Learning Objectives:

• To explore attitudes and knowledge gaps on HIV and related stigmatized issues
• To sensitize participants to various forms of stigma

Materials: Worksheet 2.5.1: Everything you always wanted to know exercise (four pages)

Time Required: 45 minutes

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Activities & Instructions

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Instructions to Participants:

1. Uncensored Brainstorming (8 minutes)

Facilitator says:

• “This exercise is an opportunity for us to explore the stigma and discrimination related to HIV.”
• “For this exercise, we would like you to work in four small groups. Let’s count off from 1 to 4.” (After the counting is done).
• “All the 1’s will get together, all the 2’s will get together and so on. Now please find your teammates and sit together.” (2 min)
• (Facilitator will give each group their corresponding worksheets—HIV +, cancer diagnosis, gay/lesbian/trans, drug addiction)
• “Now, I would like to invite each of you to spend about 5 minutes on your own to work on the worksheet. Think of all the questions you would like to ask the person, and just write them all down. Do not censor your thoughts. Do not worry about the responses. There are no right or wrong answers.” (Set timer to sound the alarm after 5 minutes.)

2. Small Group Debriefing (10 minutes)

• “Now, share your questions with the other members of your team. Do not discuss or debate them.” (5 min)
• “After you have shared your questions, work together in your small group to group them into two categories. Category A will be those questions that you would feel very comfortable asking; and Category B will be those questions you find difficult or are hesitant to ask.” (5 min)
• (After 10 minutes, get all participants to rejoin large group.)

3. Large Group Sharing (2 min/each)
   “For the large group sharing, we would like you to report just on category B, that is, the questions you wanted to ask but were afraid to do so.” (2 min/group)
4. Large group Debriefing (20 min)
   After each group reports their questions, go through the debriefing questions and summarize themes that came out.

Debriefing Questions

Preamble: The intention of this exercise is not to identify best practices in counselling and providing support, but more on exploring how social stigma inform or affect our feeling and action towards different marginalized groups of people in our community.

• What questions do we find difficult or problematic to ask? What makes it difficult?
• What do all these scenarios have in common?
• What is unique about each of these scenarios?
• How do societal expectations and stigma contribute to making the conversation (questions) difficult?

Key Summary Points

• Stigma hinders communication, creates social exclusion and perpetuates suffering.
• Our preparedness to ask questions may relate to many factors associated with “Fusion to societal rules and labels”, “Avoidance of unpleasant experiences”, and “tension and conflicts with our Values”:
  • our discomfort with what we associate with the issues that we ourselves consider to be taboo, stigmatizing or painful, e.g., we may associate cancer with death; HIV with promiscuity, etc. internalized stigma
  • our fear of being perceived as insensitive or ignorant
  • our fear of “others” or the “unknowns”
  • our fear of getting triggered due to personal experience with stigma and suffering as marginalized communities
  • our sense of conflict with our own values or judgment

• There are different social stigmas associated with different marginalized groups. Some may experience multiple levels of stigma and discrimination.
• There are differences in the experiences of the scenarios. Some relate to issues external to the person, e.g.,illness, substance use, and some relate to inherent characteristics of the person, e.g., being LGBT.
• It is important for us to be aware of our own power and privilege and how we may have internalized social stigma that would affect our interaction with others.
• The complex combination of social injustices – i.e., racism, homophobia – fear and stigma create an unsafe environment for PLHIV and other marginalized communities to access needed services, get support, share their experiences and become involved.

Source:

Li, A. T., & Wong, J. P. (2011). SJCB protocols for CHAMP Study. Toronto, ON: Community Alliance for Accessible Treatment.

Worksheet 2.5.1.a – Everything You Always Wanted to Know but Were Afraid to Ask

Group 1

Imagine if your best friend or close family member tells you that she/he/they has tested HIV+:

1. Each person on your own, think of all the questions you would like to ask her/him/them at that moment. Write them all down; do not censor your thoughts.
2. Share your questions with other members of your group. Do not discuss or debate them.
3. Group the questions into 2 categories: (A) those you would have no problem asking; and (B) those you find difficult or are hesitant to ask. (3 min)

Questions you have no problem asking	Questions you are afraid to ask

4. Report back to the large group the questions you wanted to ask but were afraid to (1 min). Be prepared to share reflections in debriefing.

Worksheet 2.5.1.b – Everything You Always Wanted to Know but Were Afraid to Ask

Group 2

Imagine if your best friend or close family member tells you that she/he/they has been diagnosed with cancer:

1. Each person on your own, think of all the questions you would like to ask her/him/them at that moment. Write them all down, do not censor your thoughts.
2. Share your questions with other members of your group. Do not discuss or debate them.
3. Group the questions into 2 categories: (A) those you would have no problem asking; and (B) those you find difficult or are hesitant to ask.

Questions you have no problem asking	Questions you are afraid to ask

4. Report back to the large group the questions you wanted to ask but were afraid to (1 minute). Be prepared to share reflections in debriefing.

Worksheet 2.5.1.c – Everything You Always Wanted to Know but Were Afraid to Ask

Group 3

Imagine if your best friend or close family member tells you that she/he/they is gay/lesbian/trans:

1. Each person on your own, think of all the questions you would like to ask her/him/them at that moment. Write them all down, do not censor your thoughts.
2. Share your questions with other members of your group. Do not discuss or debate them.
3. Group the questions into 2 categories: (A) those you would have no problem asking; and (B) those you find difficult or are hesitant to ask.

Questions you have no problem asking	Questions you are afraid to ask

4. Report back to the large group the questions you wanted to ask but were afraid to (1 minute). Be prepared to share reflections in debriefing.

Worksheet 2.5.1.d – Everything You Always Wanted to Know but Were Afraid to Ask

Group 4

Imagine if your best friend or close family member tell you that she/he/they has an addiction to drugs:

1. Each person on your own, think of all the questions you would like to ask her/him/them at that moment. Write them all down, do not censor your thoughts.
2. Share your questions with other members of your group. Do not discuss or debate them.
3. Group the questions into 2 categories: (A) those you would have no problem asking; and (B) those you find difficult or are hesitant to ask

Questions you have no problem asking	Questions you are afraid to ask

4. Report back to the large group the questions you wanted to ask but were afraid to (1 minute). Be prepared to share reflections in debriefing.