Towards a sustainable theory of health-related stigma: Lessons from the HIV/AIDS literature

Stigma has been identified as a major barrier to health care and quality of life in illness management. But unfortunately there is no common theoretical perspective on stigma. We need a sustainable theory of health-related stigma. This would start with a coherent definition of stigma that brings together both individual and social dimensions of this complex phenomenon. It would reassesses the existence of 'types' of stigma and explain how stigma relates to disadvantage. A sustainable theory would help researchers to move from theory into practice: to develop a comprehensive measurement tool for stigma and related disadvantage, and inform design, monitoring and evaluation of anti-stigma interventions. This paper draws on two recent literature reviews on HIV/AIDS stigma to introduce several key issues in developing a sustainable theory of stigma. We suggest limiting the definition of stigma to the process of othering, blaming and shaming (often called symbolic stigma). We argue that there is value in analytically separating stigma from discrimination in order to better understand the relationship between them. We also suggest the need to understand discrimination caused by stigma as only one element of stigma-related disadvantage. Copyright (c) 2006 John Wiley & Sons, Ltd.