Year: 2022
Type: article
Abstract: viewpoint Addressing Stigma is Not Enough joseph j. amon, nina sun, alexandrina iovita, ralf jurgens, and joanne csete Over the past two decades, considerable work has been done to theorize, understand, and quantify the impact of stigma and discrimination on health.Yet despite clear differences, researchers, practitioners, and donors have often designed programs, set goals, and defined indicators that fail to differentiate between the two, or that define discrimination as a sub-type of stigma. 1 Within HIV programs, stigma is often characterized as a diffuse phenomenon that originates from multiple sources including the self and "culture".2 Stigma-reduction programs must therefore possess a deep understanding of layered stigma, individual psychologies, and community dynamics, and be attentive to the intersectional nature of stigma-reflecting the multiple stigmas faced by people living with HIV (PLWHIV) as a result of their HIV status and identification as belonging to a "key population"-alongside racial, ethnic, and gender identities, and social class and economic status markers.Discrimination is often defined by HIV programs, and scholars, as "structural stigma" or "enacted stigma".3 Yet, discrimination, unlike stigma, is a human rights abuse for which there are tangible state obligations and accountability measures.The UN Committee on Economic, Social, and Cultural Rights (CESCR) defines discrimination as "any distinction, exclusion, restriction or preference… that is directly or indirectly based on the prohibited grounds of discrimination and which has the intention or effect of nullifying or impairing the recognition, enjoyment or exercise" of human rights.4 The CESCR's authoritative statement on the right to health extensively references the importance of eliminating discrimination as a barrier to the realization of the right to health but has no mention of stigma.5 In her 1999 review of the literature on discrimination and health, Krieger identifies specific types of discrimination, arising from individuals and institutions, categorized as "legal, illegal, overt (or blatant), and covert (or subtle) discrimination, and also institutional (or organizational), structural (or systemic), and interpersonal (or individual) discrimination".6 Parker and Aggleton similarly draw on a sociological understanding of discrimination as a process of dominance and subordination, and criticize the framing of
Source: PubMed Central
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4313312680