"Despite all my knowledge and years working to promote condom use, I only started using condoms consistently when I felt my existence was important. ....My existence became important and my life worth living when I received the acceptance of friends, family, neighbors, health care providers, and the community in general. Now I use condoms consistently."
- Muthukumar Natesan, a leader of a community-based organization.
About the report
July 21, 2010 - Since the beginning of the HIV epidemic, it is well known that stigma, discrimination, and gender inequality play an enormous role in furthering the spread of HIV. The response to these social drivers, however, remains inadequate to the scale and intensity of the challenges they pose. Despite prevention and other efforts to reduce high-risk behaviors such as unprotected sex, buying and selling of sex, and injecting drug use, HIV vulnerability and risk remain high.
HIV prevalence in South Asia is relatively low. The epidemic, however, is growing among marginalized groups, including sex workers, injection drug users, men who have sex with men, and transgender communities. The problem is partly due to a widespread failure to respond adequately to key social drivers of HIV: stigma and discrimination. Despite considerable progress in recent years, many projects addressing stigma and discrimination are still small in scale or in the pilot phase.
Furthermore, despite repeated recommendations for greater involvement of marginalized communities in the response to HIV, their active engagement remains scarce in most countries.
The World Bank's South Asia Region took an innovative and unique approach to addressing these gaps and needs through its 2008 Development Marketplace, “Tackling HIV and AIDS Stigma and Discrimination.” The approach included disbursing relatively small grant amounts; funding organizations led by and for marginalized groups; and supporting implementers in program design, monitoring, and evaluation.
In 2008, the competitive grants program selected 26 organizations led by and for marginalized groups from six countries to pilot innovative interventions over a 12- to 18-month period. The grant funding totaled US$1.04 million, with a maximum grant size of US$40,000. The grants program inspired these groups to implement a range of innovative and creative responses to HIV stigma and discrimination.
Structure of the Repot
Part I of this report describes key findings and lessons learned that emerged across the 26 implementers.
Part II contains case studies for six of the implementers, offering a more in-depth look at the lessons and challenges of intervening against stigma and discrimination.
Part III provides summaries of all 26 projects.