HIV stigma sucks – trust me, I would know. To put it simply, HIV stigma refers to negative stereotypes and discrimination towards people living with HIV.

Stigma has shaped not only how others see me, but how I see myself. It’s exhausting, frustrating, and unfortunately, still very common.

Stigma has also helped shape the way I view my work as a research coordinator with the REACH Nexus team. I work on projects focused on HIV stigma and have had the opportunity to learn more about stigma and its impacts on the wellbeing of people living with HIV.

86% of people living with HIV globally experience feelings of internalized stigma

This is a huge number! But here’s the good news: researchers around the world have been working on interventions to reduce stigma, and their findings offer some real hope.

What’s an Intervention?

Simply put, an intervention is a planned action or strategy designed to tackle a problem—in this case, HIV stigma. Researchers have studied different interventions to see what works best, often using a type of research called a systematic review.

A systematic review is a research method that summarizes studies on a given topic using a structured and transparent approach.

Sometimes, these reviews include a meta-analysis: a type of analysis that helps measure the effectiveness of different stigma-reduction strategies. I’ve spent a lot of time reviewing these studies, and I want to share some of the most effective strategies.

Where Are We Now?  

Most interventions to reduce HIV stigma focus on education and awareness through workshops, public campaigns, infographics, brochures, and videos. These approaches are great for providing accurate information about HIV and breaking down common misconceptions.

Many interventions also focus on reducing stigma at a personal level to help people living with HIV challenge internalized stigma. Others target relationships and communities, while some, although less common, focus on structural stigma – working to change laws and policies that unfairly discriminate against people with HIV.

What Actually Works ?

Research shows that interventions using more than one approach are more   effective. For example, combining strategies that include education with counselling or mental health support works better than education alone. Here are some key findings I discovered in my readings:

Reducing Internalized Stigma

Interventions that successfully reduce internalized stigma often include these four elements:

1. Community Involvement – Engaging people with the community in designing and delivering the intervention.
2. Education – Providing information and building skills to help participants navigate stigma.
3. Counselling – Offering counselling or psychological support to help people process their experiences.
4. Support Networks – Ensuring participants have access to social support throughout the intervention.

Addressing Stigma in Healthcare Settings

For reducing stigma in healthcare settings, either of these approaches can be effective:

1. Community Involvement + education
2. Education + total facility approach – ensuring all staff in a healthcare setting work together to shift the culture and practices around HIV.

Regardless of the setting, it is critical that interventions are tailored to the people they are intended to help. Cultural considerations, language, and specific community needs must be considered to make these strategies truly effective.

What’s Next ?

To make future stigma reduction interventions even more effective, researchers should consider the following:  

1. Continue to measure stigma using widely used and validated tools so comparison can be made across studies.  
2. Recognize that other forms of discrimination interact with HIV stigma and can influence how someone engages with your intervention.
3. Keep track of people who are unable to complete the intervention because that can identify barriers to participation.
4. Continue to share lessons learned even if success was not seen, as this information is useful for future projects.

The Bottom Line

There is no one-size-fits-all approach to ending HIV stigma. Eliminating HIV stigma can also not fall to the shoulders of people living with HIV alone. We all have a role to play. You can start by:

• Educating yourself on how stigma affects people living with HIV;
• Challenging misinformation;
• Speaking up when you see someone engaging in stigmatizing behaviour
• Amplifying the voices of people living with HIV

No matter how big or small the action, you can help make a difference – you can help us achieve the positive effect!

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For more information on how REACH Nexus is actively tacking HIV stigma in Canada, check out the Positive Actions initiative. Also, be sure to stay tuned to TPE and our socials as we continue to share key insights from the HIV Stigma Index study.