From the moment scientists identified HIV and AIDS, social responses of fear, denial, stigma and discrimination have accompanied the epidemic. Discrimination has spread rapidly, fuelling anxiety and prejudice against the groups most affected, as well as those living with HIV or AIDS. It goes without saying that HIV and AIDS are as much about social phenomena as they are about biological and medical concerns. Across the world the global epidemic of HIV/AIDS has shown itself capable of triggering responses of compassion, solidarity and support, bringing out the best in people, their families and communities. But the disease is also associated with stigma, repression and discrimination, as individuals affected (or believed to be affected) by HIV have been rejected by their families, their loved ones and their communities. This rejection holds as true in the rich countries of the north as it does in the poorer countries of the south.

Stigma is a powerful tool of social control. Stigma can be used to marginalize, exclude and exercise power over individuals who show certain characteristics. While the societal rejection of certain social groups (e.g. 'homosexuals, injecting drug users, sex workers') may predate HIV/AIDS, the disease has, in many cases, reinforced this stigma. By blaming certain individuals or groups, society can excuse itself from the responsibility of caring for and looking after such populations. This is seen not only in the manner in which 'outsider' groups are often blamed for bringing HIV into a country, but also in how such groups are denied access to the services and treatment they need.

In many societies people living with HIV and AIDS are often seen as shameful. In some societies the infection is associated with minority groups or behaviours, for example, homosexuality, In some cases HIV/AIDS may be linked to 'perversion' and those infected will be punished. Also, in some societies HIV/AIDS is seen as the result of personal irresponsibility. Sometimes, HIV and AIDS are believed to bring shame upon the family or community. And whilst negative responses to HIV/AIDS unfortunately widely exist, they often feed upon and reinforce dominant ideas of good and bad with respect to sex and illness, and proper and improper behaviours.

Factors which contribute to HIV/AIDS-related stigma include:

• HIV/AIDS is a life-threatening disease

• People are scared of contracting HIV

• The disease is associated with behaviours (such as sex between men and injecting drug-use) that are already stigmatised in many societies

• People living with HIV/AIDS are often thought of as being responsible for becoming infected

• Religious or moral beliefs lead some people to believe that having HIV/AIDS is the result of moral fault (such as promiscuity or 'deviant sex') that deserves to be punished.
  The impact of HIV/AIDS on women is particularly acute. In many developing countries, women are often economically, culturally and socially disadvantaged and lack equal access to treatment, financial support and education. In a number of societies, women are mistakenly perceived as the main transmitters of sexually transmitted diseases (STDs). Together with traditional beliefs about sex, blood and the transmission of other diseases, these beliefs provide a basis for the further stigmatisation of women within the context of HIV and AIDS.
  

HIV-positive women are treated very differently from men in many developing countries. Men are likely to be 'excused' for their behaviour that resulted in their infection, whereas women are not. In the majority of developing countries, families are the primary caregivers to sick members. There is clear evidence of the importance of the role that the family plays in providing support and care for people living with HIV/AIDS. However, not all family response is positive. Infected members of the family can find themselves stigmatised and discriminated against within the home. There is also mounting evidence that women and non-heterosexual (that is, gay or bisexual) family members are more likely to be badly treated than children and men.

While HIV is not transmitted in the majority of workplace settings, the supposed risk of transmission has been used by numerous employers to terminate or refuse employment. There is also evidence that if people living with HIV/AIDS are open about their infection status at work, they may well experience stigmatisation and discrimination by others.

Many reports reveal the extent to which people are stigmatised and discriminated against by health care systems. Many studies reveal the reality of withheld treatment, non-attendance of hospital staff to patients, HIV testing without consent, lack of confidentiality and denial of hospital facilities and medicines. Also fuelling such responses are ignorance and lack of knowledge about HIV transmission.

HIV-related stigma and discrimination remains an enormous barrier to effectively fighting the HIV and AIDS epidemic. Fear of discrimination often prevents people from seeking treatment for AIDS or from admitting their HIV status publicly. People with (or suspected of having) HIV may be turned away from healthcare services, employment, refused entry to foreign country. In some cases, they may be evicted from home by their families and rejected by their friends and colleagues. The stigma attached to HIV/AIDS can extend into the next generation, placing an emotional burden on those left behind.

Denial goes hand in hand with discrimination, with many people continuing to deny that HIV exists in their communities. Today, HIV/AIDS threatens the welfare and well being of people throughout the world. At the end of the year 2007, 33.2 million people were living with HIV and during the year 2.1 million died from AIDS-related illness. Combating the stigma and discrimination against people who are affected by HIV/AIDS is as important as developing the medical cures in the process of preventing and controlling the global epidemic.

So how can progress be made in overcoming this stigma and discrimination? How can we change people's attitudes to AIDS? A certain amount can be achieved through the legal process. In some countries people who are living with HIV or AIDS lack knowledge of their rights in society. They need to be educated, so they are able to challenge the discrimination, stigma and denial that they meet in society. Institutional and other monitoring mechanisms can enforce the rights of people living with HIV or AIDS and provide powerful means of mitigating the worst effects of discrimination and stigma.

However, no policy or law can alone combat HIV/AIDS related discrimination. The fear and prejudice that lies at the core of the HIV/AIDS discrimination needs to be tackled at the community and national levels. A more enabling environment needs to be created to increase the visibility of people with HIV/AIDS as a 'normal' part of any society. In the future, the task is to confront the fear based messages and biased social attitudes, in order to reduce the discrimination and stigma of people who are living with HIV or AIDS.

How can you fight Stigma and Discrimination?
It’s simple. Treat HIV positive people the same way you would treat a person who is HIV negative. When they are ill, show them the same care you would show anyone with any life-threatening disease.

As an individual…

• Watch your language and avoid words that are stigmatizing.

• Find time to listen and give support to people living with HIV.

• Visit and help people who are sick.

• Encourage people living with HIV to get treatment, counseling, and medical care.

• Involve others by challenging stigmatizing words when you hear them, correcting myths and misperceptions about HIV/AIDS and encouraging people to talk about their fears and concerns about the disease.
  

In the workplace…

• Hire the most qualified people regardless of their HIV status.

• Never fire someone because they are HIV positive.

• Encourage positive attitudes toward employees who are living with HIV.

• Discourage gossip and negativity towards people suspected of being HIV positive.

• Hold workshops in the workplace to educate employees about HIV/AIDS.
  

At home...

• Show people living with HIV that you care about them.

• Listen to them when they need to talk.

• Support them to stay healthy by encouraging them to take their medication, eat healthy foods and maintain a positive lifestyle.
  

In faith-based organizations…

• Talk about HIV/AIDS and the effects of stigma and discrimination.

• Hold educational workshops about HIV.

• Organize community projects that involve or support people living with HIV.

• Get persons living with HIV to give testimonies.