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HIV/AIDS Stigma & Access to Care Carlos Velez, JD Director Technical Assistance, Training and Treatment Technical Assistance, Training and Treatment Division NATIONAL  MINORITY  AIDS COUNCIL
GOALS ,[object Object],[object Object],[object Object]
OBJECTIVES ,[object Object],[object Object],[object Object],[object Object],[object Object]
OBJECTIVES ,[object Object],[object Object],[object Object],[object Object],[object Object]
OBJECTIVES ,[object Object],[object Object],[object Object],[object Object]
MODULE I KEY TERMS
Objectives ,[object Object],[object Object],[object Object]
Key Terms ,[object Object],[object Object],[object Object]
KEY TERMS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
STEREOTYPE ,[object Object]
PREJUDICE ,[object Object]
DISCRIMINATION ,[object Object]
SEXISM ,[object Object],[object Object]
RACISM ,[object Object]
HOMOPHOBIA ,[object Object]
ADDICTOPHOBIA ,[object Object]
XENOPHOBIA ,[object Object]
STIGMA ,[object Object]
The Origin of “Stigma”   ,[object Object],[object Object],[object Object],Source: Goffman, Ervin.  (1963) Stigma: Notes on the management of spoiled identity. pg. 1.
The Formation of Stigma   ,[object Object],[object Object],[object Object],[object Object],[object Object],The creation of stigma  is the result  of existing stereotypes, prejudice,  biases and other form of  oppression in our  society directed  at individual and/or groups.
EXERCISE ,[object Object],[object Object],[object Object],[object Object],[object Object]
MODULE II THE ORIGIN OF HIV/AIDS RELATED STIGMA
Objectives ,[object Object],[object Object],[object Object],[object Object]
HIV/AIDS Related Stigma ,[object Object],[object Object],[object Object]
HIV/AIDS  Related Stigma ,[object Object],Source:  Herek, G.M., et al. (1996).  AIDS and stigma: A conceptual framework and research agenda.  Research work of the National Institute of Mental Health. Pg. 1.
HIV/AIDS STIGMA ,[object Object],Source: Herek, G.M., & Capitanio, J.P.  1998.  Symbolic prejudice or fear of infection?  A functional analysis of AIDS-related stigma among heterosexual adults.  Basic Applied Social Psychology, 20(3), 230-241.
HIV/AIDS STIGMA ,[object Object],[object Object],Source:  Chesney, M. & Smith, A., 1999.  Critical delays in HIV testing and care.  The potential role of stigma.  American behavioral scientist, (42)7, 1162-1174. Pg. 1170.
Two targets of HIV/AIDS-related Stigma ,[object Object],[object Object],Source:  Herek, G.M., et al. (1996).  AIDS and stigma: A conceptual framework and research agenda.  Research work of the National Institute of Mental Health.
IMPACT OF HIV/AIDS STIGMA ,[object Object],[object Object]
The Origin of  HIV/AIDS Related Stigma ,[object Object],[object Object],[object Object]
The Origin of  HIV/AIDS Related Stigma ,[object Object],[object Object],[object Object],[object Object],Source:  Herek, G.M., & Capitanio, J.P.   1999.  AIDS stigma and sexual prejudice .  American Behavioral Scientist, 42(7), 1130-1147.
The Origin of  HIV/AIDS Related Stigma ,[object Object],[object Object],[object Object],[object Object]
The Origin of  HIV/AIDS Related Stigma ,[object Object],Source:  Institute of Medicine. No time to lose: getting more from HIV prevention.  Washington, DC: National Academy Press, 2001.
The Origin of  HIV/AIDS Related Stigma ,[object Object],[object Object],[object Object],Source: Parker, R and Aggleton, P.  (2002)  HIV/AIDS-related stigma and discrimination:  A conceptual framework and an agenda for action.
