Tackling HIV-Related Stigma and Discrimination in South Asia

Anne Stangl

Description

Although overall HIV prevalence in South Asia is low, the widespread stigma attached to HIV and AIDS impedes efforts to reach people most in need of prevention, care, and treatment services. To address this challenge, the 2008 South Asia Region Development Marketplace partnership, led by the World Bank, launched a competitive grants program to support innovative community approaches. 'Tackling HIV-Related Stigma and Discrimination in South Asia' summarizes the monitoring, evaluation, and case study data and documents successful community innovations.
Twenty-six community groups in Afghanistan, Bangladesh, India, Nepal, Pakistan, and Sri Lanka received funds. The initiatives involved a broad spectrum, including vulnerable groups as well as people living with HIV, the media, local government authorities, health workers, and religious leaders. The interventions used traditional cultural and media approaches to discuss taboo subjects. The reach of the initiatives was amplifi ed by involving opinion leaders. The strategies engaged marginalized groups to design and lead the interventions and to facilitate contact between groups experiencing stigma and the general public to reduce fears and misconceptions about transmission. Projects that combined economic and stigma reduction interventions helped the marginalized populations to overcome the internalized stigma and become empowered to advocate for their rights.
'Tackling HIV-Related Stigma and Discrimination in South Asia' identifies effective strategies to raise awareness and reports on shifts-albeit slow-of attitudes, norms, and behaviors. Through its recommendations for successful interventions to reduce barriers to effective HIV prevention, care, and treatment programs, the book provides a strong foundation on which to build stigma reduction efforts in the region and world.

Sujets

• HIV
• Stigma
• Discrimination
• AIDS
• South Asia
• World Bank
• MSM
• Sex worker
• Health

Informations

• Publié par: world-bank-publications
• Publié le: 06 juillet 2010
• Nombre de lectures: 27
• EAN13: 9780821384510
• Langue: English

