Examining the actions of faith-based organizations and their influence on HIV/AIDS-related stigma: A case study of Uganda

Background: Stigma and discrimination are widely recognized as factors that fuel the HIV/AIDS epidemic. Uganda\'s success in combating HIV/AIDS has been attributed to a number of factors, including political, religious and societal engagement and openness – actors that combat stigma and assist prevention efforts. Objectives: Our study aimed to explore perceptions of Uganda-based key decision-makers about the past, present and optimal future roles of FBOs in HIV/AIDS work, including actions to promote or dissuade stigma and discrimination. Methods:We analyzed FBO contributions in relation to priorities established in the Global Strategy Framework on HIV/AIDS, a consensus-based strategy developed by United Nations Member States.Thirty expert key informants from 11 different sectors including faith-based organizations participated in a structured interview on their perceptions of the role that FBOs have played and could most usefully play in HIV/AIDS prevention, care and support. Results: Early on, FBOs were perceived by key informants to foster HIV/AIDS-related stigma and discrimination. Respondents attributed this to inadequate knowledge, moralistic perspectives, and fear relating to the sensitive issues surrounding sexuality and death. More recent FBO efforts are perceived to dissuade HIV/AIDS-related stigma and discrimination through increased openness about HIV status among both clergy and congregation members, and the leadership of persons living with HIV/AIDS. Conclusions: Uganda\'s program continues to face challenges, including perceptions among the general population that HIV/AIDS is a cause for secrecy. By virtue of their networks and influence, respondents believe that FBOs are well-positioned to contribute to breaking the silence about HIV/AIDS which undermines prevention, care and treatment efforts. Keywords: HIV/AIDS, Faith-Based Organizations, Religion, Stigma, Discrimination,Vulnerability, Uganda African Health Sciences Vol. 7(1) 2007: pp. 55-6

Examining the actions of faith-based organizations and their influence on HIV/AIDS-related stigma: A case study of Uganda

Background: Stigma and discrimination are widely recognized as factors that fuel the HIV/AIDS epidemic. Uganda\'s success in combating HIV/AIDS has been attributed to a number of factors, including political, religious and societal engagement and openness – actors that combat stigma and assist prevention efforts. Objectives: Our study aimed to explore perceptions of Uganda-based key decision-makers about the past, present and optimal future roles of FBOs in HIV/AIDS work, including actions to promote or dissuade stigma and discrimination. Methods:We analyzed FBO contributions in relation to priorities established in the Global Strategy Framework on HIV/AIDS, a consensus-based strategy developed by United Nations Member States.Thirty expert key informants from 11 different sectors including faith-based organizations participated in a structured interview on their perceptions of the role that FBOs have played and could most usefully play in HIV/AIDS prevention, care and support. Results: Early on, FBOs were perceived by key informants to foster HIV/AIDS-related stigma and discrimination. Respondents attributed this to inadequate knowledge, moralistic perspectives, and fear relating to the sensitive issues surrounding sexuality and death. More recent FBO efforts are perceived to dissuade HIV/AIDS-related stigma and discrimination through increased openness about HIV status among both clergy and congregation members, and the leadership of persons living with HIV/AIDS. Conclusions: Uganda\'s program continues to face challenges, including perceptions among the general population that HIV/AIDS is a cause for secrecy. By virtue of their networks and influence, respondents believe that FBOs are well-positioned to contribute to breaking the silence about HIV/AIDS which undermines prevention, care and treatment efforts. Keywords: HIV/AIDS, Faith-Based Organizations, Religion, Stigma, Discrimination,Vulnerability, Uganda African Health Sciences Vol. 7(1) 2007: pp. 55-6

Using a clinic based creativity initiative to reduce HIV related stigma at the Infectious Diseases Institute, Mulago National Referral Hospital, Uganda

