Stigma and discrimination aren’t just buzz words for Elena Felix.
When she first learned that she was living with HIV in 1994 an employer in Dubai told her she was “unfit to work”. In 2006 a hospital in her native Philippines refused to perform a surgery because of her HIV status. At another hospital a nurse shouted across the ward “she has AIDS”. Her children were bullied at school. And once, during an interview, a reporter demanded to know how many men she’d slept with.
The insights of Ms Felix—Co-convenor of Philippine’s Network Plus—and other community leaders, are central to a novel initiative aimed at ramping up evidence-based stigma and discrimination reduction strategies in Southeast Asia. From June 6 to 8, government, community and news media participants from Cambodia, Indonesia, Lao PDR, the Philippines, Thailand and Viet Nam joined the “Southeast Asia Regional Workshop on HIV-related stigma and discrimination” in Bangkok, Thailand. The approach was designed by UNAIDS Asia Pacific in partnership with the HIV and Health Group at the UNDP Bangkok Regional Hub and the Asia Pacific Network of People Living with HIV (APN +), with support from USAID under the PEPFAR program.
“This methodology engages government, media and community stakeholders to facilitate learning and cross-country sharing around approaches and strategies to lower HIV-related prejudice and rights violations in both healthcare and justice settings, as well as shaping public opinion. It’s a cross-fertilisation between technical level intervention models and winning hearts and minds,” explained UNAIDS Regional Human Rights and Law Adviser, Quinten Lataire.
Stigma and discrimination reduction learning and exchange
A key element of the approach is working in, and between, country teams. This presented an opportunity for the development of joint activity plans and networking along with knowledge transfer. Through poster presentations on HIV-related stigma and discrimination intervention models, representatives from each country shared progress on innovative strategies. These ranged from decreasing stigma and discrimination in community-based HIV facilities using quality improvement measures in the Philippines to mobilising key opinion leaders and using mass media to reduce HIV-related stigma and discrimination in Viet Nam.
There were also sideline dialogues. Team Thailand, for example, learned in more detail about Viet Nam’s Undetectable = Untransmittable (U=U) campaign and Cambodia’s Community-led Monitoring (CLM) roadmap.
Participants received capacity building around the HIV-related stigma and discrimination framework of change, monitoring and evaluation and sustainable financing of stigma and discrimination reduction intervention models. Cambodia, Indonesia, the Philippines and Viet Nam shared their experience in implementing national strategies to address stigma and discrimination in justice settings, such as deploying community paralegals, training law enforcement officers and sensitising judicial officers, including magistrates, judges and prosecutors.
“National level activities to address HIV are most effective with political buy-in, local ownership and multi-stakeholder groups that bring together government and civil society to ensure an enabling HIV legal and policy environment,” explained UNDP Policy Specialist, Kathryn Johnson. “Convening these stakeholders allows for diverse perspectives, including the lived experience of how laws and their implementation impact communities.”
Community perspectives were also critical for bringing the reporters up to speed. They learned about innovations in the modern HIV response and gained an understanding of how stigma and discrimination are undermining progress toward ending the AIDS epidemic. They then participated in interactive sessions around story framing, ethics and language-use.
On day 2 journalists divided into two groups for site visits. One group visited the Rainbow Sky Alliance of Thailand (RSAT), a community-led clinic providing prevention, testing, treatment and care services to gay men and other men who have sex with men, people who use drugs, sex workers and transgender people. The other group was hosted at the Ozone Foundation, a community organisation providing harm reduction, testing and treatment services for people who use drugs.
“Storytelling is critical,” reflected APN+ Program Manager, Harry Prabowo. “We need policymakers and the public at large to have access to the information, analysis and perspectives that shift public opinion and deepen understanding of the issues around stigma and discrimination. We look forward to expanding this area of work.”
Simultaneous interpretation was a critical workshop approach for ensuring inclusion and full collaboration. One output of the workshop is a terminology guideline with translations in Khmer, Indonesian, Laotian, Tagalog, Thai and Vietnamese developed by the country teams themselves.
Other participant commitments for follow-up are implementing joint strategies to strengthen news media coverage in-country. Every journalist has committed to producing at least one story in the immediate aftermath of the workshop. Further, UNAIDS will convene a network of journalists covering stigma and discrimination to facilitate continuous learning and expanded engagement of reporters, producers and editors across the region. A compendium of models for stigma and discrimination reduction will integrate inputs from all the countries and become a resource for future stigma and discrimination reduction work.