Tweetchat 3: What keeps stigma alive, and can innovation help to end it?

SA AIDS Conference 2019:  Tweetchat 3

What keeps stigma alive, and can innovation help to end it?

Moderator:                         Vanessa Carter (Health Care Social Media and Communications South Africa)

Date:                                     Thursday, 13 June 2019

Time:                                     13:30 – 14:30 (SAST)

Hashtags:                            #TBHIVCare #StopStigma

How to participate:

Start your answers with T1, T2, T3, T4 or CT for transcript purposes. Answer only after the moderator prompts. Questions will be prompted every 10 minutes, but keep answers coming using the relevant T and number. Anyone can participate! Use the #TBHIVCare or #StopStigma hashtag in all your tweets so that you are visible to others in the chat and on the transcript.

Chat Overview

Join us for a 60-minute Twitter with TB HIV Care – live from the 2019 SA AIDS Conference in Durban. Everyone is welcome to join the chat, including those at the conference and those not, doctors, nurses, entrepreneurs, policymakers, advocates, academics, pharma, educators, students, IT developers, journalists, data scientists, civil society, NPOs, researchers, etc. both locally and internationally.

Our topic for the session focuses on stigma – what keeps it alive, how it can be addressed and if innovation can play a role in ending stigma.

The transcript will be recorded by Symplur Analytics (



T1: How does stigma affect people, especially those affected by HIV and/or TB? (e.g. reluctance to seek treatment and follow-up care)

T2: What drives stigma?

T3: How do we address stigma and what do you think are the greatest challenges of doing so?

T4: How do you think digital technologies and other innovative ideas could help address stigma in South Africa?

Closing: What other thoughts would you like to add?


Blog: 3. What keeps stigma alive, and can innovation help to end it?

Stigma refers to the process of devaluing or discrediting individuals – often because of perceptions related to culture, gender, race and health. People with HIV and TB (and other illnesses) often face stigma. Discrimination follows stigma, and is the unfair and unjust treatment of an individual based on their real or perceived HIV and/or TB status. Stigma has a profound effect on individuals, communities and society. It results in a range of excluding behaviours, it isolates, divides and breaks down communities; it undermines human rights and results in the internalisation of blame and shame. (Source: Southern African HIV Clinicians Society).

This internalisation of shame is referred to as self-stigma and it, in turn, has an impact on a person’s mental health, but it also impacts on the uptake of HIV testing, prevention and treatment services. Crucially, for people living with HIV, self-stigma often means that they don’t access life-saving antiretroviral treatment. (Source:

There is a strong relationship between stigma and HIV. People who experience stigma and discrimination are often marginalised (socially, economically and legally) and made more vulnerable to HIV (such as sex workers and people who inject drugs), while those living with HIV are more vulnerable to experiencing stigma and discrimination.

South Africa’s national People Living with HIV Stigma Index (2014) showed evidence of some positive strides being made in terms of combatting stigma and discrimination as experienced by PLHIV – especially in the healthcare sector as only a small proportion of individuals in the study reported having experienced discrimination because of their HIV-positive status. Nevertheless, there is still some evidence of stigma and discrimination of PLHIV experienced in the health care sector. Moderate levels of HIV-related external and internalized stigma and discrimination were found. Moderately high TB-related stigma was also found. Of concern is the level of internalized stigma found in this study, which is probably a consequence of the lack of adequate psychosocial support that is currently available for PLHIV to address the psychological consequences of receiving an HIV-positive diagnosis including associated mental health issues. As the report concludes, ‘stigma mitigation campaigns are greatly needed in the South African context’. (Source:

How do we address stigma in 2019? Myths and misinformation around HIV persist; can we adopt a new approach to tackling stigma and discrimination? Can e-health play a role? During this 60-minute session, we explore why stigma remains so difficult to overcome and what we can do differently. This session is hosted by TB HIV Care as part of their SA AIDS Conference 2019 conversations.