HIV/AIDS-related stigma and discrimination: A conceptual framework and an agenda for action

In 1987, Jonathan Mann, then director of the WHO Global Programme on AIDS, identified three phases of the HIV/AIDS epidemic: the epidemic of HIV, the epidemic of AIDS, and the epidemic of stigma, discrimination, and denial. Despite international efforts to tackle HIV/AIDS since then, stigma and discrimination (S&D) remain among the most poorly understood aspects of the epidemic. This poor understanding is due in part to the complexity and diversity of S&D, but also to limitations in current thinking within the field and the inadequacy of available theoretical and methodological tools. This paper proposes a new conceptual framework to help inform thinking about the processes of S&D, about the way these processes relate to HIV/AIDS, and about potential interventions to address S&D and minimize their impact. The paper analyzes the sources of S&D, the ways in which HIV/AIDS-related S&D manifests itself, and the contexts in which HIV/AIDS-related S&D take place; highlights the limitations of current thinking and argues that S&D need to be understood as social rather than individual processes; and identifies an agenda for research and intervention.