitute of Human Virology, Baltimore, United States, 4Improving Men's Health Initiative, Abuja, Nigeria, 5US Military HIV Research Project, Silver Spring, United States

Moderated discussion

Powerpoints presentations
#Retweet this: HIV stigma in the twitterverse - Miriam Vega Dabbah

Children's poverty and poor health override AIDS-related orphanhood in predicting stigma and bullying - Marija Pantelic

Discrimination among men who have sex with men in Nigeria: assessment of the immediate HIV-related impact of anti-gay laws - Sheree Schwartz

Rapporteur report

Track D report by Shalini Bharat

This session focused on the theme of HIV stigma. Each of the five presentations covered a different population (general public, HIV positive women, orphan children, MSM, and health care providers) providing a mixed understanding of the topic of stigma.

Vega Dabbah et al. talked about growing popularity of the social media public discourse through it HIV related themes could be a useful way to gauge sentiments of the general public. This paper reported an analysis of 282,244 public stream Twitter referencing HIV/AIDS before, during and after International Aids Conferences-2012 over a period of 23 days. Tweets were analysed for polarity and classified by 7 stigma related emotions. Overall, messages related more to information dissemination, but the top three emotions expressed were: disgust, anger and amusement- sentiments found closely related to stigma in previous literature. From this one study authors conclude that IAC 2012 had an immediate and definite impact on public sphere expressions about HIV/AIDS. Given the potential for opinion generation such as public shaming for controversial sentiments and re-tweeting, HashTag Activism may find some use in shaping public sentiments about HIV.

Logie et al paper reported findings from a community based multi-method study of African, Caribbean and Black women living with HIV in Canada. Employing a critical feminist intersectional approach the study assessed social, structural and health correlates of perceived poverty among them. Building on a qualitative study, a cross sectional survey was carried out with 176 women of colour living with HIV. Nearly half of the women perceived themselves to be poor. Multiple regression analyses showed self perceived poverty was associated with higher experience of stigma, sexism, racism, poor health outcomes, and poor social support. Findings provide further support to the salience of an intersectional approach to explore convergence of multiple axes of exclusion among HIV positive women and the need for developing multi-level interventions to address poverty and intersecting stigmas.

 Panteli et al study assessed the association of AIDS related orphanhood, extreme poverty and poor health with perceived stigma and bullying among 484 AIDS orphans in rural Zambia using quantitative measures. Poverty and poor health, more than AIDS orphan status, were associated with perceived stigma as well as bullying among the children. Findings underscore the need for structural interventions such as, poverty alleviation and health promotion programs, to address stigma and bullying among orphans.

 Harapan et al presentation was about yet another quantitative study on stigma but carried out among those who are generally identified the stigmatisers namely, the health care providers. The study assessed stigmatizing attitudes among doctors, nurses, midwives and supporting staff towards PLHIV in Aceh, a low HIV case -load region of Indonesia and where Islamic Sharia law is practised. Being Muslim, high level of value driven stigma and overestimation of HIV transmission risk were main predictors of stigma requiring intervention to address stigma among health providers.

 Scwartz et al ‘late breaker’ paper reported discrimination experienced by MSM and the potentially negative impact on their health following a law criminalizing same sex relationships in Nigeria in January 2014. The law that prohibits same sex marriages also criminalises public show of such relationships. A prospective cohort of MSM was enrolled in Abuja using the respondent driven sampling method between March 2013 to June 2014. Stigma, access to health care and HIV related clinical outcomes were assessed at enrolment and once every quarter. In the post-law period MSM in the cohort reported significant increase in fear around seeking health care and in avoiding seeking health care due to their MSM status. Those who avoided open communication were more likely to avoid treatment and report low viral suppression. Authors conclude that discriminatory policies are likely to prevent MSM engagement with health care.  During discussion the law was defended citing it as an internal matter of the country and not for discussion in an international forum. MSM were said to constitute a small minority in Nigeria and hence not a major problem.

Session Recommendations

Overall, the papers highlighted the intersectionality of HIV stigma with poverty, racism, sexism, health inequities, and moral values and the importance of addressing stigma through multi-level interventions. The lack of stigma intervention based studies was a glaring gap in the session with concerns raised about the challenge of addressing interlocking stigmas. A late breaker paper in this session brought to sharp focus the crippling and damaging impact of legislation criminalizing same sex relationships on the health and quality of life of MSM. 


    The organizers reserve the right to amend the programme.