Shame-Less: Stigma Interventions That Work

Published: July 22, 2016

by Michael Clark

One of the hot new areas of the sociological aspects of HIV surround stigma and ways to reduce it as an individual or a community. I attended multiple sessions reviewing data from research projects around the world. From sex workers in Dominican Republic to the recently diagnosed in Lesotho, there is demand for evidence-based intervention strategies that work.

Maria Carrasco from Johns Hopkins presented her research through the lens of philosopher Michel Foucault. Essentially, Foucault’s idea is that every opportunity for liberation is also a possibility for oppression (and vice versa) and we police ideas, identities and norms precisely because of their appeal or stigma. Just as “The Gaze” of society may or may not be always looking serves to enforce social and societal norms. Marginalization resulting from stigma, Carrasco argues, is a strategy to discipline those who have engaged in behaviors that are deemed to violate the established norms and “threaten social order”. However, from this, resistance gives an opportunity for power. From this, she offers three strategies to combat stigma: provide a safe place to strengthen social cohesion and challenge stigma by developing new narratives; embed stigma reduction strategies into ongoing HIV prevention, treatment and care programs; and implement multi-level interventions that address multiple sources and forms of stigma.

In practice, Fulbright scholar Kimberly Hartson of UCSF offered one technique she developed in Lesotho. She found that micro-affirmations that are integrated into existing prevention strategies showed a marked decrease in perceived stress in persons newly diagnosed with HIV. A simple affirmation like “please write a few lines about something that is important to you in your life, such as family or friends or even something that makes you laugh.” Dr. Hartson’s suggestion is simple but the data shows that it is an effective way to combat stigma and the stress associated with it.

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