First Step: Internal Discussions or Community Conversations

Health departments may benefit from having preliminary conversations about stigma internally with the health department staff and, potentially, other allied government entity staff. Health departments often face internal challenges when addressing stigma and discrimination (such as non-gender inclusive policies or lack of cultural competency training)  and thus may consider having a Stigma Conversation to help government staff enhance their understanding of these issues and how to address them effectively in their work. Such conversations might not happen organically if health department staff feel like they will be judged by external stakeholders. 

Health departments interested in first having internal discussions around stigma should consider the following steps:

  • Develop internal work groups of champions dedicated to reducing stigma both within the health department and in communities we serve.
  • Meet with leadership of different departments, offices, or sections to ascertain buy-in for hosting conversations or trainings around stigma and discrimination. Such buy-in is critical for getting staff to engage and see value in any action planning conducted.
  • Conduct a preliminary assessment, adapting the Pre-Stigma Conversation Assessment survey or with additional tools within the NASTAD Evaluating Stigma Vignette. Such assessments should investigate what staff see are critical areas for intervention to promote equitable access to health services by all populations, including those most affected by HIV.
  • Reach out to local communities to assess their views on health department services and if they create welcoming environments for all. Such data can then go in to developing interventions.
  • Host the Stigma Conversation, using the tools showcased in the pages linked below, based on the data gathered and analyzed. This includes action planning.
  • Implement stigma reduction interventions (including hosting a Stigma Conversation with external partners) and continue dialogue around ways all can be involved in reducing stigma.

Community Engagement in Internal Conversations

If it is decided to have Stigma Conversations internally first, it may be worthwhile to still invite community members or partners to specific Stigma Conversations sessions to provide their expertise on ways the health department can address stigma and discrimination. This can also promote a sense of transparency, accountability and trust between the health department and community stakeholders.  Health department planners should think carefully of when to invite community stakeholders and other partners to the conversation. The NASTAD stakeholder assessment tool can help in deciding which partners to invite.