UC Irvine GHREAT faculty, students, and colleagues collaborated on a manuscript entitled “Stigma in the time of Ebola and what we can learn from HIV”. The article was recently published in Global Health Action ahead of print: http://www.globalhealthaction.net/index.php/gha/article/view/26058
The researchers defined stigma based on the works of early theorists as an attribute or characteristic that is deeply discrediting, against the norm of a social unit, and devalued. HIV and Ebola related stigmas refer to the derogatory attitudes, beliefs, and behaviors directed toward people living with the diseases and those presumed to be infected. Stigmatizing attitudes and behaviors directed towards people living with HIV/AIDS include patient blaming, refusal/denial of care, suboptimal care, neglect, and ungrounded fear of contagion. Stigma associated with Ebola consists of harassment, violence, prohibiting re-entry to community, and destruction of personal property.
Both diseases have striking similarities but important differences in the context of stigma that must be considered when designing interventions. For instance, both HIV and Ebola have been categorized as divine retribution for past sins and propagandas for population control. Misconceptions about transmission have been fueled by irrational fears of contracting the pathogen and erroneous beliefs that only specific populations (poor, migrants, homosexuals, and sex workers) are at risk for infection. Unlike in Ebola-infected persons, individuals who are already stigmatized and criminalized such as injection drug users and gay men have a disproportionately higher risk for contracting HIV, leading to double stigma. Moreover, even though some patients survive Ebola despite of its high case-fatality rate, the stigma of having had the disease is not alleviated.
Many stigma reduction programs have proven effective in addressing HIV/AIDS related stigma and we recommend applying these strategies to Ebola. Programs that focus on empowerment and mobilization of prominent community leaders, promotion of contact with survivors, social activism and advocacy by grassroots organizations, and resilience-building may be impactful. However, in the long-run, education, prevention, and a therapeutic vaccine are the optimal solutions.
Manuscript authors include Ms. Mariam Davtyan, a stellar doctoral student in the UC Irvine Program of Public Health, Dr. Brandon Brown from the Global Health Research, Education and Translation (GHREAT) Initiative at the UC Irvine Program in Public Health, and Morenike Folayan from Obafemi Awolowo University, Ile-Ife, Nigeria.