BACKGROUND: Stigma has been associated with chronic health conditions such as HIV/AIDS, leprosy, tuberculosis, Mental illness and Epilepsy. Different forms of stigma have been identified: enacted stigma, perceived stigma, and self stigma. Stigma is increasingly regarded as a key driver of the HIV/AIDS epidemic and has a major impact on public health interventions. OBJECTIVES: The initiative was to provide activities in the clinic while patients waited to be seen by healthcare professionals. It was envisaged this would contribute to reduction of clinic based stigma felt by clients. METHODS: This was a repeated cross-sectional survey (October–November 2005 and March–April 2007) that was conducted at the Infectious Diseases Institute clinic (IDC) at Mulago, the national referral hospital in Uganda. We utilized quantitative (survey) and qualitative (key informants, focus group discussions) methods to collect the data. Data were collected on stigma before the creativity initiative intervention was implemented, and a second phase survey was conducted to assess effectiveness of the interventions. RESULTS: Clients who attended the IDC before the creativity intervention were about twice as likely to fear catching an infection as those who came after the intervention. The proportion that had fears to be seen by a friend or relative at the clinic decreased. Thus during the implementation of the Creativity intervention, HIV related stigma was reduced in this clinic setting. CONCLUSIONS: The creativity intervention helped to build self esteem and improved communication among those attending the clinic; there was observed ambiance at the clinic and clients became empowered, with creative, communication and networking skills. Improved knowledge and communication are key in addressing self stigma among HIV positive individuals

Using a clinic based creativity initiative to reduce HIV related stigma at the Infectious Diseases Institute, Mulago National Referral Hospital, Uganda

Background: Stigma has been associated with chronic health conditions such as HIV/AIDS, leprosy, tuberculosis, Mental illness and Epilepsy. Different forms of stigma have been identified: enacted stigma, perceived stigma, and self stigma. Stigma is increasingly regarded as a key driver of the HIV/AIDS epidemic and has a major impact on public health interventions. Objectives The initiative was to provide activities in the clinic while patients waited to be seen by healthcare professionals. It was envisaged this would contribute to reduction of clinic based stigma felt by clients. Methods: This was a repeated cross-sectional survey (October-November 2005 and March-April 2007) that was conducted at the Infectious Diseases Institute clinic (IDC) at Mulago, the national referral hospital in Uganda. We utilized quantitative (survey) and qualitative (key informants, focus group discussions) methods to collect the data. Data were collected on stigma before the creativity initiative intervention was implemented, and a second phase survey was conducted to assess effectiveness of the interventions. Results: Clients who attended the IDC before the creativity intervention were about twice as likely to fear catching an infection as those who came after the intervention. The proportion that had fears to be seen by a friend or relative at the clinic decreased. Thus during the implementation of the Creativity intervention, HIV related stigma was reduced in this clinic setting. Conclusions: The creativity intervention helped to build self esteem and improved communication among those attending the clinic; there was observed ambiance at the clinic and clients became empowered, with creative, communication and networking skills. Improved knowledge and communication are key in addressing self stigma among HIV positive individual

Creating social spaces to tackle AIDS-related stigma: reviewing the role of church groups in Sub-Saharan Africa

An expanding body of literature explores the role of African church groups in facilitating or hindering the support of people living with AIDS and challenging or contributing to HIV/AIDS-related stigma. Treating church groups as social spaces in which HIV/AIDS-related stigma may potentially be challenged, we systematically review this literature, identifying five themes that highlight the complex and contradictory role of the church as a potential agent of health-enhancing social change. In many ways the church perpetuates HIV/AIDS-related stigma through (i) moralistic attitudes and (ii) its reinforcement of conservative gender ideologies. However some churches have managed move towards action that makes a more positive contribution to HIV/AIDS management through (iii) promoting various forms of social control for HIV prevention, (iv) contributing to the care and support of the AIDS-affected and (v) providing social spaces for challenging stigmatising ideas and practices. We conclude that church groups, including church leadership, can play a key role in facilitating or hindering the creation of supportive social spaces to challenge stigma. Much work remains to be done in developing deeper understandings of the multi-layered factors that enable some churches, but not others, to respond effectively to HIV/AIDS