Rethink Positive: It’s Time to Rethink HIV

By Tarrant County Public Health Disease Surveillance, Outreach and Prevention Division

“Stigma” has become a recent buzzword:

  • TV News anchors are talking about stigma
  • People are posting about stigma on social media
  • People are DMing about it, and it’s even made it to water-cooler chatter

Tarrant County Public Health (TCPH) wants to ensure that ending HIV stigma is more than just a buzz in our community’s ear. We need to keep people healthy by ending the HIV stigma. TCPH has had an individual-level HIV prevention program for years, including HIV testing, PrEP services, and caring for those who are HIV positive. Now we aim to overpower the HIV epidemic at the structural level – wherever people living with HIV encounter the system: in healthcare, education, community organizations, and corrections. 

TCPH created Rethink Positive with a grant funded by the CDC and the State of Texas. We are reaching out to healthcare providers, educators, school nurses, staff of community organizations, and correctional institutions. We don’t need to tell people living with HIV that a stigma exists; we need to change the negativity within the establishment.

We’ve adapted an evidence-based anti-HIV stigma program created by Health Policy Project that has successfully reduced stigma in nine other countries. More information on the Health Policy Project’s efforts can be found on their website

We’ve adapted the program to be relevant to our Tarrant County communities and have created interesting, engaging, and practical exercises. Our workshops include the basics on HIV and how it’s transmitted, education on institutionalized racism and its impact on the HIV epidemic, definitions and examples of HIV stigma and discrimination, and optional modules on Universal Precautions and creating a Best Practices Action Plan.

Our customized workshops are appropriate for our participants’ work environment, with examples of recognizing and challenging the stigma that are realistic. The workshops are offered online and in person. Our online workshops are one hour long, while our in-person workshops range from 1½ hours to several days in length.

The workshops started in February of 2021, and we have received valuable feedback that participants are enjoying the material and are learning about HIV stigma, its causes, and how to challenge stigma in their work environments. We’ve created an in-person exercise called a “Stigma Walk,” in which individual experiences of stigma are exemplified in a powerful way. Participants especially like the Stigma Walk exercise. They have indicated that they have learned about the importance of combatting HIV stigma and changing their workplace to be a more welcoming environment.

A program aimed at reducing HIV stigma is successful only if it changes the institutionalized stigma experienced by people living with HIV and those at risk. At present, participants complete HIV- and stigma-knowledge pre-and post-tests to measure the impact of the training. We also plan to have healthcare providers survey their patients on existing stigma in their facility before the workshop and 3- and 6-months post-workshop. We will be using evidence-based stigma-measuring tools that have been revised to specifically measure HIV-related stigma to confirm we are making a real difference in reducing systemic HIV-related stigma.

TCPH is excited to make a difference in our community by combatting institutionalized HIV stigma. We invite everyone to join the effort by instituting changes in their own organization and reaching out to other entities to inform them about the importance of ending the HIV epidemic.

To learn more about our Rethink Positive program or to schedule a workshop for your organization, we invite you to visit our webpage, rethinkpositive.tarrantcounty.com, contact us by via email at PHOutreach@tarrantconty.com or call or text us at 682-216-0657. 


Cultivating a stigma-free climate of appreciation and inclusion is one of the Achieving Together Plan’s focus areas. To learn more about addressing stigma, see the Stigma Resources Page on our website

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