Good face, bad mind? hiv stigma and tolerance rhetoric in barbados

Despiteefforts to acknowledge the structural drivers of HIV,programmaticresponses continue to be framed by ideas of personal risk,individualautonomy and moral responsibility. HTV prevention in particular is severely constrained by stigma that deters openness about serostatus and promotes public and private shame and blame. This paper examines experiences of stigma in relation to HIV and associated sexual and social characteristics in Barbados and the English-speaking Caribbean. To understand the intensity of HIV stigma,it exainines the physical,sexualand moral characteristics of HIV in comparison with other stigmatised diseases and conditions. By exploring the impact of stigma and identifying the limitations of approaches to stigma reduction informed by 'tolerance rhetoric',thepaper proposes an alternative and innovative framework for HTV response programming.