Stigma, HIV/AIDS and Prevention of Mother-to-Child Transmission

For some time now, HIV/AIDS-related stigma has been a major stumbling block in addressing HIV prevention, treatment, and care worldwide. In mid-2001, the Panos Institute Global AIDS Programme and UNICEF initiated a pilot project to explore the complexities of this stigma in greater depth. The long-term aims of this work were to promote greater understanding among policymakers and non-governmental organisations (NGOs) of the causes, expressions, and impact of such stigma and what action might be taken to reduce it. The specific aims of the pilot project were to:

• Assess and provide an initial analysis of the extent of perceived and enacted stigma among health providers, those receiving care, and decision makers.
• Consider stigma in general and, more specifically, that surrounding mother-to-child transmission (MTCT).
• Inform a wider information programme about such stigma and the steps that can be taken to alleviate it.

This pilot research initiative was conducted in four countries: India, Ukraine, Burkina Faso, and Zambia.

This report provides a country-by-country analysis of the findings of the research in general, and a comparative analysis of the specific forms, contexts, determinants, and implications of stigma in relation to MTCT.

The Table of Contents includes:

• Executive Summary
• Introduction
• Stigma, discrimination and denial - a brief literature overview
• Research methodology
• The research questions
• Research sites
• Zambia
• India
• Ukraine
• Burkina Faso
• Key Findings
• Zambia
• Forms
• HIV/AIDS as a traditional disease or witchcraft
• Contexts of stigma-health care settings
• The family
• Stigma or fatigue?
• The community
• The workplace
• In school
• Politics
• Causes and impact
• India
• Forms
• Contexts of stigma-health care settings
• The family
• The community
• The workplace
• Government and official responses
• Causes and impact
• Ukraine
• Forms
• Contexts of stigma-health care settings
• The family
• The community
• The workplace
• Causes and impact
• Burkina Faso
• Forms
• Contexts of stigma-health care settings
• The family
• The community
• Causes and impact
• Responses to stigma and recommendations
• Mother-to-child transmission of HIV
• Introduction
• Vertical transmission of HIV
• MTCT prevention initiatives
• Forms of stigma surrounding MTCT
• Contexts of stigma - health care settings
• The family
• HIV antibody testing: consent, partner notification and disclosure
• Reasons for testing
• The cost of care
• Preventing vertical transmission
• Infant feeding
• Implications and recommendations
• Appendix 1
• References