The Vicious Circle of Stigma & Discrimination Source: Parker, R and Aggleton, P.  (2002)  HIV/AIDS-related stigma and discrimination:  A conceptual framework and an agenda for action. HIV/AIDS is associated with marginalized behaviors, and PLWH/A are stigmatized because they are assumed to be from a marginalized group.  HIV/AIDS PLWH/A Marginalized Groups Ex.: GLB/T, IDU,  Commercial Sex Worker Are seen as Are Seen as  responsible for
The Vicious Circle of Stigma & Discrimination Source: Parker, R and Aggleton, P.  (2002)  HIV/AIDS-related stigma and discrimination:  A conceptual framework and an agenda for action. Marginalized groups are further  marginalized because they are  assumed to have HIV/AIDS. HIV/AIDS PLWH/A Marginalized Groups Ex.: GLB/T, IDU,  Commercial Sex Worker Are seen as Are Seen as  responsible for
The Expression of  HIV/AIDS Stigma ,[object Object],[object Object]
The Expression of  HIV/AIDS Stigma ,[object Object]
PREVALENCE ,[object Object],Source: Gordis, L. 1996.  Epidemiology.   Pg. 32.
I NCIDENCE ,[object Object],Source: Gordis, L. 1996.  Epidemiology. Pg. 31
The Expression of  HIV/AIDS Stigma ,[object Object],[object Object],[object Object],[object Object],[object Object],Source:  Herek, G.M. (1990). Illness, stigma, and AIDS. In P. Costa & G.R. VandenBos (Eds.),  Psychological aspects of serious illness  (pp. 103-150). Washington, DC: American Psychological Association.
The Expression of  HIV/AIDS Stigma ,[object Object],[object Object],[object Object],Source:  Herek, G., Capitanio, J., & Widaman, K.  2002.  HIV-related stigma and knowledge in the United States.  American Journal of Public Health, 2002, 92(3), 1-14.
Negative Feelings Toward PLWH/A Source:  Herek, G., Capitanio, J., & Widaman, K.  2002.  HIV-related stigma and knowledge in the United States.  American Journal of Public Health, 2002, 92(3), 1-14.
The Expression of  HIV/AIDS Stigma ,[object Object],[object Object]
The Expression of  HIV/AIDS Stigma ,[object Object],[object Object],Source:  Herek, G.M., & Capitanio, J.P.   1999.  AIDS stigma and sexual prejudice .  American Behavioral Scientist, 42(7), 1130-1147.
The Expression of  HIV/AIDS Stigma Source:  Herek, G., Capitanio, J., & Widaman, K.  2002.  HIV-related stigma and knowledge in the United States.  American Journal of Public Health, 2002, 92(3), 1-14.  Q: “People who got AIDS through sex  or drugs use have gotten what they deserve.”
The Expression of  HIV/AIDS Stigma Q: “Most people with AIDS are responsible for having their illness.” Source:  Herek, G., Capitanio, J., & Widaman, K.  2002.  HIV-related stigma and knowledge in the United States.  American Journal of Public Health, 2002, 92(3), 1-14.
Public's views on personal  responsibility for contracting HIV Q:“In general, it’s people’s own fault if they get AIDS.” Source: Kaiser Family Foundation Poll Report
The Expression of  HIV/AIDS Stigma ,[object Object],[object Object]
The Expression of  HIV/AIDS Stigma ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Herek, G.M., et al.  (1998). AIDS and stigma: A conceptual framework and research agenda.  AIDS and Public Policy Journal, 13  (1), 36-47.
