Professor Joanne Naidoo: Stigma, Syndemics & Symbolic (isms) in HIV Care - Nelson Mandela University (EN)

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PROFESSORIAL INAUGURAL LECTURE PROFESSOR JOANNE NAIDOO Topic: Stigma Syndemics & Symbolic (isms) in the context of HIV: Ways of Knowing in Health Care Faculty of Health Sciences 18 October 2021

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Full Lecture Joanne Naidoo A18 Oct 2021

Inaugural Lecture of Professor Joanne Rachel Naidoo Stigma, Syndemics & Symbolic (isms) in the context of HIV: Ways of Knowing in Health Care Faculty of Health Sciences 18 th October 2021 1

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Full Lecture Joanne Naidoo A18 Oct 2021

Summary The negating effect of stigma on health outcomes has been widely established. Described as a hidden burden of disease, stigma significantly influences the inequities in health. The seminal work of Sociologist, Erving Goffman’s initially published in 1963 continue to underpin our current understanding of stigma as socially influenced through the symbolic interactions of everyday experiences that influences behaviour. Within the context of HIV, stigma remains a barrier in ending the epidemic and is associated with diminished health outcomes, health seeking patterns and poor quality of life.

The significant advances in HIV treatment, has increased the life expectancy of people living with HIV, and has shifted the management of HIV as a manageable chronic illness. However the negative stigma outcomes experienced by people living with HIV remains. Moreover, the interactions of other syndemics (that is the co-existence of another disease/s, or social factors) further contributes to the stigma experienced by people living with HIV. This may refer to the co-existence of TB, depressive or other mental health disorder, younger woman, pregnancy, and occupations or work type industry, such as mini-bus taxi drivers, sex workers to name a few syndemics.

Central to the health are the values and attributes of caring, towards the restorative process for sustained health and improved wellbeing. To enable care, there is a need for health care professionals to know how to care. Patterns of Knowing or Ways of Knowing developed by nurse theorist Barbra Carper (1975, 1978) and extended by Chinn and Kramer (2008) has become widely applied in nursing and health professions education and training. Ways of knowing acknowledges five inter related facets (empirical, ethical, personal, aesthetic and emancipatory) inherent in the provision of holistic care.

The lecture will reflect on the syndemics associated with HIV related stigma, and the symbolic interactions with health care; in the provision of health care and in education and training of health care professionals. This will be framed against ways of knowing, how health care professionals know how to care, the inherent and learnt symbolic meanings in how care is provided, and its potential to demystify and eliminate the perpetuated HIV related stigma. Key words: HIV related stigma, ways of knowing, behavioural interactions health professional care 2

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Full Lecture Joanne Naidoo A18 Oct 2021

Acknowledgement and Appreciation It is incredibly humbling to share this space with so many prolific scholars whose work continue to shape nursing and health sciences scholarship. This achievement is through the acknowledgment of peers in the discipline and my colleagues at Nelson Mandela University, who have reviewed the body of work I have co-created with students and colleagues and determined it to being significant to meet this milestone. Thank You! I recognise the responsibility that comes with this position and will endeavour to continue to enhance Nursing and Health Sciences scholarship.

I have been and continue to be surrounded by many individuals whose perspectives and experiences have intersected with mine. I am grateful for everyone who have been and continue to join me in this journey of learning and discovery. I recognise the collective celebration of achievement this is for my: - Family and in particular my husband (Neil), daughter (Alexandra), parents (Raymond and Rosemary Kisten), - Friends and colleagues and for the Nursing Profession I also Acknowledge and Thank 1. Nelson Mandela University Management, the Faculty of Health Sciences and in particular the colleagues and friends (past and present) from the Department of Nursing Sciences.

Thank You for the manner in which I have always had a sense of belonging since I joined in 2017. Thank You for your incredible support. 2. Friends and colleagues from the University of KwaZulu –Natal. Firm roots require conducive conditions for growth. I acknowledge the experiences and opportunities of learning and scholarship that I have engaged with in the more than 16 years I have been part of the Department of Nursing at UKZN. 3. Colleagues from affiliate institutions nationally and beyond 4. Students past and present 5. The NMU Publicity, Audio-visual Team and all involved in ensuring the lecture can take place under the context of COVID 19 protocols 3

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