Why Language Matters:

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Why Language Matters: Facing HIV Stigma in Our Own Words Together, we can change the course of the HIV epidemic one woman at a time. #onewomanatatime #thewellproject

Why Language Matters Have you ever heard a person living with HIV describe themselves as I am HIV? Do the words infection or infected feel negative to you? Are you offended when you are referred to by your health condition first, instead of as a person first? The words people use to talk about HIV affect the way people living with HIV feel about themselves These words also have an impact on how others perceive people living with HIV

Why Language Matters Helps shape understanding of the world we live in Is the foundation of our stories Describes who we are, how we connect with others, with ourselves Words can inspire, empower, bring us hope... They can also bully, scare, destroy our sense of self

Why Language Matters Women may experience multiple forms of oppression, discrimination Based on gender, race, sexual identity, socioeconomic status, or other factors Often reinforced through language An aggressive, powerful woman may be called bitch A man with same qualities considered ambitious, viewed with respect Adding an HIV diagnosis can magnify this oppression experience Affects self-worth, confidence, self-identity

Why Language Matters Language that reinforces stigma and discrimination, repeated over years, affects health and well-being of women living with HIV Stigma and stress have a negative effect on women s quality of life Can affect her family, children, job, even pregnancies Stress of stigma can affect immune system HIV-related stigma affects prevention, deters people from being tested for HIV, and makes disclosure more difficult

Why Language Matters Consequences of HIV-related stigma (from 2005 study) include: Loss of income Loss of hope Increased feelings of worthlessness Increased internalized stigma Poor care in healthcare system, especially from non-hiv professionals Loss of reputation in family and community Rare to find a woman living with HIV who has not felt stigmatized in some way

What Is HIV Stigma Communication? The narrative (public story of connected events) about HIV includes myths and false stereotypes that: Stigmatize HIV Isolate people living with HIV Stigmatizing stereotypes make for good rumors, gossip News media often uses them to get attention for stories Emotions most often shared in rumors are fear, anger, or disgust, research shows Rumors then become part of our social environment, regardless of whether they are true

What Is HIV Stigma Communication? Stigma communication can exist in language, labels, messages used to educate or talk about a health condition or group of people Certain medical conditions stigmatized more often than others; seen as moral issues, character flaws, instead of biological diseases Leprosy ( lepers ), mental health ( the mentally ill ), substance use ( addicts ; junkies ), HIV ( infected ) Reducing people to a label dismisses their humanity, sets them apart from others

What Is HIV Stigma Communication? HIV stigma communication is found in: History of the HIV epidemic Media Social marketing prevention campaigns Policies Research literature Movies Our own heads Language we hear (from family or friends, news headlines, research articles, and more) becomes language we use to describe ourselves and others

What Is People-First Language? Puts person before illness or label Describes and respects who they are, not what they happen to have been diagnosed with Helps eliminate prejudice; removes value judgments Describing people by labels or medical diagnoses devalues and disrespects them as individuals Never hear cancerous people or I am cancer positive Often hear HIV-infected woman Preferred phrase is woman living with HIV ; refers to person first, before mentioning their health condition

The Denver Principles Document written by HIV advocates in 1983 In opening words, Denver Principles called for use of person-first language: We condemn attempts to label us as 'victims,' a term which implies defeat, and we are only occasionally 'patients,' a term which implies passivity, helplessness, and dependence upon the care of others. We are 'People With AIDS.'" This narrative describes people living with HIV as human, valuable; shows respect, compassion

Preferred Language About HIV Stigmatizing Language ( Try not to use") HIV-infected person HIV or AIDS patient, AIDS or HIV carrier Positives or HIVers Died of AIDS, to die of AIDS AIDS virus Full-blown AIDS HIV virus Zero new infections Preferred Language ( Use this instead ) Person living with HIV; PLHIV Never use infected when referring to a person Died of AIDS-related illness, AIDS-related complications, end-stage HIV HIV (AIDS is a diagnosis, not a virus; it cannot be transmitted) There is no medical definition for this phrase; simply use the term AIDS, or Stage 3 HIV This is redundant; simply use the term HIV Zero new HIV transmissions

Preferred Language About HIV Stigmatizing Language ( Try not to use") HIV infections HIV infected Became infected Serodiscordant couple Mother-to-child transmission Victim, innocent victim, sufferer, contaminated, infected Preferred Language ( Use this instead ) HIV transmissions; diagnosed with HIV Living with HIV; diagnosed with HIV Contracted or acquired; diagnosed with Serodifferent, magnetic, or mixed-status couple Vertical transmission or perinatal transmission Person living with HIV; survivor; warrior Again, never use the term infected when referring to a person