The Expression of  HIV/AIDS Stigma ,[object Object],[object Object],[object Object],Source: Kaiser Family Foundation Poll Report
Public's views on discrimination  against PLWH/A Q: “Do you think there has been a lot of discrimination against people with AIDS, or do you think their treatment has been generally appropriate?” Source: Kaiser Family Foundation Poll Report
The Expression of  HIV/AIDS Stigma ,[object Object],[object Object],[object Object],[object Object],[object Object]
The Expression of  HIV/AIDS Stigma ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The Expression of  HIV/AIDS Stigma ,[object Object],[object Object],[object Object],[object Object]
MODULE III HIV/AIDS STIGMA AND IMPACT ON ACCESS TO SERVICES AND CARE
Objectives ,[object Object],[object Object],[object Object]
HIV/AIDS Stigma: Impact on Care ,[object Object],[object Object]
HIV/AIDS Stigma:  Individual Impact ,[object Object]
HIV/AIDS Stigma:  Barrier to Care ,[object Object],Herek, G., Capitanio, J., & Widaman, K.  2002.  HIV-related stigma and knowledge in the United States.  American Journal of Public Health, 2002, 92(3), 1-14. Pg. 1.
HIV/AIDS Stigma:  Barrier to Care ,[object Object],[object Object],[object Object],[object Object],**Source:  Parker and Aggleton.  HIV/AIDS-related stigma and discrimination:  A conceptual framework and an agenda for action.  May  2002.
HIV/AIDS Stigma:Impact on Testing & Counseling ,[object Object],Valdiserri, Ronald. 2002.  HIV/AIDS Stigma: An Impediment to Public Health.  American Journal of Public Health 2002 92: 341-342.  
HIV/AIDS Stigma:Impact on Testing & Counseling   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
HIV/AIDS Stigma:Impact on Testing and Counseling ,[object Object],[object Object],Source:  Chesney, M. & Smith, A.  1999.  Critical delays in HIV testing and care: the potential role of stigma.  American Behavioral Scientis t, 42(7), 1162-1174.
HIV/AIDS Stigma:Impact on Testing & Counseling ,[object Object],[object Object],[object Object],[object Object],Source:  Chesney, M. & Smith, A.  1999.  Critical delays in HIV testing and care: the potential role of stigma.  American Behavioral Scientis t, 42(7), 1162-1174.
HIV/AIDS Stigma:Impact on Testing & Counseling ,[object Object],[object Object],[object Object],Source:  Chesney, M. & Smith, A.  1999.  Critical delays in HIV testing and care: the potential role of stigma.  American Behavioral Scientis t, 42(7), 1162-1174.
HIV/AIDS Stigma:Impact on Testing & Counseling ,[object Object],[object Object]
HIV/AIDS Stigma:Impact on Testing & Counseling ,[object Object],[object Object],[object Object],Source: KFF Health Poll Report.  August 2000.
HIV/AIDS Stigma:  Barrier to Care ,[object Object],[object Object],Source:  Chesney, M. & Smith, A.  1999.  Critical delays in HIV testing and care: the potential role of stigma.  American Behavioral Scientis t, 42(7), 1162-1174.
HIV/AIDS Stigma:  Barrier to Care ,[object Object],[object Object],[object Object],[object Object],Source:  Chesney, M. & Smith, A.  1999.  Critical delays in HIV testing and care: the potential role of stigma.  American Behavioral Scientis t, 42(7), 1162-1174.
HIV/AIDS Stigma:  Barrier to Care ,[object Object],[object Object],Source:  Chesney, M. & Smith, A.  1999.  Critical delays in HIV testing and care: the potential role of stigma.  American Behavioral Scientis t, 42(7), 1162-1174.
HIV/AIDS Stigma:  Barrier to Care ,[object Object],[object Object],[object Object],[object Object],[object Object],Source:  Chesney, M. & Smith, A.  1999.  Critical delays in HIV testing and care: the potential role of stigma. American Behavioral Scientis t, 42(7), 1162-1174 .
HIV/AIDS Stigma:  Barrier to Care ,[object Object],[object Object],[object Object],Source:  Raveis, V. & Siegel, K., 1998.  Factors associated with HIV-infected  women’s delay in seeking medical care.  AIDS care, 5(10), 549-562.