Extrait

DIRECTIONS IN DEVELOPMENT
Human De v elopmen t
T ack ling HIV-Relat ed
Stigma and Discrimination
in South AsiaTackling HIV-Related Stigma and
Discrimination in South AsiaTackling HIV-Related
Stigma and Discrimination
in South Asia
Anne Stangl, Dara Carr, Laura Brady, Traci Eckhaus,
Mariam Claeson, and Laura Nyblade© 2010 The International Bank for Reconstruction and Development / The World Bank
1818 H Street NW
Washington DC 20433
Telephone: [phone]
Internet: www.worldbank.org
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All rights reserved
1 2 3 4 13 12 11 10
This volume is a product of the staff of the International Bank for Reconstruction and Development /
The World Bank. The findings, interpretations, and conclusions expressed in this volume do not necessar-
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ance of such boundaries.
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ISBN: 978-0-8213-8449-7
eISBN: 978-0-8213-8451-0
DOI: 10.1596/978-0-8213-8449-7
Library of Congress Cataloging-in-Publication Data
Tackling HIV-related stigma and discrimination in South Asia / Anne Stangl ... [et al.].
p. ; cm.
Includes bibliographical references and index.
ISBN 978-0-8213-8449-7 — ISBN 978-0-8213-8451-0 (electronic)
1. AIDS (Disease)—South Asia. 2. Stigma (Social psychology)—South Asia. I. Stang, Anne.
II. World Bank.
[DNLM: 1. HIV Infections—psychology—Afghanistan. 2. HIV Infections—psychology—Asia,
Western. 3. Health Education—standards—Afghanistan. 4. Health Education—standards—Asia,
W 5. Health Knowledge, Attitudes, Practice—Afghanistan. 6. Health Knowledge, Attitudes,
Practice—Asia, Western. 7. Health Promotion—standards—Afghanistan. 8. Health Promotion—
standards—Asia, W 9. International Cooperation—Afghanistan. 10. International Cooperation—
Asia, Western. 11. Prejudice—Afghanistan. 12. Prejudice—Asia, Western. WC 503.7 T118 2010]
RA643.86.S67T33 2010
362.196'979200954—dc22
2010022090
Cover photo: Shehab Uddin/Drik/Majority World
The cover photo shows Rupali and Mithu, who work as community health workers for the Society for
Positive Atmosphere and Related Support to HIV/AIDS (SPARSHA) to reduce HIV-related stigma in
the villages of West Bengal. They live openly with HIV.
Cover design: Naylor Design, Washington, DCContents
Preface xi
Acknowledgments xvii
Contributors xix
Abbreviations xxi
Chapter 1 Introduction and Background 1
Note 3
Reference 4
PART I Key Findings and Lessons Learned from
26 Stigma Reduction Innovations in
South Asia 5
Chapter 2 Methods 7
Program Data 7
Case Study Methodology 8
Chapter 3 Program Findings 9
Findings across Programs 9
Lessons from Specific Program Approaches 11
Note 29
vvi Contents
Chapter 4 Capacity-Strengthening Efforts
and Lessons Learned 31
Types of Capacity-Strengthening Support and
Technical Assistance Provided to
Implementers 31
Recommendations for Strengthening
Programmatic and M&E Capacity 34
References 35
Chapter 5 Recommendations for Action 37
Promote Intensified Government Support
for a Scaled-Up Response to Stigma and
Discrimination 37
Promote Government Adoption of Stigma
Reduction Efforts in Health Care 38
Encourage Replication of Promising Approaches
through Organization-to-Organization
Knowledge Transfer 38
Promote Use of Multipronged Programming
Strategies for Increased Effectiveness 39
Leverage Cultural and Media Efforts of SARDM
Implementers to Maximize Reach and Results 39
Further Sharpen and Refine Tools for Religious
Leaders 40
Foster Stronger Private Sector Engagement for
Greater Economic Opportunity 41
Ensure That an Expanded Response to Stigma
and Discrimination Provides Economic
Opportunities for Marginalized Populations 41
Support Implementers in Strengthening Their
Capacity to Expand 42
PART II Six Case Studies Highlighting Best Practices
for Reducing Stigma and Discrimination 43
Chapter 6 Using Theater to Reduce Stigma and
Discrimination against Men Who Have Sex
with Men in Rural South India 45
Implementation 46
Results 47
Lessons Learned 51Contents vii
Chapter 7 Fighting Internalized Stigma among Injecting Drug
Users in Bangladesh: A Combination Program to
Support Economic and Social Reintegration 53
Implementation 54
Results 56
Lessons Learned 57
Chapter 8 The Gateway to Public Opinion: Harnessing
Local Journalists to Fight Stigma and
Discrimination in Bangladesh 61
Implementation 62
Results 63
Lessons Learned 64
Notes 66
Chapter 9 Taking It to the Village: Reducing Stigma
through Traditional Street Theater in Tamil Nadu 67
Implementation 68
Results 70
Lessons Learned 73
Chapter 10 Celebrating Those Who Care: A Radio Program
by HIV-Positive Journalists in Maharashtra 77
Implementation 79
Results 80
Lessons Learned 81
Recommendations 83
Chapter 11 Ensuring Dignity and Rights among Female
Sex Workers in Bangalore: A Community-Led
Advocacy Campaign to Reduce Stigma and
Discrimination 85
Implementation 86
Results 87
Lessons Learned 89
PART III Project Summaries of the 26 Stigma
Reduction Projects 91
Chapter 12 Afghanistan 93
Afghan Family Guidance Association 93viii Contents
Afghan Help and Training Program 97
Concern Worldwide 101
Chapter 13 Bangladesh 105
Drik Picture Library 105
Job Opportunity and Business
Support–Bangladesh 108
Nari Unnayan Shakti 112
Chapter 14 India 117
Ashodaya Samithi 117
Development Initiative 120
ISTV Network 123
Lotus Integrated AIDS Awareness Sangam 126
Nalandaway Foundation 129
Sai Paranjpye Films 131
Saral 134
Society for Positive Atmosphere and
Related Support to HIV/AIDS 137
Swathi Mahila Sangha 141
The Communication Hub 144
Voluntary Health Association of Tripura 148
We Care Social Service Society 151
Chapter 15 Nepal 155
Federation of Sexual and Gender
Minorities Nepal 155
Himalayan Association against STI-AIDS 159
National NGOs Network Group against
AIDS–Nepal 163
Chapter 16 Pakistan 167
Integrated Health Services 167
New Light AIDS Control Society 170
Pakistan Press Foundation 174
Chapter 17 Sri Lanka 179
Alliance Lanka 179
Lanka+ 182