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Stigma and Discrimination [message #1703] Tue, 01 April 2014 04:05 Go to next message
UNAIDSSIM is currently offline  UNAIDSSIM
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Registered: April 2014
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Proposed modification

Question 932

Current wording: Would you buy fresh vegetables from a shopkeeper or vendor if you knew that this person had the AIDS virus? (Yes/No/Don't Know)

Proposed modified wording: Would you buy fresh vegetables from a shopkeeper or vendor if you knew that this person had HIV? (Yes/No/It depends/Don't know or Not sure)

Rationale: The question will continue to monitor "accepting attitudes" towards people living with HIV and remains similar to the current question, enabling continued monitoring of trends. The additional disaggregation of negative responses will allow better capturing monitoring of discriminatory attitudes. Responses "no" and "it depends" to this question will contribute to the calculation of GARPR core indicator 8.1 (Percentage of women and men aged 15-49 who report discriminatory attitudes towards people living with HIV), approved by the MERG.

Priority of proposed additions:

Priority should be given to including the question "Do you think children living with HIV should be able to attend school with children who are HIV negative?", which is part of GARPR core indicator 8.1 already approved by the MERG.

Proposed additions (to Section 9 - HIV/AIDS)

Do you think children living with HIV should be able to attend school with children who are HIV negative?

Rationale and proposed data use: Responses to this question, jointly with responses to question 932 (modification proposed), will be used to calculate responses to GARPR indicator 8.1 (Percentage of women and men aged 15-49 who report discriminatory attitudes towards people living with HIV), approved by the MERG.

Prior validation: This indicator has been deemed relevant and promising by the UNAIDS MERG, it recommending that questions be included in the DHS questionnaire and data collected to be used for further analysis and finalization of the indicator. The question was tested in cognitive interviews and in a nationally representative pilot survey similar to a DHS in Rwanda between June and August 2011in a review process led by a Global Stigma and Discrimination Indicator Working Group.

Information needed: Disaggregated by sex (Male; Female) and age group (15-19 years; 20-24 years; 25 49 years)
Where to collect: All countries

Proposed additions (to Section 9 - HIV/AIDS)

In your opinion, are people hesitant to take an HIV test due to fear of people's reaction if the test result is positive for HIV? (Yes; No; Don't Know/Not Sure)

Do people talk badly about people living with or thought to be living with HIV? (Yes; No; It Depends; Don't Know/Not Sure)

Do people living with or thought to be living with HIV lose respect or standing? (Yes; No; It Depends; Don't Know/Not Sure)

Do you agree or disagree with the following statement: I would be ashamed if someone in my family had HIV (Agree; Disagree; Don't Know/No Opinion)

Rationale and proposed data use: Responses for each of these individual questions (based on the same denominator) will contribute to the calculations of a consolidated response for the composite indicator "Percentage of people who report negative individual- and population-level manifestations of HIV-related stigma", which will seek to measure progress towards reducing several common manifestations of HIV-related stigma: anticipated stigma, perceived community stigma, and shame.

Prior validation: This indicator has been deemed relevant and promising by the UNAIDS MERG, it recommending that questions be included in the DHS questionnaire and data collected to be used for further analysis and finalization of the indicator. The question was tested in cognitive interviews and in a nationally representative pilot survey similar to a DHS in Rwanda between June and August 2011in a review process led by a Global Stigma and Discrimination Indicator Working Group.

Information needed: Disaggregated by sex (Male; Female) and age group (15-19 years; 20-24 years; 25-49 years)

Where to collect: All countries

Proposed additions (to Section 9 - HIV/AIDS)

Do you fear that you could contract HIV if you come into contact with the saliva of a person living with HIV? (Yes; No; Don't know/Not sure; Not applicable)

Rationale and proposed data use: This question will respond to the proposed GARPR indicator "Percentage of people who report fear of HIV infection through non-invasive contact with a person living with HIV", to measure progress towards reducing fear of HIV transmission through casual contact with a person living with HIV, a key driver of HIV-related stigma.

Prior validation: This indicator has been deemed relevant and promising by the UNAIDS MERG, it recommending that questions be included in the DHS questionnaire and data collected to be used for further analysis and finalization of the indicator. The question was tested in cognitive interviews and in a nationally representative pilot survey similar to a DHS in Rwanda between June and August 2011in a review process led by a Global Stigma and Discrimination Indicator Working Group.