HIV/AIDS Stigma:   Disclosure of Status ,[object Object],[object Object]
HIV/AIDS Stigma:   Disclosure of Status ,[object Object],Source:  Chesney, M. & Smith, A., 1999.  Critical delays in HIV testing and care.  The potential role of stigma. American behavioral scientist, (42)7, 1162-1174.
HIV/AIDS Stigma:   Disclosure of Status ,[object Object],[object Object],[object Object],Source:  Herek, G.M. (1990). Illness, stigma, and AIDS. In P. Costa & G.R. VandenBos (Eds.), Psychological aspects of serious illness  (pp. 103-150). Washington, DC: American Psychological Association.
HIV/AIDS Stigma:   Disclosure of Status ,[object Object],[object Object],[object Object],[object Object],Source:  Herek, G.M. (1990). Illness, stigma, and AIDS. In P. Costa & G.R. VandenBos (Eds.), Psychological aspects of serious illness  (pp. 103-150). Washington, DC: American Psychological Association.
HIV/AIDS Stigma:   Disclosure of Status ,[object Object],[object Object],[object Object],Source:  Chesney, M. & Smith, A., 1999.  Critical delays in HIV testing and care.  The potential role of stigma. American behavioral scientist, (42)7, 1162-1174.
HIV/AIDS Stigma:   Disclosure of Status ,[object Object],[object Object],[object Object],Source:  Chesney, M. & Smith, A., 1999.  Critical delays in HIV testing and care.  The potential role of stigma. American behavioral scientist, (42)7, 1162-1174.
HIV/AIDS:  Racial/Ethnic  Health Disparities ,[object Object],[object Object]
HIV/AIDS:  Racial/Ethnic  Health Disparities ,[object Object],[object Object],Source: Unequal Treatment: Confronting racial and ethnic disparities in health care. 2002
HIV/AIDS:  Racial/Ethnic  Health Disparities ,[object Object],[object Object],Source: Unequal Treatment: Confronting racial and ethnic disparities in health care., p.5.
HIV/AIDS:  Racial/Ethnic  Health Disparities ,[object Object],[object Object],[object Object]
HIV/AIDS:  Racial/Ethnic  Health Disparities ,[object Object],[object Object],Source:  Institute of Medicine Report.  Unequal treatment: confronting racial and ethnic disparities in health care.  National Academy press, 2002.
HIV/AIDS:  Racial/Ethnic  Health Disparities ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Shapiro, et al.  1999.  Variations in the care of HIV-infected adults in the US.  JAMA, 281:24(June):2305-2315  **MMWR.  Late versus early testing of HIV-16 sites, United States, 2000-2003.  June 27, 2003/Vol.52/No.25.
HIV/AIDS:  Racial/Ethnic  Health Disparities ,[object Object],[object Object],[object Object],[object Object]
MODULE IV HIV/AIDS STIGMA AND MANIFESTATION IN SOCIETY
Objectives ,[object Object],[object Object],[object Object],[object Object]
HIV/AIDS:  Related Stigma ,[object Object],[object Object],[object Object],*Source:  Herek, G.M., et al.  (1998). AIDS and stigma: A conceptual framework and research agenda.  AIDS and Public Policy Journal, 13  (1), 36-47.
HIV/AIDS:  Related Stigma ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Source:  Herek, G.M., et al.  (1998). AIDS and stigma: A conceptual framework and research agenda.  AIDS and Public Policy Journal, 13  (1), 36-47.
HIV/AIDS:  Related Stigma ,[object Object],[object Object],[object Object],[object Object],[object Object],Source:  Herek, G.M., et al.  (1998). AIDS and stigma: A conceptual framework and research agenda.  AIDS and Public Policy Journal, 13  (1), 36-47.
HIV/AIDS:  Related Stigma ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Source:  Herek, G.M., et al.  (1998). AIDS and stigma: A conceptual framework and research agenda.  AIDS and Public Policy Journal, 13  (1), 36-47.