Preferred Language About HIV Stigmatizing Language ( Try not to use") To catch AIDS, to contract AIDS, transmit AIDS, to catch HIV Compliant Prostitute or prostitution Promiscuous Unprotected sex Preferred Language ( Use this instead ) An AIDS diagnosis; developed AIDS; to contract HIV (AIDS is a diagnosis; cannot be passed from one person to the next) Adherent Sex worker; sale of sexual services; transactional sex This is a value judgment and should be avoided. Use "multiple partners" Sex without barriers or treatment-asprevention methods Condomless sex Condomlesssex with (or without) PrEP

Preferred Language About HIV Stigmatizing Language ( Try not to use") Death sentence, fatal condition, or lifethreatening condition Tainted blood; dirty needles Clean, as in I am clean, are you End HIV, End AIDS Preferred Language ( Use this instead ) HIV is a chronic and manageable health condition as long as people are in care and treatment Blood containing HIV; shared needles Referring to yourself or others as being clean suggests that those living with HIV are dirty. Avoid this term. End HIV transmission, end HIV-related deaths Be specific: are we ending AIDS diagnoses or are we ending the transmission of HIV?

Language and Empowerment Important to note: Terms and phrases like "living with AIDS" and I am HIV-positive have been empowering to many people living with HIV For others, these terms may not describe their experience; may feel stigmatizing Words and language mean different things to different people, at different times in their lives Allow others to define themselves as they wish; always start from a place of respect

Two Kinds of Stigma External stigma comes from: What we hear from family, friends, providers, others What we read or hear in media Internal stigma comes from: Self-judgment and negative self-talk we hear in our heads Developed by our life experiences -- with stigma, discrimination, shame, guilt

Negative Self-Talk Things we tell ourselves daily; define who we are inside Sometimes, a story we tell ourselves: We are not good enough, strong enough, smart enough, or beautiful enough We deserve everything challenging that has happened to us We are damaged goods One of the first places to start to make change is in the language we hear in our own heads

Empowering Women Through Language To address internalized stigma, we can change messages we say to ourselves Helps to change self-image We begin to treat ourselves with more compassion Things you can do to make these changes: Mirror work and self-affirmations Examining and changing our self-talk

Mirror Work and Positive Affirmations Mirror work involves looking in mirror, saying positive affirmations (messages we tell ourselves): "Thank you! That's wonderful!" when something good happens in life "This thing will pass, but I love you, and that is forever" when something bad happens "Looking good!" as you look at your own lovely face Researchers have found that positive affirmations and mirror work have helped many women improve their self-image, confidence, outlook, health, well-being

Examining and Changing Our Self-Talk Write down thoughts, messages you tell yourself (negative self-talk) Review messages by yourself or with friends Examine specific language you choose to describe yourself and current situation; ask yourself: Are these thoughts true? Are these thoughts helpful? Do they tear me down, or empower and lift me up? Try replacing old image with a new, more accurate image of yourself (positive self-talk)

Examining and Changing Our Self-Talk Examples of Negative Self-Talk I am infected with a horrible disease; no one will love me I deserve HIV; it s my fault I can t do anything right; I am not good enough I am an HIV-infected mother, daughter, woman Examples of Positive Self-Talk I am living with HIV and I am lovable I can follow my goals and dreams and live an amazing life I am a woman living with HIV and I can empower myself and others

Changing Language, Making Change For many WLHIV, thinking about and making changes to their HIV language has been empowering For some, it has led to pointing out stigmatizing language used by others: family, friends, providers Others may begin reaching out to media when outlets use inappropriate language Some people join campaigns working on language issues HIV advocates have won changes to stigmatizing language used by large institutions (e.g., U.S. CDC)

Changing Language, Making Change These are powerful ways to be an advocate; they don't all involve being a loud voice in a big crowd Each time anyone questions (even to themselves) the use of a phrase that fuels stigma and ignorance, they contribute to building hope This is part of changing our culture from one that disrespects women living with HIV, to one that uses language to support power and dignity of all women

Learn More! To learn more about this topic, and for links to articles featuring more details, please read the full fact sheet on this topic: Why Language Matters: Facing HIV Stigma in Our Own Words For more fact sheets and to connect to our community of women living with HIV, visit: www.facebook.com/thewellproject www.twitter.com/thewellproject