Stigma and Discrimination

The HIV/AIDS (human immunodeficiency virus/acquired immune deficiency syndrome) epidemic in India is a rapidly escalating crisis. The government’s estimate that about 4 million persons in the country are HIV-positive is widely thought to understate the true figure. Throughout the country, persons in traditionally high-risk groups, including women in prostitution, injecting drug users, and men who have sex with men, have been shown to have alarmingly high rates of infection. In several states of India, such as Maharashtra and Tamil Nadu, the epidemic has spread to the general population. Programs that provide information, condoms and HIV testing to persons in high-risk groups are crucial to preventing the further spread of the disease.

This initiative aims to increase the impact of the response to stigma and discrimination by: facilitating and supporting information exchange, discussion and transparency among HIV and AIDS actors worldwide; documenting stigma issues at HIV and AIDS-related events; increasing coordinated participation of new and existing partners; facilitating long-distance learning; and encouraging exchange of ideas.

Bangladesh is at a critical moment in its emerging epidemic of acquired immune deficiency syndrome (AIDS). The prevalence of human immunodeficiency virus (HIV) in the population remains relatively low by official estimates, yet several factors suggest the risk of a devastating epidemic. Bangladesh is neighbor to major epidemics in India and Southeast Asia, and there is a good deal of migration across national borders. Bangladesh has a high rate of poverty, systemic gender inequality, and an inadequate health care system.

For over 27 years, our world has been living with HIV. And in just this short time, AIDS has become one of the make-or-break global crises of our age, undermining not just the health prospects of entire societies but also their ability to reduce poverty, promote development, and maintain national security. And in too many regions AIDS continues to expand – every single day 7 400 people are newly infected with HIV, and nearly 5 500 people die from AIDS- related illnesses.

From July 2001 to November 2002, the Asia Pacific Network of People Living with HIV/AIDS (APN+) conducted the first regional documentation of AIDS-related discrimination in Asia. The project is an action-based, peer-led study that aimed to develop an understanding of the nature, pattern and extent of AIDS-related discrimination in several Asian countries. The project was designed and implemented by people living with HIV (positive people) and received ethical approval and funding from UNAIDS.

Universal access signifies both a concrete commitment and a renewed resolve among people the world over to reverse the course of the epidemic. It is not a new initiative. It is a process that builds on past initiatives and infuses existing initiatives with new momentum.

The countries of Asia and the Pacific stand at a crossroads, facing two diverging routes to the future. One route is “business as usual”. Though the easiest and cheapest route to take at the beginning, it ends up in rising levels of HIV infection and a toll far higher than the estimated 500 000 AIDS-related deaths that occurred in the region during 2004. The other route is one of determined prevention and care initiatives. Harder and more expensive at the beginning, it ends up stopping the epidemic in its tracks, and minimizing both its human and economic costs.

Despite the pervasiveness of HIV-related stigma and discrimination in national HIV epidemics and their harmful impact in terms of public health and human rights, they remain seriously neglected issues in most national responses to HIV.

This publication is the Executive Summary of a qualitative research study undertaken by UNDP Regional HIV and Development Programme - in partnership with UNAIDS, the International Organization for Migration (IOM), the United Nations Development Fund for Women (UNIFEM), Coordination of Action Research for AIDS and Mobility in Asia (CARAM Asia), and the Caritas Lebanon Migrant Center (CLMC) - on the HIV vulnerabilities of Asian migrant women in Arab states. The study covered four countries of origin: Bangladesh, Pakistan, Philippines, and Sri Lanka; and three host countries: Bahrain, Lebanon, and the United Arab Emirates (UAE).

This report is based on a survey of the experience of more than 2000 respondents living with HIV in China. The survey will increase the understanding of how stigma and discrimination is experienced by people living with HIV (PLHIV) and it is hoped that the results will inform future discussions, programmes and policies in China.