Stigmatization, Consequences of

J. E. Mill traced the concept of stigma to classical Greece, where it was used to refer to physical markings in individuals who were seen as having “tarnished moral character” because of their actions (traitors, criminals) or origins (slaves). Since then, stigma has been used in an extensive variety of contexts to explain undesirable characteristics ranging from perceptions of welfare recipients to children with HIV/AIDS.

Erving Goffman identified three types of stigma. The first type, abominations of the body, refers to stigma associated with physical markings such as a deformity or disability. In other words, abominations of the body involve stigma that are the results of a visual difference that a society or group views as undesirable. For example, the stigma faced by leprosy patients would fit into this category. The second type of stigma involves blemishes of character, referring to individuals who are stigmatized because of their behaviors, “way of being,” or identity characteristics. The third type of stigma, ethnic stigma, occurs when individuals are stigmatized because they belong to a particular group that others view unfavorably. Stigma directed to racial/ethnic groups would fit into this category.

Stigma has been used since classical times to ascribe a spoiled identity to individuals and groups because of physical markings, their values, or their belonging to a particular group. The intensity of the stigma process may vary according to the severity ascribed to the behaviors.

Experiencing stigma has a range of physical and social consequences. It is important for health communication scholars to understand these consequences because stigma creates an environment that makes it harder for prevention programs to have a meaningful impact. First, and most important, stigma impacts the well-being of the stigmatized. Being ostracized, blamed, or shamed can impact an individual's mental health. Furthermore, this social pain can be manifested physically. Rachel A. Smith noted that the social pain caused by being stigmatized is comparable to physical pain because “it engages the same neural mechanisms that support the experience of physical pain.” The stigma experiences of people living with AIDS (PLAs) serve as a great illustration. HIV/AIDS stigma has the distinctive feature of combining the physical, moral, and ethnic stigmatizations. Its complexity and pervasiveness make it a considerable barrier to prevention work.

HIV/AIDS stigma is unique because it provides a particular set of complex characteristics that combines all three types of stigma [Page 1336]outlined earlier. First, there is an opportunity for “abomination of the body,” the stigma based on physical marking: the image of emaciated AIDS patients is strongly associated with the disease. A stereotypical image of AIDS is one of lifeless individuals wasting away. These individuals face the potential of being stigmatized based on their physical appearance regardless of whether or not they have made the choice to disclose their status. Second, PLAs also face stigma based on “blemishes of character” related to the source of transmission. For example, women may be stigmatized because of the potential of sexual transmission. A female PLA may be seen (and has been seen in many countries) as promiscuous. Third, opportunities for ethnic stigma have existed almost as long as HIV/AIDS itself. People have stigmatized certain groups because they blame them for causing or spreading AIDS. For example, commercial sex workers have faced this type of stigmatization.

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