Opinion: Key takeaways from the AIDS 2022 Community Networking Session

Jacopo Andreose, Senior Vice President, Intercontinental Region & Global Patient Solutions, Gilead Sciences

I recently had the honor of participating in the AIDS 2022 Community Networking Section, hosted jointly by Gilead, the International AIDS Society and APCOM Foundation. The session featured Champions from the Me and My Healthcare Provider* from Brazil, Mexico and Taiwan – a program proudly supported by Gilead. Beyond the excitement of finally being able to meet our community partners in-person, the frank and heartfelt discussions inspired all of us to revisit the role that healthcare providers play in the delivery of stigma-free services and examine our own best practices.

Here are three takeaways.

1. Never take for granted that stigma in HIV care is a multi-dimensional issue.

In the regions that we serve around the world, the experience of stigma differs from person to person and setting to setting. For example, while stigma is most often thought of as external pressure placed on an individual by society, it can also manifest in internalised behavior that impacts how people seek care. Stigma is also commonly observed at intersections of services, meaning while stigma-free service may be maintained in one part of care such as at the HIV clinic, it does not necessarily carry through the entire patient journey into other health specialties; or gaps may exist between cities and regions. We must be aware of these nuances and not be complacent in our discussions of stigma and its impacts.

2. Reframing the doctor-patient relationship to consider stigma will bring about powerful outcomes in people-centred care.

A doctor’s relationship with the client is ever evolving, and exploring creative ways to improve this relationship through a stigma-free approach is paramount. “We should extend our care to clients in their personal life – individualize our services to help remove barriers in their HIV care,” noted Lee Pei-fen, a Me and My Healthcare Provider Champion from Taiwan. This means creating approaches that address stigma head on, removing traditional barriers of the role of the doctor that can impede honest dialogue, and tailoring care that is specific to different types of clients so each person feels valued.

The words of Dr. Javier Martìnez Badillo, a Me and My Healthcare Provider Champion from Mexico, also resonate: “Care without stigma describes a horizontal connection between two souls: that of the health provider and that of the client.” Dr. Badillo’s remarks illustrate the collaborative approach between doctor and client that is needed to bring about true stigma-free care.

3. The simplest gestures—flexibility, availability, stability and openness—are the huge steps towards stigma-free service delivery.

While some might consider stigma-free care delivery to be daunting, key factors associated with it are surprisingly simple: flexible teams, availability of supportive peers and a stable team of familiar healthcare providers. Of course, the physical environment should also be welcoming and not daunting for those who may already experience self-stigma.

Sharing with each other successes that we have seen in unlocking stigma-free service delivery is critical as we continue to move forward. Start small with each individual before trying to generate the momentum for wider societal change.

Healthcare providers play a central role in the fight to eliminate HIV. I am grateful for the dedciated advocates that shared, challenged, and expanded our perspectives during the AIDS 2022 Community Networking session. They are the embodiment the words of Dr. Demitrius Montenegro, a Me and My Healthcare Provider Champion from Brazil: “Stigma is like a window on the wall. Some providers have their window open, while some keep the window closed. We should work together to widen each other’s window for a bright future!”

*Launched in 2015 by IAS – the International AIDS Society – Me & My Healthcare Provider promotes best practices in inclusive and stigma-free healthcare service delivery for people living with and affected by HIV. With the support of Gilead Sciences, the program has been expanded to Taiwan and Hong Kong in Asia; and renewed in Brazil and Mexico in Latin America since 2021. The above-mentioned healthcare providers are champions who have attended the AIDS2022 as per invitation by IAS.  For the full list of champions, please visit www.iasociety.org/me-and-my-healthcare-provider.