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Key Elements for Successful
Stigma-Reduction Programming:
Lessons Learned in the Global Effort
to Reduce HIV
Laura Nyblade, Ph.DDirector Stigma, Discrimination and Gender
ICRWHoward University, December 1st, 2010
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Presentation Format
• Background
• Programmatic Principals
• Key Elements
• A few resources
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ICRW’s Mission
• To empower women, advance gender equality and fight poverty globally
• To accomplish this, ICRW works with partners to collect empirical evidence, build capacity and advocate for evidence-based, practical ways to change institutions,
policies and programs.
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ICRW’s Global HIV Stigma Program1999-Present
Building Insight to Catalyze Action
Cambodia, Ethiopia, India, Tanzania,
Viet Nam, Zambia,
South Asia Regional effort
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Implementation and Funding Partners
• Miz Hasab Research Center, Ethiopia
• Muhimbili University College of the Health Sciences, Tanzania
• Kimara Peer Educators and Training Trust, Tanzania
• ZAMBART Project & Kara Counseling and Training Trust, Zambia
• Institute for Social Development Studies, Vietnam
• Bhoruka Public Welfare Trust and Prepare, India
• Care, Mozambique
• PACT-Cambodia
• 26 WB grantees in Afghanistan, Bangladesh, India, Nepal, Pakistan & Sri Lanka
• Global Network of People Living with HIV
• International Planned Parenthood Foundation
• Johns Hopkins University
• Change Project, AED
• DFID
• FHI
• HORIZONS
• Levi Strauss Foundation
• MAC AIDS Fund
• PACT/Community REACH
• PACT-Vietnam
• Positive Action Program, GlaxoSmithKline
• SIDA
• Synergy Project, SSS
• The Bill & Melinda Gates Foundation
• UNAIDS
• USAID (Global, REDSO and Mission funding)
• World Bank South Asia Region
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Insight to Action on Stigma
• Formative multi-country research to disentangle and define HIV stigma
• Development of practical stigma-reduction tools
• Measurement & evaluation tools: Testing and
validation of stigma indicators
• Implementation & evaluation of stigma-reduction
interventions
• Advocacy through guidance and ‘How-To’ documents
• Technical Assistance for implementation and M&E
• Modeling
• Facilitating knowledge sharing
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Key Programmatic Principals
for Successful Stigma-Reduction Programs
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Individual
• Address attitudes and behaviors
Immediate Actionable Causes• Lack of awareness
• Fear of casual contact
• Values linking PLHIV with immoral behavior
Environmental
• Meet needs for information,
training, and supplies
Structural
• Polices, laws, and
systems
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• Foster understanding and motivation
for stigma reduction by creating:
– Recognition of stigma
– The benefits of reducing it
– Safe space to reflect and gain
skills for change
Create Understanding: Close the Intention-Action Gap
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Address HIV Transmission Fears & Misconceptions
• How it is and is not transmitted
• In-depth information
• Interactively: Allow for
• “Yes I know that, but why…?”
• Listen, learn & respond to specific fears
related to daily living context
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Discuss and Challenge the ‘Taboo’
• Provide safe spaces to discuss, reflect, understand and question:
– The values and beliefs that underlie stigma and discrimination
� Where they come from
� What they do
– Gender, inequity, sexuality, violence, drug use
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Start at ‘home’
• Space/support to reflect on, evaluate & change
• Organizational level
–programs, practices and policies
• Individual/Personal level
• Build skills
• Provide ongoing support for learning and change
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Key Elements for Successful
Stigma-Reduction Programs
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Gate Keepers
Understanding & Ownership
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Involving Multiple Change Agents
• Facilitate interaction, reduce ‘distance’
– advocacy campaigns
– Model & uphold desirable behavior
• Create alliances & form new
partnerships
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Range and Combination of Approaches
• Participatory
learning
• Community
meetings
• Cultural Mediums
• Written Materials
of Local
Relevance
• Media Channels
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• Address self-stigma
• Develop & Support
Networks
• Capacity strengthening
– Training: new knowledge and skills
• Access to prevention and
treatment services
• Income generation
Effective efforts are led by or continuously engage marginalized communities
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A Toolkit for Action
• Based on 4 country study
• Participatory development
• Successfully used with wide
range of audiences
– 40+ countries
– 7 languages
• Living document
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A New Global Network
• SAN web resources– Stay up to date on the latest developments
– Access an extensive e-library
– Share your experiences, ideas and materials
– Collaborate with other network members
• Join the network:– Sign up for the E-Forum by sending a blank e-
mail to:
• Web site coming soon! (January 2011)www.StigmaActionNetwork.org