Information needed: Disaggregated by sex (Male; Female) and age group (15-19 years; 20-24 years; 25-49 years)

Where to collect: All countries

Proposed deletions (from Section 9 - HIV/AIDS)

Question 933 - If a member of your family got infected with the AIDS virus, would you want it to remain a secret or not?
Question 934 - If a member of your family became sick with AIDS, would you be willing to care for her or him in your own household?
Question 935 - In your opinion, if a female teacher has the AIDS virus but is not sick, should she be allowed to continue teaching in the school?

Rationale: These questions would be replaced by the new questions proposed.
Re: Stigma and Discrimination [message #1763 is a reply to message #1703] Wed, 02 April 2014 13:26 Go to previous messageGo to next message
UNAIDS_RAL is currently offline  UNAIDS_RAL
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As indicated by our colleagues from the Strategic Information Management Division of UNAIDS, the questions recommended for addition will be used to construct three indicators deemed relevant and promising by the UNAIDS MERG, including one that is part of the Core GARPR indicators.

The 6 new questions recommended, together with the modified question 932, would serve as important ways to measure progress towards Target 8 of the 2011 Political Declaration on HIV and AIDS (available at http://www.unaids.org/en/media/unaids/contentassets/document s/document/2011/06/20110610_un_a-res-65-277_en.pdf), by which UN member states have committed to eliminate stigma and discrimination.

These additions would not overburden the HIV/AIDS module of the questionnaire, as we are also suggesting the removal of 3 questions (933-935) which have provide to be unreliable measures, or have reached high level of agreement and can not be used to measure change over time.
Re: Stigma and Discrimination [message #1791 is a reply to message #1703] Thu, 03 April 2014 07:10 Go to previous messageGo to next message
james.hargreaves@lshtm.ac is currently offline  james.hargreaves@lshtm.ac
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I am a researcher in the field of HIV/AIDS stigma and discrimination who has participated in some aspects of the discussions that lead to the suggestions made below.

I offer support to the proposed changes.

The wording of the proposed questions emerges from a highly robust consultation that has been undertaken over several years and which has included many key researchers in this area. Those questions proposed for deletion do not adequately capture HIV-related stigma and its drivers and as such are not optimal for surveillance purposes, nor to track changes in HIV-related stigma over time. For related reasons they are also not optimal for research purposes.

The proposed additions more appriopriately capture important aspects of HIV-related stigma and are likely to improve monitoring in this area. I hope researchers will also begin to use those items proposed below alongside localy adapted wording.



James Hargreaves, Director, Centre for Evaluation, London School of Hygiene and Tropical Medicine
Re: Stigma and Discrimination [message #1830 is a reply to message #1703] Fri, 04 April 2014 00:30 Go to previous messageGo to next message
poteattc is currently offline  poteattc
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The Office of the U.S. Global AIDS Coordinator strongly supports the use of these MERG approved stigma indicators. Monitoring HIV stigma is an important part of supporting an enabling environment for access to HIV services.
Re: Stigma and Discrimination [message #1897 is a reply to message #1703] Mon, 07 April 2014 05:51 Go to previous messageGo to next message
cwolf is currently offline  cwolf
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Registered: April 2014
Location: DC
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On behalf of the Key Populations team at USAID Office of HIV/AIDS, I would like to support the changes ICRW has requested.

Cameron Wolf, PhD, MSc
Senior HIV/AIDS Advisor for Key Populations
USAID Office of HIV/AIDS
Re: Stigma and Discrimination [message #1944 is a reply to message #1791] Thu, 10 April 2014 11:10 Go to previous message
lnyblade
Messages: 2
Registered: March 2014
Member
On behalf of the Health Policy Project, I am writing in support of accepting ICRW's proposed changes to the stigma and discrimination questions. These proposed changes are based on a rigorous and inclusive research process involving a range of stakeholders from across the globe, taking place over many years. The proposed changes will strengthen the global community's ability to better measure stigma, track trends over time, and have meaningful data for evaluating efforts to reduce stigma and discrimination and their links to key health outcomes.

Laura Nyblade
Senior Technical Advisor, Stigma and Discrimination
Health Policy Project and RTI
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