Stigma and Discrimination

Stigma is a type of negative label that people place on other people, which stems from viewing others as less valuable than the majority.  Discrimination is an enacted stigma, whereby this negative perception of others is put into practice.  People may behave unfairly, disrespectfully or cruelly towards others since they believe they do not deserve to be treatment any better.

 

In Europe, people with HIV, viral Hepatitis and TB often experience stigma and discrimination because of their condition, which can harm their mental and physical health.

In Europe there are a number of causes for stigma and discrimination directed at Africans patients living in Europe who have HIV, viral Hepatitis or TB.

 

  • A lack of knowledge and understanding of the transmission routes of HIV, viral Hepatitis and TB has resulted in an erroneous fear of contagion through casual contact, sharing utensils and bathroom facilities. 

 

  • Some associate these communicable diseases with already marginalised groups, such as African immigrants, injecting drug users, men who have sex with men, prisoners and sex workers.

 

  • The routes for transmitting HIV and viral Hepatitis, such as sex and injecting drug use are already viewed by some as morally questionable behaviours; therefore some people may believe that infection can identify people’s lifestyles, while those who have acquired these diseases deserve the punishment of living with the infection.

 

  • Some people may be of the opinion that Africans living in Europe who have a communicable or chronic condition are ‘health tourists’, utilising the host country’s resources at the expense of nationals and disapprove of them for this reason.

HIV, viral Hepatitis and TB-related stigma and discrimination towards African patients living in Europe presents itself in many different ways:

 

  • People living with the condition, and their family members, may be rejected by partners, relatives, friends and the community; as well as subjected to verbal and physical violence. 

 

  • Intolerance exhibited by non-specialist healthcare workers remains prevalent; ranging from uttering disrespectful comments, refusing treatment, heightened hygienic practices, enforcing isolation and breaching confidentiality. 

 

  • Children with HIV or viral Hepatitis may be forbidden from attending schools.

 

  • Employees who disclose their status to employers may be denied employment or promotion; while in certain European countries employers require applicants or current employees of particular jobs to undergo HIV testing and consequently deny employment based on sero-positive status.

The consequences of HIV, viral Hepatitis and TB-related stigma and discrimination can have a debilitating impact on the index patients and the wider public:

 

  • People living with HIV, viral Hepatitis or TB may begin to self-stigmatise and internalise all of the negative attitudes that others have towards them.  This can result in patients developing severe depression, suicidal thoughts and becoming isolated.  A reduction in self-esteem can lead to people refusing to access monitoring, non-adherence to treatment and poor nutrition, since they feel they do not deserve to improve their health or that loved ones would be better off without them.

 

  • People may avoid disclosing their status to sexual or drug injecting partners or be deterred from utilising safer practices for fear of activating suspicion; which can expose partners to infection; while putting the index patient at risk of developing super infection as well as other sexually transmitted and blood borne viruses. 

 

  • Anxiety over real and perceived stigma and discrimination can impede people from accessing HIV, viral Hepatitis and TB diagnostic services, monitoring and adhering to treatment in the event they are seen entering the healthcare facility or medication is discovered and their condition is exposed. 

 

  • Patients living with HIV or viral Hepatitis may avoid seeking support from non-specialist healthcare practitioners for other illnesses, or refuse to disclose their condition to non-specialist healthcare practitioners, which can seriously impact upon correct diagnoses and treatments.

Recommendations

1 . AWARENESS CAMPAIGNS THAT INFORM AND CHALLENGE

 

In order to lessen some of the triggers of HIV, viral Hepatitis and TB- related stigma and discrimination, EATAN petitions European governments to invest in campaigns that inform patients, healthcare workers and the general public about these communicable conditions, dispelling transmission myths and challenging the view that infection is a result of morally questionable behaviour.

 

2 . INCREASE OF PROVISIONS FOR PSYCHO-SOCIAL SUPPORT

 

EATAN urges greater investment in a range of psycho-social support offered to patients and their families; which can provide confidential and safe avenues for gaining information and advice, sharing experiences, lowering isolation, depression and suicide among people living with HIV, viral Hepatitis and TB.

 

3 . FORTIFYING ANTI-DISCRIMINATION LEGISLATION AND FACILITATING JUSTICE

 

EATAN petitions European governments to strengthen anti-discrimination laws to protect people living with HIV, viral Hepatitis or TB.People must also be enabled avenues to report incidents of discrimination without fear of reprisals or breaches of confidentiality and to receive justice if discriminated against because of their condition(s).

This initiative has been independently developed by EATAN, and was made possible through sponsorship from ViiV Healthcare and Gilead Sciences. EATAN acknowledges that ViiV Healthcare and Gilead Sciences has not had any control or input into the structure or content of the initiative.

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