HIV/AIDS:  Related Stigma ,[object Object],[object Object],[object Object]
HIV/AIDS:  Related Stigma ,[object Object],[object Object],[object Object],[object Object],[object Object],Source:  Snyder, M. et al. (1999)  Punished for their good deeds:  Stigmatization for AIDS volunteers. American Behavioral Scientist.  42(7), 1175-92.
HIV/AIDS:  Related Stigma ,[object Object],[object Object]
HIV/AIDS:  Related Stigma ,[object Object],[object Object],[object Object],[object Object],Source:  Fazio, R.H. (1990)  Multiple processes by which attitudes guide behavior:  the Mode Model as an integrative framework. Advances in experimental and Social Psychology.  (23)75-109.
HIV/AIDS:  Related Stigma ,[object Object],[object Object],[object Object],[object Object],[object Object]
The MODE Model Person Sees Attitude Object (e.g., gay man, sex worker, drug user) Automatic Process -Object is evaluated-an unconscious process Homosexual/promiscuous Sex worker /immoral Drug user/criminal Cost/Benefit Process -person weighs the cost of a particular attitude-relevant behavior Attitude towards individual expressed
HIV/AIDS:  Related Stigma ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
HIV/AIDS:  Related Stigma ,[object Object],[object Object],[object Object],[object Object]
HIV/AIDS:  Related Stigma ,[object Object],[object Object],[object Object],[object Object]
MODULE V THE PROCESS OF COUNTERING  HIV/AIDS STIGMA
Objectives ,[object Object],[object Object],[object Object],[object Object]
COUNTERING  HIV/AIDS STIGMA ,[object Object],[object Object],[object Object]
COUNTERING  HIV/AIDS STIGMA ,[object Object],[object Object],[object Object],[object Object],[object Object]
COUNTERING  HIV/AIDS STIGMA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Source: Brown, L., Trujillo, L., & Macintyre, K.  Interventions to reduce HIV/AIDS stigma: What have we learned?  August 2001.
COUNTERING  HIV/AIDS STIGMA ,[object Object],[object Object],[object Object],Source: Brown, L., Trujillo, L., & Macintyre, K.  Interventions to reduce HIV/AIDS stigma: What have we learned?  August 2001.
COUNTERING  HIV/AIDS STIGMA ,[object Object],[object Object],[object Object],Source: Brown, L., Trujillo, L., & Macintyre, K.  Interventions to reduce HIV/AIDS stigma: What have we learned?  August 2001.
COUNTERING  HIV/AIDS STIGMA ,[object Object],[object Object],[object Object],[object Object],Source: Brown, L., Trujillo, L., & Macintyre, K.  Interventions to reduce HIV/AIDS stigma: What have we learned?  August 2001.
COUNTERING  HIV/AIDS STIGMA ,[object Object],[object Object],Source: Brown, L., Trujillo, L., & Macintyre, K.  Interventions to reduce HIV/AIDS stigma: What have we learned?  August 2001.
