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298765
Disease-related stigma, the social construction of target groups, and South Africa's programs for AIDS & TB
Tuesday, November 18, 2014
While there are many studies evaluating the impact of specific intervention strategies on target populations, there is a limited assessment of the political factors that shape how these intervention strategies become policies. Disease-related stigma may be one of these important political factors. Using over 500 government policy documents, speeches, and statements, as well as approximately 25 interviews with policymakers, non-governmental organization leaders, scholars, and researchers, I analyze the role of stigma in AIDS and tuberculosis (TB) policy in South Africa from 1994 until present. AIDS and TB are chosen specifically for this study because they have important similarities and differences that aid in the analysis of stigma. For example, they affect similar population groups but vary according to symbolic (harsh moral judgment) and instrumental (fear-based) stigma. South Africa was chosen because it is the country with the largest number of people living with HIV and the third largest number of people with TB. Results suggest that even though AIDS and TB affect largely the same population groups in South Africa (70% of TB patients are HIV positive), the government was more aggressive in addressing TB because of two primary factors: perceived differences in the responsibility for infection (TB patients are seen as more vulnerable and innocent than HIV/AIDS patients – evidence of symbolic stigma), and the burden of treatment on health systems (the curability of TB and cost-effectiveness of TB treatment compared to the incurability of AIDS and the expense of AIDS treatment).
Learning Areas:
Public health or related public policy
Social and behavioral sciences
Learning Objectives:
Describe how the different types of stigma associated with HIV/AIDS and TB shape perceptions of policy target groups
Explain how these different perceptions of policy target groups then contribute to different levels of government effort in policy scale-up
Keyword(s): Policy/Policy Development, HIV/AIDS
Presenting author's disclosure statement:Qualified on the content I am responsible for because: I have been the primary author and investigator on several studies of global health policies, including a study of the effectiveness of the Global Partnership to Stop TB and a cross-national quantitative assessment of the impact of stigma on the scale-up of treatment for AIDS and TB. My primary research interests include the role of stigma in health policy design and implementation and the politics of health policymaking at the global and domestic levels.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines,
and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed
in my presentation.