Strategies to tackle stigma

Recently, I’ve been thinking about how you might tackle HIV stigma across a whole range of different groups, such as gay/bisexual men and heterosexuals, men and women, from White and diverse cultures, sex workers and injecting drug users and white picket fencers.

There have been some generic approaches, often making very broad appeals (“motherhood statements”) for dignity/respect.  I’m not fond of this approach, because it’s easy to agree without thinking to a general sentiment, and changing attitudes takes mental effort.

In other words, if you want social change, you need to get people thinking.  But you need to provoke a particular kind of thoughtful, attentive, seeing-both-sides mental state.

If you get people riled up emotionally, at some point they will shut down, dig in, get tunnel vision, and defend their positions. Tabloid and talkback journalism counts on that reaction. In fact, exposing misinformed people to factual corrections can sometimes make the initial beliefs even stronger.

The literature on stigma reduction is really clear that it’s not about ‘correcting myths’ with accurate information.  You really need people who practice stigma to rethink the social and emotional purposes that underpin their belief in the stereotypes.

Discussion groups are brilliant for this purpose, but you can’t put the entire population through six-week groups, 12 people at a time!

There have been social marketing campaigns against stigma, but I am skeptical about whether this approach can work;  reducing complex issues down to single-minded propositions tends to result in broad appeals (wishy-washy) or shock tactics (which backfire).

Where community-level interventions have worked, they have been multi-strategic and multi-level, using a social marketing campaign headlined by name-and-face personal narratives, backed up by community diffusion activities through opinion leaders and more localised opportunities for debate and discussion, and giving audience members some concrete action they can take to demonstrate their commitment.

All of that calls for time, effort, and resources, and if you take diffusion seriously, your intervention looks less like an ad campaign and more like a social change movement.  Does this sound familiar?  In Australia, think of thisisoz, and worldwide, Dan Savage’s It Gets Better project or the Obama campaign or the recent Egyptian revolution.

But don’t get carried away thinking the technology does the work.  What matters is whether your message makes people think.  You might create the greatest Facebook page in the world, but that’s not much use if people Like-and-forget it.

In Pt 2, I’ll talk about the message content, and a theme I think might work across all those different social groups I listed above.