The HIV Center for Clinical and Behavioral Studies at the New York State Psychiatric Institute and Columbia University, in collaboration with the National Institute of Hygiene of the Moroccan Ministry of Health and the UCLA Program in Global Health, propose to conduct a Middle East/North Africa (MENA)-specific Think Tank on HIV/AIDS stigma and HIV prevention. This workshop will engage experts in the behavioral, social, and biomedical sciences from throughout the MENA region and the US;a series of manuscripts addressing the regional impact of stigma on HIV/AIDS vulnerability will be commissioned and reviewed at the meeting. Final versions of the manuscript series will be published in a peer-reviewed journal along with the major recommendations emanating from the Think Tank. HIV/AIDS stigma and discrimination in the Middle East and North Africa are widely cited as critical barriers to prevention and care, facilitating HIV transmission and impeding surveillance efforts. Within the region, where HIV and STIs are associated with immorality and behaviors prohibited by Arab and Islamic culture, public health officials and providers describe stigma as an ongoing challenge to HIV prevention. Despite consensus on the importance of HIV/AIDS stigma, little is known about existing programs and strategies that target stigma reduction in the region. Even less is known regarding the scientific characterization and measurement of HIV/AIDS stigma;much of what is available is vague, speculative, and often limited to observational accounts of its consequences. Characterization of regional drivers of HIV/AIDS stigma, which prevents large MENA populations from protecting themselves or accessing care, has both immediate and long-term scientific and public health significance. We will convene the MENA Think Tank on Stigma and HIV Prevention to (1) define and characterize individual, cultural, and structural factors giving rise to MENA region-specific HIV/AIDS stigma;(2) develop an analytical framework for measurement and surveillance of HIV/AIDS stigma in the Middle East and North Africa;(3) produce a focused series of manuscripts to be published collectively as a Special Issue of a relevant peer-reviewed journal;(4) develop and disseminate a MENA region-specific HIV/AIDS stigma research agenda;and (5) create research partnerships that result in concrete research proposals and projects following on the research agenda to be articulated at the conference. The proposed Think Tank will have concrete outcomes - publications in peer-reviewed journals, formation of a MENA network on HIV/AIDS, and specific collaborative research projects and proposals - that will build lasting partnerships to make scientific and programmatic contributions to the field. We are specifically structuring the proposed Think Tank to result in the formation of stronger regional collaborations to pursue specific research projects related to HIV stigma in the MENA region, as well as the funding to support such work.
The public health significance of the Think Tank derives from the production of a rigorous and regionally specific research agenda designed to drive effective and measurable public health outcomes. The ability to quickly identify, measure, and intervene with HIV/AIDS stigma will allow for the protection of HIV-negative populations with measures that will prevent the development of full blown epidemics. Removing the cover of stigma from at-risk populations through understanding the social processes that put them at risk will allow for development of public health programs that specifically address the varied needs of MENA migrant/refugee populations, as well as members of more well characterized at-risk groups that may experience MENA-specific forms of stigma and discrimination. Long-term public health goals set by the meeting experts will expand into addressing gender parity in the region, constructive forms of non-punitive cultural responses to sexual diversity and other HIV risk behaviors, empowering a highly mobile emerging youth population for regional and international risks, increasing political will and commitments, and raising HIV/AIDS on the priorities of MENA governments so that responses are driven by actual risks rather than stigmas.
