HIV related stigma

What is HIV-related stigma?

HIV-related stigma is still a major challenge for Scotland and we want to finally see an end stigma in Scotland. As the number of people diagnosed with HIV continues to grow each year in Scotland, we must work to ensure that no person living with or affected by HIV experiences any negative impact on their quality of life due to stigma.

HIV carries its own stigma and is the negative beliefs, feelings and attitudes towards people who are living with or are affected by HIV. Often, dated and inaccurate views of HIV as an untreatable disease, lack of knowledge and transmission being associated with taboo topics such as sex, gender identity and drug use have contributed to the stigma. It is a process where power inequalities are maintained through the devaluation and disempowerment of people living with, or perceived to be living with HIV, the groups most affected, and activities linked to transmission.

There is significant evidence that indicates that stigma undermines prevention efforts, leads to increased risk, non-disclosure and poorer adherence to treatment. This can in turn lead to increases in late diagnosis which can negatively impact on a person’s quality of life and life expectancy.

HIV is most prevalent among groups already stigmatised in Scotland, including gay, bisexual and other men who have sex with men (MSM), black and minority ethnic groups, people who inject drugs, sex workers and transgender people. People from these communities can experience stigma because of their association with HIV.

HIV stigma can be separated into three categories: discrimination, perceived stigma and self-stigma.

Discrimination is the enactment of stigma. It happens when a person is treated less favourably than another in a similar situation and when this treatment cannot be justified. An example of discrimination is being denied access to medical treatment based on HIV status, race, gender or sexuality.

Perceived stigma is a result of social attitudes and language used towards people living with or assumed to be living with HIV. Perceived stigma is an expectation of negative treatment amongst people living with and affected by HIV. This is commonly based on past experiences of stigma. Perceived stigma is often linked with key risk populations based on assumptions about sexual practices, drug use or immigration status.

Self-stigma occurs when an individual believes and internalises negative attitudes and stereotypes about themselves and their HIV status or perceived risk to HIV due to their work, drug use or gender identity. It affects the way individuals feel about themselves as well as how they perceive and manage other experiences of stigma or discrimination. Feelings of self-stigma include blame, internalised shame and a feeling that HIV is a punishment.

What's happening in Scotland?

The Scottish Government stated in the Sexual Health and Blood Borne Virus Framework 2015-2020 that they are committed to raising awareness around HIV as a public health issue, both in relation to important health messages (prevention, testing and diagnosis) but also as a means of tackling and reducing stigma.

In Scotland, there are a number of informative and accessible projects targeted at ending stigma. A few key projects are:

Despite some progress in challenging HIV-related stigma in Scotland, much more needs to be done.

What we're doing

For more information on how to get involved in this work, visit our Stigma Strategy page.