Integrating a Youth-based Stigma and Discrimination Reduction Curriculum in Higher Education

To institutionalise and sustain stigma reduction within an educational setting, the project team first sought to gain buy-in from college management. This was based on the belief that t is important to start with the "gatekeepers" (in this case, senior management at the college) to ensure buy-in. Training faculty members as change agents helped to mainstream stigma reduction and promote sustainability. After this, they trained a cadre of faculty members as master trainers who in turn would train students. A 3-day training was held for 17 faculty members from various disciplines to address gaps detected prior to the training, such as a lack of knowledge about HIV and stigmatising attitudes. The faculty training focused on the meaning, forms, causes, and consequences of stigma, as well as myths and misconceptions around HIV and AIDS. To help the faculty understand HIV-related stigma, the training first explored stigma and discrimination based on caste, gender and socioeconomic status. This was part of an effort to motivate faculty members to question their own attitudes and overcome any reluctance to start conversations with their students on sensitive topics such as sex, sexuality, and condoms.

Sixty-four students across different disciplines took part in a 3-day workshop facilitated by the master trainers. All of the second-year graduation students were informed about the programme and were asked to volunteer. About 75 students volunteered, of whom 64 attended the workshop. More girls than boys participated in the training. The workshop covered the forms, drivers, and manifestations of stigma. Stigmatising attitudes and value judgements about people living with HIV (PLHIV) and key populations were confronted through discussion and debates. Including stigma based on caste, class, economic status, and religion was part of an effort to help participants understand and relate to the stigma and discrimination faced by PLHIV. Sessions included activities such as:

• Naming stigma through pictures: This exercise sought to help students identify, understand, articulate, and question stigma as a social construct.
• Stigma tree: This exercise had students visually map and reflect on the routes or causes, forms, and effects of stigma. It was meant to help students analyse how it feels to be stigmatised and its various effects, such as depression, loneliness, isolation, and self-destruction.
• Value clarification: In this session, students reflected on their levels of moral judgment around stigma and questioned their beliefs. For instance, there were clear ambiguities around statements such as "women should tolerate violence", "premarital sex is a choice", and "women who carry condoms are usually sex workers".

Next, students and faculty visited community-based organisations (CBOs) working with PLHIV and key populations, including men who have sex with men (MSM), transgender individuals, and female sex workers (FSWs) in the cities of Ahmedabad, Surat, Rajkot, and Baroda. According to organisers, the majority of students had never knowingly interacted with a female sex worker and had social judgements about their profession. Most students held misconceptions about transgender people, and almost no student/faculty reported ever having knowingly spoken with MSM. Before the training, only one-third of students agreed that MSM have the same rights as heterosexuals; 19% thought that being gay was immoral. The visits were designed to foster collective reflection and greater acceptance.

Noting that peer-led approaches that involve students as role models and change agents are important in an educational setting, and with support from college management and the faculty, the trained students conducted a campaign among 300 college peers featuring: their own kits on stigma reduction, a short film on HIV-related stigma, and engagement with other students to share their learning.

HIV/AIDS, Youth, Rights

Pre- and post-intervention surveys with the students revealed that:

• "Blaming attitudes" towards PLHIV regarding "wrong" or "immoral" behaviour declined from 21% to 5%.
• Agreement that "PLHIV should be 'ashamed' of themselves" reduced from 67% to 35%.
• There was an overall positive shift in attitudes towards key populations.
• Students were more open to discussing sexuality and sex and felt that it was important to do so.
• The proportion of students who tested for HIV increased from 9% to 19%.