This document illustrates lessons learned from implementing the toolkit Understanding and Challenging HIV Stigma across Africa. The toolkit was produced for and by HIV trainers in Africa to help trainers plan and organise educational sessions with community leaders or to assist organised groups with raising awareness and promoting practical action to challenge HIV stigma and discrimination.

"Stigmatising attitudes and behaviour are influenced by many factors. A lot of research has been carried out to develop an array of tools and indicators to support programmers in monitoring and evaluating interventions that aim to reduce stigma, but measuring change is still one of the biggest challenges.

We hope that this resource will provide inspiration to partners, programmers, donors and other stakeholders, and help them integrate stigma reduction into the HIV programmes they run, manage and fund. In this way we can move towards an expanded response.

The aim of this tool is to present different examples of stigma reduction activities that have been integrated into HIV programmes for long-term impact and sustainability. These examples have been taken from organisations and programmes around Africa...

Stigma reduction activities have been integrated with wider programmes in a number of ways as a result of initial training by the Regional Stigma Training Programme. The most common approach has been through the incorporation of stigma exercises into training courses or workplace and community activities. However, there are also examples of how stigma reduction has been integrated into policies, throughout programmes, and how it has led to national government interventions to understand structural issues around stigma. The overall results show that creating opportunities for greater awareness and understanding of stigma is the first step to changing it; strategies to then scale up the change, through integration at different levels, can have real impact.

We hope that the range of examples shared here will illustrate how stigma interventions can be tailored to fit many contexts. The main part of this tool is divided into eight thematic sections [1. Treatment access; 2. Children’s programmes; 3. Tuberculosis programmes; 4. Workplace programmes; 5. Health care settings; 6. The military; 7. Training institutions; 8. Developing policies to address stigma reduction]. Each of these sections follows the following format:

• an outline of the principles and rationale for integrating stigma reduction into that thematic area
• examples showing how different organisations achieved integration
• significant change stories and case studies that provide more detail."

International HIV/AIDS Alliance website, June 27 2011.