The Effects of HIV Related Stigma

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This is, arguably, the most pervasive barrier that impedes access to fair and effective health services as well as food and treatment by deepening inequalities at all other levels involved in this study. Stigma refers to attitudes or beliefs about what is socially unacceptable expressed through discriminatory, or unjust, behaviors that produce feelings of shame and self-stigmatization (MANET+ 2012; AVERT; Pebody 2012). This causes social exclusion and it can undermine the success of community-based responses, reducing the life chances of stigmatized individuals. The extent of stigma is difficult to measure as it is experienced in different ways depending on people’s membership in certain social groups. This is because stigma often builds upon existing prejudices, such as racism, sexism and homophobia, which shape different levels of vulnerability (MANET+ 2012: 18; VSO 2005: 7). As we saw in earlier chapters, prisoners are disproportionately affected by the disease burden (see Appendix, table #) due to poor institutions that also encourage illicit behavior such as MSM, all of which reproduce stigma. For this reason, prisons have been generally neglected in government priorities and public action; in Zambia, it was not until 1990 when efforts began to address these problems, long after developments for other high risk groups such as sex workers and truck drivers (Simooya & Sanjobo 2001: 241). This section focuses on stigma toward PLWHIV and MSM to explore the intersecting
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