The Limits of Current Approaches to Stigma: Applying Honneth’s Theory of Recognition to Address AIDS-Related Stigma in South Africa Erin Stern MsC Health, Community & Development, LSE (London School of Economics & Political Science) CADRE (Centre for AIDS Development Research & Evaluation) e-mail: e.stern@ru.ac.za Background Theory and Research Stigma, for being both a major barrier to HIV/ AIDS treatment, and damaging people’s capacities to protect themselves from HIV, has been acknowledged as a key driver of the HIV/ AIDS epidemic (Ogden & Nyblade, 2005). While the feld of social psychology has clarifed the cognitive and emotional processes involved in stigma, and recognized the need to address stigma at a community level, interventions are often decontextualised from larger social processes and rest on an unclear understanding of stigma. Such approaches have slowed the advancement of effective actions to counter stigma. In light of the detrimental impact of stigma on HIV/AIDS, a better understanding of how to combat stigma for PLWHA is warranted. Honneth’s (1996) theory of recognition, which refers to the reciprocal respect for both the unique and equal status of others, has the potential to clarify the current understanding of AIDS-related stigma. For specifying the necessary criteria for individuals to create and maintain a positive identity, which is recognition through love & self- confdence, rights & self-respect, and solidarity & self esteem, the concept of recognition indicates more precisely how to contest stigma (Taylor, 1991) (fgure 1). This study seeks to answer the following: - What are the current challenges to combat stigma for PLWHA in a rural South African setting and how has the TAC responded to this? - How might Honneth’s (1996) theory of recognition enhance the current conception of combating stigma for PLWHA? Question Methods The researcher spent three weeks in Lusikisiki (fgure 2), South Africa to assess how the Treatment Action Campaign (TAC) enhances recognition, and in doing so, fghts stigma for PLWHA through 12 interviews of TAC members and participant observation of two TAC meetings. Results Members of TAC were given opportunities to relate to themselves in the three positive modes as outlined by Honneth (1996). Interviewees discussed how the TAC has promoted their self- esteem, self-confdence and self-acceptance, and in doing so, has helped them contest stigmatizing representations of being HIV positive. Love & Self-Confdence Solidarity & Self- Esteem Rights & Self-Respect Mode # 1 TAC promotes recognition through Love & Self-Confdence - Promotes acceptance of one’s status - Encourages individuals to live positively with HIV/AIDS - Promotes disclosing one’s status to loved ones - Combats denial of the disease - Addresses gender-based violence Mode # 2 TAC promotes recognition through Rights & Self-Respect - Fights for Access to treatment - Teaches treatment literacy - Teaches civil rights - Teaches rights for HIV positive people against discrimination Mode # 3 TAC promotes recognition through Solidarity & Self-Esteem - Establishes support groups - Encourages members to extend HIV ownership to others - Promotes transparency of the disease - TAC also fghts the stigma of being HIV positive by educating its members about the causes and ways to prevent HIV/AIDS, dispelling the myths surrounding HIV/AIDS. Figure 1: Honneth’s (1996) Three Forms of Recognition as Pathways to Positive Identity Formation Lessons Learned - Applying Honneth’s (1996) criteria to promote recognition for PLWHA can be a useful way to contest and transform stigma. - The achievement of the TAC in obliging the state to introduce ARVs has not been matched by a campaign that ties housing, employment and social equality to AIDS. If programs hope to effectively combat stigma, they need to adequately address issues of inequality, as stigma is often a consequence of structural inequalities. - The concept of recognition asserts the need for stigma interventions to be implemented at the community level. - While the stigma literature emphasizes the importance of promoting a positive identity to combat stigma for PLWHA, few have outlined how to do this. Honneth’s (1996) theory provides a framework for how individuals can transform stigmatizing representations of themselves to positive ones if given the opportunity to be recognized in all three levels of society. - While stigma is a complex phenomenon, it is not helpful to reject a clear defnition of stigma since there are more commonalities across cultures in the causes and consequences of stigma than differences (Ogden & Nyblade, 2005). Honneth’s (1996) theory of recognition constitutes a more defnitive conception of stigma for being anything that hinders the formation of a positive identity by threatening the three positive modes of relating to self experience, self realization, whereby one can articulate their needs. - The current stigma research frequently overlooks the importance of love and meaningful relationships to contest stigma. Honneth’s (1996) form of recognition of love and self-confdence makes room for this crucial yet understudied aspect of stigma. Conclusion and Prospects “ Because the TAC has managed to turn stones to bread.” (Interviewee #9) By identifying stigma as misrecognition, new targets can be created for anti-stigma intervention programs and their evaluation. The concept of recognition can inform and clarify future stigma measurement to assess whether individuals are recognized in the realms of love, legal order and achievement. Any program seeking to dispute stigma should thus provide opportunities for affection and acceptance, address rights and inequalities in society, and utilize community participation and solidarity. References Fisher, P. (2008b). Wellbeing and empowerment: the importance of recognition. Sociology of Health & Illness, 30(4), 0141-9889. Honneth, A. (1996). The Struggle for Recognition: The Moral Grammar of Social Conficts. Boston: MIT Press. Honneth, A. (2001). Recognition or Redistribution? Changing Perspectives on the Moral Ordr of Society. Theory, Culture & Society, 18(2-3), 43-55. Ogden, J. & Nyblade, L. (2005). Common at its core: HIV and AIDS stigma across contexts. Washington: ICRW. Yang, L., Kleinman, A., Link, B., Phelan, J., Lee, S., Good, B. (2007). Culture and stigma: Adding moral experience to stigma theory. Social Science & Medicine, 64, 1524-1535. Acknowledgements I would like to thank Dr. Cathy Campbell for supervising this study, members of the TAC in Lusikisiki, South Africa who were willing to share their experiences with me, and the XVIII International AIDS Scholarship fund for supporting my attendance at the XVIII International AIDS Conference. View publication stats View publication stats