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Stigma Package

  • The USAID- and PEPFAR-funded Health Policy Project (HPP) has led a global effort to compile and refine a coordinated package of “best practice” tools for health facilities. HPP brought together a group of international experts to review, prioritize, adapt, and synthesize existing measures and programmatic tools for stigma reduction. The resulting intervention package supports an evidence-informed response in health facilities and offers the following advantages:

    • Synthesis of existing tools into a streamlined research-to-action approach
    • A “total facility” approach that involves all levels of health facility staff
    • A questionnaire, field-tested in six countries for broad applicability across diverse settings
    • A “best of” set of training exercises culled from field experiences in nine countries in Africa, the Caribbean, and South and Southeast Asia
    • Training menus for different types of facility staff and timeframes
    • Action planning and policy development to support a sustained, multilevel response.

    The tools in this package may be used or adapted to counter stigma and discrimination based on HIV status, gender identity, sexual orientation, and behaviors such as sex work or injecting drug use.

  • For people living with and affected by HIV, stigma and discrimination within health facilities are serious barriers to healthcare access and engagement. Researchers have documented numerous instances worldwide of people living with HIV receiving substandard care or being deterred from seeking care. Although progress has been made in training and other interventions to reduce HIV-related stigma in healthcare facilities, these programs have not been institutionalized as routine practice or implemented on a large scale. Moreover, the tools for measuring stigma tend to be lengthy and time-consuming to administer, thus infeasible for use in facilities.

    To address these issues, an international team of researchers developed and piloted a brief, globally standardized questionnaire for measuring stigma and discrimination in health facilities. This tool can help facilitate routine monitoring of HIV-related stigma as well as the expansion and improvement of programming and policies at the health-facility level.

    Based on the pilot's findings, two final questionnaires are now available: a brief version for program evaluation and a comprehensive version for research purposes. Each questionnaire can be used for high-prevalence or low-prevalence settings.