Addressing Stigma in Healthcare Facilities: A “Secret Shopper” Intervention

Stigma and discrimination continue to be major barriers to healthcare access, particularly for people living with and at risk of acquiring HIV. The United States National 2020 HIV/AIDS Strategy, numerous state and local Ending the HIV Epidemic Initiatives, and international policies call for ending stigma around HIV to ensure effective health care access, increase the number of people on treatment, and reduce new HIV infections.

Effective interventions require data, particularly at a granular level within health service sites, which may not often be readily available due to a lack of metrics to measure stigma and discrimination. Anecdotal evidence exists in communities, yet tangible data collection is needed to ensure the right programs are in the right places. The following brief provides a framework for health departments to adopt an innovative approach to engage communities in monitoring and evaluating stigma and discriminatory behaviors in health facilities; the secret shopper program.