A comparative study of stigma and discrimination related to leprosy and HIV/AIDS

A literature review was conducted with the aim to review and compare the determinants, manifestations and consequences of stigma and discrimination in leprosy and in HIV/AIDS and to make recommendations for interventions. While many endemic countries may have reached the elimination target of less than one case per 10.000 people, the major concerns for a person affected by leprosy are disability and stigma. Fear and misconceptions still prevail and still leprosy-affected people are insulted, isolated and rejected. Stigma and discrimination (S&D) causes psychosocial problems resulting in great suffering for those affected by leprosy. HIV/AIDS is feared because of disease and death. S&D is fuelled by lack of knowledge and sexual norms. HIV/AIDS has reinforced stigmatization of already socially rejected groups like homosexuals, injecting drug users, and sex workers. People can be unfairly and unjustly treated because of their actual or presumed HIV status or because of their association with a certain group. The following findings are relevant in leprosy and HIV/AIDS (a) stigma is not a static attribute but a dynamic process (b) the ways to creating S&D, self-stigma and selfdiscrimination are similar; (c) the response of the individual to a negative stereotype will play an important part in determining the severity of self stigma; (d) deterioration of physical condition increases the severity of stigma in society; (e) improvement of condition can reverse S&D and the one affected can regain his/her social position in the community; (f) the consequences of stigma are surprisingly similar in leprosy and HIV/AIDS, in different cultures and public health programmes. Recommendations for interventions are included in this literature review.