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StigmaTEAMPRES

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Information about StigmaTEAMPRES
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Published on January 2, 2008

Author: Dennison

Source: authorstream.com

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Lundi Joko Anglican Church of Southern Africa HIV and AIDS Office :  Lundi Joko Anglican Church of Southern Africa HIV and AIDS Office Reducing Stigma What is Stigma?:  What is Stigma? Stigma has been defined as a blaming and ‘othering’ response, a way of thinking that helps people justify or deal with their fear of the disease. Stigma ‘brands’ or ‘marks’ people as being undesirably different. To stigmatise people is to see them as unacceptable and of less value because of a feature or a quality they have, and to blame them for it. Spotting stigma:  Spotting stigma What do you think that the people in the pictures might be feeling? – Why? Slide (S4.3) 1 What do you see in the pictures? What signs of possible stigma do you see? What forms of Stigma do we see? Slide4:  “Understanding and challenging Stigma” – Toolkit for Action – Change Project - 2004 Slide5:  “Understanding and challenging Stigma” – Toolkit for Action – Change Project - 2004 Slide6:  “Understanding and challenging Stigma” – Toolkit for Action – Change Project - 2004 Slide7:  “Understanding and challenging Stigma” – Toolkit for Action – Change Project - 2004 Slide8:  “Understanding and challenging Stigma” – Toolkit for Action – Change Project - 2004 Slide9:  “Understanding and challenging Stigma” – Toolkit for Action – Change Project - 2004 Slide10:  “Understanding and challenging Stigma” – Toolkit for Action – Change Project - 2004 Slide11:  “Understanding and challenging Stigma” – Toolkit for Action – Change Project - 2004 Slide12:  “Understanding and challenging Stigma” – Toolkit for Action – Change Project - 2004 Forms of stigma:  Forms of stigma Slide (S4.3) 2 Isolation, insults, judging, blaming Self-stigma – Believe & internalize negative attitudes, reactions & actions from others Fail to accept themselves Blame / ‘over-blame’ themselves Stigma by association – whole family affected by stigma Stigma by looks / appearance / type of occupation Societal Stigma- People wrongly / inaccurately blame others for their conditions / misfortunes Impact of HIV & AIDS related stigma:  Impact of HIV & AIDS related stigma Slide (S4.3) 5 Drives HIV & AIDS epidemic underground People die from preventable, postponeable & manageable conditions People continue to be unnecessarily infected, sick, bereaved, widowed & orphaned Duration & quality of life reduced Effects of stigma:  Effects of stigma Slide (S4.3) 6 Persons living with HIV & AIDS feeling isolated, rejected, condemned, forgotten, useless Kicked out of family, house, work, rented accommodation, organisation, etc Drop-out from school (resulting from peer pressure – insults, teasing, ridicule etc ) Depression, suicide, alcoholism Yourself and stigma:  Yourself and stigma What happened? How did it feel? What impact did it have on you? Situations where you felt isolated or rejected for being regarded as different from others (or when you saw other people treated this way…) Slide (S4.3) 7 How did it FEEL to be stigmatised? :  How did it FEEL to be stigmatised? Get into pairs if you feel comfortable to share your stories with another person Slide18:  What happened? How did you feel? What was your attitude? How did you behave? Others and stigma Situations where you isolated or rejected other people because you saw them as being different Write down … :  Write down … … that you associate with stigma thoughts feelings words As people of faith and members of the church, think about … :  As people of faith and members of the church, think about … what we say what we hear other people of faith saying … that stigmatizes HIV and AIDS and stigmatizes people living with HIV & AIDS. Anglican Church of Southern Africa HIV and AIDS Office Research :  Anglican Church of Southern Africa HIV and AIDS Office Research The nature and extent of HIV and AIDS stigma in the church Worry about infection Despite a high level of factual knowledge, nearly 25 to 30% of respondents, including field workers, were unsure about the risk of transmission through kissing and through sharing dishes, including the communion cup. In some congregations, people living with HIV and AIDS are deliberately or unintentionally excluded from communion. Since the shared communion cup is a key symbol of union and inclusion, the church needs to address not only ignorance but also the worry that is fuelling concerns over shared communion. Expected stigma Most respondents expected others in their congregations to be more judgemental than they themselves were. This expected stigma and discrimination can be a problem, even where it doesn’t reflect actual discrimination. Worry about stigma or discrimination can be as damaging as being stigmatised directly, as it discourages testing, causes PLWHA and their families to withdraw socially and makes disclosure of HIV status difficult. Internalised stigma The study found that most Anglicans expressed much lower levels of blaming and shaming attitudes towards people living with HIV and AIDS than were found in a comparable cross-denominational study in Tanzania. In spite of this, people in the general sample reported equally high levels of self-shame (internalised stigma) when asked how they would feel if they or a family member became HIV-positive. This pattern of low blame and high shame was particularly marked among clergy, who also seemed to have greater difficulty in disclosing their HIV status. Slide22:  Mixed messages People are still making moral judgements around sexual behaviour and the link to HIV status. This could be partly because