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This article reviews 22 studies that test a variety of interventions to decrease AIDS stigma in developed and developing countries. This article assesses published studies that met stringent evaluation criteria in order to draw lessons for future development of interventions to combat stigma. The target group, setting, type of intervention, measures, and scale of these studies varied tremendously. The majority (14) of the studies aimed to increase tolerance of persons living with HIV/AIDS (PLHA) among the general population. The remaining studies tested interventions to increase willingness to treat PLHA among health care providers or improve coping strategies for dealing with AIDS stigma among PLHA or at-risk groups. Results suggest some stigma reduction interventions appear to work, at least on a small scale and in the short term, but many gaps remain especially in relation to scale and duration of impact and in terms of gendered impact of stigma reduction interventions.
Stigma and discrimination relating to HIV/AIDS (AIDS stigma) undermine public health efforts to combat the epidemic (Malcolm et al., 1998; UNAIDS, 2002; UNAIDS, 2000). AIDS stigma negatively affects preventive behaviors (e.g., condom use), HIV test-seeking behavior, care-seeking behavior on diagnosis, quality of care provided to HIV-positive patients, and perception and treatment of persons living with HIV/AIDS (PLHA) by communities, families, and partners (Gerbert, Macquire, Bleeker, Coates, & McPhee, 1991; Herek & Glunt, 1988; Herek, 1990; Macintyre, Brown & Sosler, 2001; Malcolm et al., 1998; Muyinda, Seeley, Pickering & Barton, 1997). One of the most surprising elements of AIDS stigma is its ubiquitous nature even where the epidemic is widespread and affecting so many people, such as in sub-Saharan Africa. Therefore, as many in the HIV/AIDS community note, decreasing AIDS stigma is a vital step in stemming the epidemic (Cameron, 2000; Goldin, 1994; Malcolm et al., 1998; UNAIDS, 2000b). Given this situation, it is critical that interventions that effectively reduce AIDS stigma be identified and implemented.
The objectives of this article are to describe interventions aimed at decreasing AIDS stigma, summarize common characteristics and audiences, and identify which aspects of these interventions have proven successful. The term AIDS stigma is used throughout this article to refer to all types of stigma related to HIV and AIDS. We have intentionally maintained a global perspective, though the...