Zero HIV Stigma Consensus Statement
(Released #ZeroHIVStigmaDay; July 21, 2023)
The UN Political Declaration on HIV/AIDS addresses stigma and discrimination as key components in the global response to the HIV pandemic. The Political Declaration is a critical document that outlines the commitments and strategies of UN member-states in tackling HIV and achieving specific targets related to prevention, treatment, care, and support.
The Declaration acknowledges that stigma and discrimination remain significant barriers to effective HIV prevention and treatment efforts. It recognizes that stigma can prevent individuals from accessing HIV testing, treatment, and support services, and can hinder their ability to lead healthy and productive lives. To address HIV stigma and discrimination, the Political Declaration includes various commitments:
- Promoting Human Rights. The Political Declaration emphasizes the importance of promoting and protecting human rights for all, including those living with or affected by HIV/AIDS. It calls for the elimination of all forms of discrimination, including those based on HIV status, and reaffirms the commitment to ensure equal access to healthcare and social services.
- Reducing Stigma and Discrimination. The Political Declaration commits to reducing stigma and discrimination by implementing comprehensive stigma reduction strategies. It calls on member states to address social and cultural norms that perpetuate stigma and to promote evidence-based interventions to combat HIV-related discrimination.
- Involving Communities. The Political Declaration highlights the crucial role of communities, including people living with HIV, in the response to the pandemic. It calls for the meaningful involvement of affected communities in policy development, program implementation, and monitoring and evaluation efforts. This involvement helps ensure that stigma reduction efforts are contextually relevant and responsive to the needs of those affected by HIV/AIDS without creating more harm or contributing to systemic violence.
- Advocating for Legal and Policy Reform. The Political Declaration urges member states to review and reform laws and policies that fuel stigma and discrimination against people living with HIV. It encourages countries to enact legislation that protects the rights of those affected by HIV/AIDS and prohibits discrimination based on HIV status.
- Strengthening Health Systems. The Political Declaration emphasizes the importance of strengthening health systems to provide non-discriminatory and equitable access to healthcare services for all, including HIV prevention, treatment, and support services, ultimately improving the quality of life for people living with HIV.
Overall, the Political Declaration recognizes stigma and discrimination as significant barriers to achieving the goals of ending the HIV epidemic by 2030. By addressing stigma and discrimination, the Declaration aims to create an empowering environment that promotes human rights, increases access to HIV services, and improves health outcomes for all individuals affected by HIV/AIDS.
In planning the launch of Zero HIV Stigma Day (July 21, 2023), the International Association of Providers of AIDS Care (IAPAC) formed and consulted an Expert Advisory Committee on Lived Experiences with HIV Stigma. The consultative process informed a set of nine commitments to end three forms of HIV stigma – self-stigma, interpersonal stigma, and institutional stigma – with an emphasis on treating people living with HIV as human first. The commitments are predicated on the recognition that HIV stigma perpetuates discrimination, hinders access to healthcare, and undermines efforts to prevent new HIV transmissions and provide comprehensive care to those living with HIV. The commitments also reflect an acknowledgement that HIV stigma intersects with race, gender identity, sexual orientation, and migrant status, leading to multiple layers of discrimination and marginalization.
Following are the commitments proposed by the Expert Advisory Committee on Lived Experiences with HIV Stigma to supplement Political Declaration commitments and guide HIV stigma elimination efforts:
- Promoting Inclusivity and Intersectionality. Because HIV stigma intersects with other forms of discrimination and social determinants of health, efforts to eliminate stigma should reflect an intersectional approach that acknowledges and addresses how race, gender identity, sexual orientation, and migrant status compound its impact and affects access to HIV and health services.
- Empowering Individuals: We should work to empower individuals living with HIV to challenge self-stigma and build resilience, including by increasing awareness of Undetectable equals Untransmittable (U=U) as a life-affirming message. Our efforts should promote self-acceptance and foster a sense of belonging and dignity for all individuals, irrespective of their HIV status.
- Education and Awareness: We should engage in education and awareness campaigns to debunk myths and misinformation about HIV. Young people particularly can benefit from learning about comprehensive sexuality education as it empowers them with knowledge, skills, attitudes, and values to realize their health, well-being, and dignity as well as to develop respectful social and sexual relationships. Our messaging should promote empathy, compassion, and an understanding of HIV as a health condition rather than a source of shame or judgement.
- Fostering Safe Spaces: We should commit to creating safe spaces that are free from discrimination, where individuals living with HIV can access healthcare services, psychosocial support, and legal assistance without fear of judgment or mistreatment.
- Community-Led Approaches: We should acknowledge the vital role of all affected communities in driving change and combating HIV stigma. Our efforts should support community-led initiatives and the meaningful involvement of people living with and affected by HIV in designing and implementing stigma reduction strategies.
- Advocacy for Policy Change: We should advocate for policies that protect the rights and dignity of individuals living with HIV, including measures to address intersectional discrimination, promote equal access to healthcare and social services with meaningful quality of life metrics, and a wide range of legal reforms, including the repeal of criminalization laws.
- Strengthening Institutional Support: We should commit to working with healthcare institutions, governments, and other entities to develop and implement policies that eliminate institutional stigma and promote equitable access to HIV prevention, treatment, and care.
- Empathy and Compassion: We should foster empathy and compassion within institutions and communities to build an environment of support and understanding for individuals living with and affected by HIV, with a further emphasis on intersectionality with race, gender identity, sexual orientation, and migrant status.
- Accountability and Evaluation: We should regularly assess the impact of our efforts in eliminating HIV stigma and promoting intersectional approaches. Transparent reporting and accountability will be crucial to ensure continuous improvement in our work.
In addition to advocating adoption of the nine commitments, the IAPAC Expert Advisory Committee on Lived Experiences with HIV Stigma calls on global, national, and local institutions to re-affirm their commitment to collective action, collaboration, and shared responsibility in ending HIV stigma. Moreover, the committee advocates the development of updated policy recommendations and implementation frameworks to guide governments, policymakers, and stakeholders in adopting and implementing anti-HIV stigma policies and programs. Finally, while emphasizing that the HIV epidemic cannot be ended without ending HIV stigma, the committee concludes with a reminder that our collective aim should be a world where all individuals are treated with dignity, respect, and equality, regardless of their HIV status, race, gender identity, sexual orientation, or migrant status.
