Leading the Model for Change: Working with the Community to Eliminate HIV-Related Stigma in Hawaii

Stuart Watson’s MPH’20 practicum work is at the heart of the Hawaii 2 Zero initiative to end the AIDS epidemic across the state. The need is especially important for Native Hawaiians/Pacific Islanders (NHPI), who are diagnosed with AIDS at a higher proportion than are any other racial/ethnic group in Hawaii and compared to NHPIs in the United States overall.

For Watson, the key to ending the AIDS epidemic is being able to diagnose people earlier in the stages of HIV infection, linking them to treatment, and getting them virally suppressed. However, a barrier to these efforts is overcoming the negative attitudes and beliefs about people living with HIV.

“Really, we just have to find the last few who aren't diagnosed or aren't on treatment, which begs the questions, why haven’t they been diagnosed yet, or why don't they stay on treatment?” says Watson.

Some of those answers came from the work he did in conducting focus groups with the community to understand how people living with HIV, and people who are at risk for HIV, experience stigma. The work was part of the Zero HIV-related Stigma Subcommittee that he led with the Hawaii Department of Health’s Community Planning Group in his role as an HIV care program specialist.

Participants expressed the concerns they encountered from family and friends, including fear of infecting others, even if just washing their clothes together, as well as their own feelings of uneasiness in disclosing to friends and family due to stigma.

Watson says there was widespread consensus that the best way to eliminate stigma is to prevent it from starting by talking openly about HIV and its risk factors, beginning at an early age.

“The general public doesn't really know about HIV anymore because it isn't in the news like it was at the beginning of the epidemic,” says Watson. “It's no longer a death sentence, and it's even more easily managed than diabetes or hypertension. With general and widespread knowledge about it, I believe the pressure and stigma around it will go away.”

The focus groups’ findings will be incorporated into Hawaii’s State Plan, and will include recommendations to develop programming for schools, churches, and recreational areas to promote open dialogue.

POSTED 2/10/2020 AT 11:41 AM IN #practicum