HIV, stigma and discrimination in the Pacific

New study reveals extent of stigma and discrimination confronting people living with HIV in the Pacific

A new study has found that people living with the human immunodeficiency virus (HIV) in the Pacific islands are experiencing high levels of stigma and discrimination, resulting in social exclusion and hindering access to basic social services including health care.

The People Living with HIV Stigma Index Study, conducted by the Fiji Network of People Living with HIV (FJN+) with support from the United Nations Development Programme (UNDP), covers seven countries: Federated States of Micronesia, Kiribati, Palau, Republic of the Marshall Islands, Samoa, Tonga and Vanuatu.

The study provides valuable data on the real lived experiences of people living with HIV, and will inform programmes, interventions and policies to ensure more effective HIV responses in the region. The data will also be an important advocacy tool for networks of people living with HIV and civil society organizations working with groups that are most vulnerable to HIV.

“If countries are to achieve the 2030 Agenda for Sustainable Development, the principles of equality, inclusion and non-discrimination must be adhered to, and this must include people living with HIV – one of the most vulnerable groups in society,” said Programme Manager of the Multi-Country Western Pacific Programme at UNDP Pacific Office in Fiji, Anna Chernyshova.

“Only by conducting this type of in-depth research can we identify the sources of stigma, and then formulate ways to address and eliminate it,” said Stigma Index Project Coordinator at FJN+, Jokapeci Tuberi Cati.

“It’s clear that aggressive public awareness and prevention campaigns are needed in the region to counter outdated understandings on HIV and build greater acceptance of people living with HIV in communities. These findings will be very useful for the advocacy work of FJN+ and other people living with HIV networks in the Pacific.”

One of the key findings was the high levels of internal stigma that participants reported. Over 70 percent of respondents reported feeling ashamed, guilty, blamed themselves or had low self-esteem in the previous 12 months and 22 percent had felt suicidal. To address this, the study recommends providing wellness and psychosocial support to people living with HIV and their affected spouses, partners, families and children. Access to counselling is important not only in the early stages following diagnosis but throughout a person’s life.

“The study has illuminated a number of problems that must be dealt with as part of efforts to strengthen HIV responses in Pacific island countries,” said FJN+ Board Chair, Emosi Ratini.

“The reports of stigma and discrimination at health care settings are especially concerning, since this can have the effect of pushing people away from getting tested and seeking treatment, and contributing to poorer health outcomes.”

Treatment literacy and knowledge related to mother to child transmission was found to be very low. Providing improved information, education and communication materials is needed that specifically target women, men and transgender people living with HIV. The materials should include a focus on sexual and reproductive health and family planning, with information on coping mechanisms for parents with HIV.

"This study is the reality of the situation of People Living with HIV in these Pacific countries,” said Country Director at the UNAIDS Pacific Office, Renata Ram.

“The discrimination faced seriously undermines basic human rights, which should not be tolerated.”

She added, “Stigma and discrimination sets back progress in efforts towards the UNAIDS goal of "Getting to Zero" that is Zero new HIV infections, Zero Discrimination and Zero AIDS-related deaths. Let us use this opportunity to take the lessons learned from this study to re-orient our approach to the HIV response in the Pacific."

The study used a standard questionnaire and methodology developed by a global partnership consisting of the Global Network of People Living with HIV, the International Community of Women Living with HIV and the Joint United Nations Programme on HIV/AIDS (UNAIDS). Country level reports for each of the countries involved in the study are forthcoming.

The study was supported by the Multi-Country Western Pacific Integrated HIV/TB Project through the Global Fund to fight AIDS, Tuberculosis and Malaria.

A similar study was also undertaken for Fiji and the results of this will be released soon.

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Download the report: http://www.pacific.undp.org/content/pacific/en/home/library/DG/overview-report-of-people-living-with-hiv-stigma.html

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