What Works for Women and Girls

eneficial in addition to individual counseling for reducing stigma within the household.Thirteen thousand patients have received counseling. Five thousand six hundredsixty-seven patients living with HIV/AIDS have been followed longitudinally since 1993with medical and psychosocial care. Seven hundred fifty-four couples accessed couplescounseling and 698 accessed family counseling. Disclosure, pressure to have childrenby family members unaware of their serostatus, discrimination, and hiding medication,which can alert others to their serostatus, were issues addressed (James et al., 2004).(Gray III) (stigma, discrimination, counseling, couples, India)4. Implementation of non-discriminatory workplace policies may reduce stigma anddiscrimination.With the technical support of the International Labor Organization (ILO), ten enterprisesin six sectors of the economy of Nepal implemented HIV/AIDS workplace policies.While only 73% of workers were willing to work with an HIV-positive co-worker priorto workplace policies, following implementation of workplace policies this increasedsignificantly to over 94%. Worker’s views that employers should not fire HIV-positiveworkers increased from 61% to 81% (Singh, 2008). (Gray IV) (employment, policies,Nepal)A program established in 2003 in Thailand to create formal company HIV/AIDS policiesand implement awareness and education for managers and employees found thatacceptance in working with HIV-positive colleagues, such as sharing a meal, increasedfrom 40% in 2005 to 95% after implementation (no dates given). Employees’ reportedcondom use in casual sexual encounters also increased from 16% to 49% (Pramualratana,2008). (Gray IV) (employment, policies, education, condom use, Thailand)5. Recruited opinion leaders can reduce stigmatizing behaviors in the community.A cluster-randomized behavioral intervention trial conducted in 14 villages in Anhuiprovince, China found that recruited opinion leaders reduced the prevalence of stigmatizingbehaviors observed and reported by community members. Seven villages wererandomized to receive the intervention which consisted of four weeks of training for742 opinion leaders followed by monthly reunion sessions, as well as eight weeks ofskills training and monthly reunions for 150 people living with HIV. 330 people livingwith HIV were followed for one year in both control and intervention villages. Threecross-sectional surveys were carried out among 950 randomly selected villagers. At 12months, the prevalence of stigmatizing behaviors observed and reported by communitymembers was significantly lower in intervention villages at fewer than 42% comparedto 56% in control villages. The intervention achieved a reduction in reported stigmaof 27%. Reports from people living with HIV indicated corresponding decreased inperceived stigma, with significantly reduced perception of stigmatizing behaviors (Xuet al., 2008). (Gray II) (opinion leaders, stigma, China)334 CHAPTER 11 STRENGTHENING THE ENABLING ENVIRONMENT