The Power of Peers: Self-Stigma Impacts, Peer Support and Engagement

This chapter discusses the impacts of stigma, societal, untended and self-stigma, on children and adolescents living with HIV (C&ALHIV). This cohort can face particular challenges, whether generic social exclusion and poverty, or those specific to growing up with HIV: naming HIV, family experience of HIV, secrecy, adherence, sexual health, talking to others about HIV and transition into adult care. Consideration is given to the interaction between intended and unintended stigma and these issues, and how this then impacts on the child’s perception of him/herself and the development of self-stigma. It then offers examples of models of psycho-social peer support and participation that have been developed in the UK, focusing on two evaluated models of practice: the residential therapeutic intervention F2B and the participation work of the CHIVA Youth Committee. Both focus on building resilience, increasing self-esteem and challenging self-stigma in C&ALHIV. The chapter concludes that the focus needs to move from protectionist practice in health, social care and the home, to engaging C&ALHIV from a young age in decisions in their heath care, providing them with information and places to safely explore the challenges they face.