Academic journal article Asian Social Science

Impacts of Internal Stigma among the People Living with HIV/AIDS in Bangladesh: An Empirical Account

Academic journal article Asian Social Science

Impacts of Internal Stigma among the People Living with HIV/AIDS in Bangladesh: An Empirical Account

Article excerpt


All over the world HIV/AIDS related stigma and discrimination are of growing concern. At the same time self or internal stigma is one of the influential facts that make people living with HIV/AIDS (PLWHAs) to feel ashamed and guilty about their positive status. But the matter of stigma has been largely ignored by the existing policy of Bangladesh. This paper critically assesses how internal stigma contributes to keeping people from accessing HIV prevention, care and treatment services and adopting key preventive behaviors. This qualitative research is based on in-depth interview and case study method, located at Dhaka city, Ashar Alo Society (AAS), a service delivery center for HIV/AIDS patients. This study also revealed that internal stigma forced the PLWHAs to accept and believe that their disease is a moral punishment; they also perceived the disease as a result of their misdeeds. Many participants felt ashamed and tried to hide their status from everybody. Observation showed that HIV is regarded as an invisible contagious disease because PLWHAs hide their diseases even from their wives as a result the wives get infected with the disease in ignorance. These findings enabled us to understand the existing situation of PLWHAs and the impact of stigma and discriminatory behavior on their lifestyles in Bangladesh. The study suggested that the existing situation can be improved by formulating related strategies to reduce stigma and discrimination of PLWHAs.

Keywords: HIV/AIDS, Stigma, Internal Stigma, discrimination, Bangladesh

1. Introduction

Self or internal stigma is a daily reality and continuous strike in the mind of people living with HIV/AIDS (PLWHAs). Stigma is a disrespectful and discreditable issue for PLWHAs which makes them vulnerable and debased. Internal stigma is rooted in the helplessness of PLWHAs and their lack of control over the situation. Internal or self stigma fosters PLWHAs to change their socio-cultural practices due to their positive status. According to United Nations AIDS (UNAIDS), HIV-related stigma and discrimination stand in the way of HIV prevention efforts- they lead people to be afraid to seek out information about how to reduce their exposure to HIV, and to adopt safer behavior in case this raises suspicion about their HIV status (UNAIDS,2010). PLWHAs are reluctant to provide information about their positive statuses to their close relatives. They worry if they provide the information they will be stigmatized and discriminated and may be their situation will be more critical than the present.

Internal stigma makes PLWHAs feel culpable and embarrassed of their status. As the major responsible factor for HIV/AIDS transmission is unsafe sexual intercourse throughout the world, society believe that PLWHAs are only infected with the virus due to unethical sexual practices which are prohibited in Bangladesh. As Bangladesh owns collectivistic family nature, as a result not only the HIV positive individual is neglected but also their family members suffer the negligence of the society. Consequently, PLWHAs hide their status to avoid social criticism. One USA study found that internal stigma contributes significantly to levels of depression, anxiety and hopelessness in PLWHAs (Lee et al., 2002). According to surveys conducted using People Living with HIV Stigma Index, instances of stigma and discrimination exact profound psychological costs, resulting in feelings of guilt, shame and suicidal thoughts (UNAIDS, 2013). PLWHAs feel an urge to think the disease is the result of their wrong activities. It may lead to loss of hope which makes them physically exhausted and mentally debased.

This may lead to reduction of self confidence, loss of motivation, withdrawal from social contract, avoidance of work and health based interactions and abandonment of planning for the future (UNAIDS, 2011). HIV/AIDS is the debasement of personality and dehumanization of man. PLWHAs have feelings of misery rather than well-being. …

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