COUNTERING  HIV/AIDS STIGMA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
COUNTERING  HIV/AIDS STIGMA ,[object Object],[object Object],[object Object],[object Object],[object Object]
COUNTERING  HIV/AIDS STIGMA ,[object Object],[object Object],[object Object],[object Object],[object Object]
COUNTERING  HIV/AIDS STIGMA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
COUNTERING  HIV/AIDS STIGMA ,[object Object],[object Object],[object Object],[object Object],[object Object]
COUNTERING  HIV/AIDS STIGMA ,[object Object],[object Object],[object Object]
MODULE VI COUNTERING THE EFFECTS OF HIV/AIDS STIGMA WITHIN ORGANIZATIONS
Objectives ,[object Object],[object Object],[object Object]
REDUCING BARRIERS ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],REDUCING BARRIERS
[object Object],REDUCING BARRIERS
[object Object],[object Object],REDUCING BARRIERS
[object Object],[object Object],REDUCING BARRIERS
REDUCING BARRIERS ,[object Object],[object Object]
[object Object],[object Object],REDUCING BARRIERS
[object Object],[object Object],[object Object],[object Object],[object Object],REDUCING BARRIERS
[object Object],[object Object],[object Object],[object Object],[object Object],REDUCING BARRIERS
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],REDUCING BARRIERS
[object Object],[object Object],[object Object],REDUCING BARRIERS

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2006 stigma nmac u

  • 1. HIV/AIDS Stigma & Access to Care Carlos Velez, JD Director Technical Assistance, Training and Treatment Technical Assistance, Training and Treatment Division NATIONAL MINORITY AIDS COUNCIL
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  • 6. MODULE I KEY TERMS
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  • 22. MODULE II THE ORIGIN OF HIV/AIDS RELATED STIGMA
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  • 35. The Vicious Circle of Stigma & Discrimination Source: Parker, R and Aggleton, P. (2002) HIV/AIDS-related stigma and discrimination: A conceptual framework and an agenda for action. HIV/AIDS is associated with marginalized behaviors, and PLWH/A are stigmatized because they are assumed to be from a marginalized group. HIV/AIDS PLWH/A Marginalized Groups Ex.: GLB/T, IDU, Commercial Sex Worker Are seen as Are Seen as responsible for
  • 36. The Vicious Circle of Stigma & Discrimination Source: Parker, R and Aggleton, P. (2002) HIV/AIDS-related stigma and discrimination: A conceptual framework and an agenda for action. Marginalized groups are further marginalized because they are assumed to have HIV/AIDS. HIV/AIDS PLWH/A Marginalized Groups Ex.: GLB/T, IDU, Commercial Sex Worker Are seen as Are Seen as responsible for
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  • 43. Negative Feelings Toward PLWH/A Source: Herek, G., Capitanio, J., & Widaman, K. 2002. HIV-related stigma and knowledge in the United States. American Journal of Public Health, 2002, 92(3), 1-14.
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  • 46. The Expression of HIV/AIDS Stigma Source: Herek, G., Capitanio, J., & Widaman, K. 2002. HIV-related stigma and knowledge in the United States. American Journal of Public Health, 2002, 92(3), 1-14. Q: “People who got AIDS through sex or drugs use have gotten what they deserve.”
  • 47. The Expression of HIV/AIDS Stigma Q: “Most people with AIDS are responsible for having their illness.” Source: Herek, G., Capitanio, J., & Widaman, K. 2002. HIV-related stigma and knowledge in the United States. American Journal of Public Health, 2002, 92(3), 1-14.
  • 48. Public's views on personal responsibility for contracting HIV Q:“In general, it’s people’s own fault if they get AIDS.” Source: Kaiser Family Foundation Poll Report
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  • 52. Public's views on discrimination against PLWH/A Q: “Do you think there has been a lot of discrimination against people with AIDS, or do you think their treatment has been generally appropriate?” Source: Kaiser Family Foundation Poll Report
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  • 56. MODULE III HIV/AIDS STIGMA AND IMPACT ON ACCESS TO SERVICES AND CARE
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  • 87. MODULE IV HIV/AIDS STIGMA AND MANIFESTATION IN SOCIETY
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  • 98. The MODE Model Person Sees Attitude Object (e.g., gay man, sex worker, drug user) Automatic Process -Object is evaluated-an unconscious process Homosexual/promiscuous Sex worker /immoral Drug user/criminal Cost/Benefit Process -person weighs the cost of a particular attitude-relevant behavior Attitude towards individual expressed
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  • 102. MODULE V THE PROCESS OF COUNTERING HIV/AIDS STIGMA
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  • 117. MODULE VI COUNTERING THE EFFECTS OF HIV/AIDS STIGMA WITHIN ORGANIZATIONS
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Notas do Editor

  1. Ask Audience about other identities they may think about.