the church, in its prevention and anti-stigma campaigns, is giving mixed messages on the link between HIV infection and sin. ABC prevention messages represent sexual behaviour as a matter of individual choice and focus on certain kinds of high risk sexual behaviour that are also morally censured by the church (premarital sex and adultery). In fact, all unprotected sex places people at risk for HIV, and there are other risk factors and other modes of HIV transmission that are unrelated to sexual behaviour. The church needs to bridge the gap between social and individual explanations for HIV in order to stop giving mixed messages on prevention and against stigma. Marginalisation Stigma and discrimination were reported to be higher in some regions than in others, but no region can be assumed to be immune from the problem. Around 10–15% of respondents overall reported that they had observed or experienced discrimination in the last year. Families of PLWHA and people working on HIV and AIDS issues also seem to be marginalised and stigmatised in some parishes. About 4% of respondents reported that PLWHA were excluded from the church because of their status. However, the great majority of respondents said their congregation was ‘very’ or ‘quite’ welcoming and caring towards people living with HIV and AIDS. Theological confusion that HIV contracted through Reported blaming attitudes were not always consistent: people seldom agreed that HIV and AIDS was a punishment from God, but agreed more often sex or drugs was deserved. Theological work is needed with clergy as well as congregants, discussing questions of personal and social responsibility and blame in relation to supernatural forces and perhaps comparing a number of different illnesses (leprosy, cancer, TB, HIV and AIDS) to give people a sense of perspective. Slide23:  Disclosure Respondents were less likely to disclose their HIV positive status to someone in the church than to family, sexual partners, friends or support group members. The church can be the hardest place to disclose one’s status. Although most respondents reported positive experiences, there were no guarantees of positive outcomes. A substantial and worrying proportion of PLWHA respondents felt ‘often’ or ‘sometimes’ less respected (22 %) and gossiped about (25 %) after their HIV status became known, and 19% reported losing friends. Disclosure seems particularly difficult for clergy. Because normal employment legislation does not apply to them, clergy are vulnerable to discrimination unless they are protected by specific workplace policies on HIV and AIDS. Also, there are few HIV-positive bishops or priests who have disclosed their status and can act as role models. The church does not need to force disclosure on PLWHA, but it should try to create safe spaces in which confidences will be respected, support will be given and people are protected as much as possible against negative consequences. Supportive structures can be put in place for everyone in congregations, without necessitating disclosure. Spirituality HIV-positive church members can derive considerable support from their relationship with God, even where they have not disclosed their status in the church or to their priest. About half of PLWHA reported feeling closer to God after their diagnosis with HIV, though many also struggled to pray at this time. Preachers, prayer groups and Bible study groups should pay specific attention to discussing ways to enhance all congregants’ spiritual relationships with God in a time of HIV and AIDS, emphasising theological aspects of lament, resistance and hope. As people of faith… how is God calling us to respond to stigma? an “EFFECTIVE ANGLICAN MISSION”:  As people of faith… how is God calling us to respond to stigma? an “EFFECTIVE ANGLICAN MISSION” HOW CAN WE FIGHT STIGMA?:  HOW CAN WE FIGHT STIGMA? Qualitative research needs to be done for assessment, developing a deeper sense of the worries, concerns and experiences around HIV and AIDS in the church. The qualitative research can be coupled with a workshop-style programme that creates safe spaces to address stigma and discrimination not only in relation to HIV and AIDS but more generally, by addressing ignorance, worry, blaming and shaming, and exclusion.. HOW ELSE CAN WE FIGHT STIGMA?:  HOW ELSE CAN WE FIGHT STIGMA? Leadership from congregations should be targeted for training on HIV and AIDS, counselling and facilitation, and theology. Debate and Initiate new kinds of non-stigmatising and inclusive approaches to understanding sexuality, illness and moral discourse within the church (such as lament, the ethics of hospitality, and reviving a discussion of social justice). The church has promoted a good, non-stigmatising message at the highest level, but this needs to be fleshed out with further theological debate on the relationship between HIV infection, sexual practice and sin. [Media campaigns, Development of new Liturgies etc] Question to ponder What does an Effective Anglican Mission mean in the context of HIV and AIDS Stigma?:  Question to ponder What does an Effective Anglican Mission mean in the context of HIV and AIDS Stigma? : Slide28:  "In HIV/AIDS, it is not the condition itself that hurts most (because many other diseases and conditions lead to serious suffering and death), but the stigma and the possibility of rejection and discrimination, misunderstanding and loss of trust that HIV-positive people have to deal with”. Canon Gideon Byamugisha Slide29:  “How important it is that those of us who are HIV-positive continue to live rather than waiting to die." Canon Gideon Byamugisha Anglican Church of Southern Africa HIV and AIDS Office www.anglicanaids.org:  Anglican Church of Southern Africa HIV and AIDS Office www.anglicanaids.org

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