When Anti-Stigma Campaigns Backfire: What We Need to Do Differently

Stigma reduction campaigns are built on good intentions, but good intentions don’t guarantee good outcomes. If we want campaigns that actually reduce harm, we have to acknowledge how different audiences interpret these messages, how systems generate stigma, and how language and power shape the impact.

That was the topic of the most recent Spotlight on Stigma webinar, which took place on 23 October 2025, featuring Professor Jason T Siegel, Professor Marco Yzer, Dr Elena Jeffreys and Aisya A Zaharin, chaired by Scientia Professor Carla Treloar and Dr. Elena Cama from the UNSW Centre for Social Research in Health.

The webinar made it very clear: a message intended to reduce stigma can just as easily deepen it.

“Anti-stigma campaigns can do a world of good… but we do believe that some campaigns do have unintended effects… anyone who is trying to improve the world for people through anti-stigma campaigns has to accept you can cause harm,” Professor Jason T. Siegel.

Siegal pointed to real examples: myth-vs-fact campaigns for HIV that unintentionally reinforced the myth in people’s minds, and public health messaging that framed alcohol dependence as a “brain condition,” which led some to feel less able to change their drinking because the campaign implied they had no control.

Here’s how we can minimise the damage.

1). People with lived experience don’t see campaigns the same way the general population does

People come to a campaign from very different positions. Some are potential targets of the stigma, some are advocates, and some are potential stigmatisers.

Most campaigns are built for “the general population,” but people living with the condition see themselves in the message. And sometimes what they see isn’t support, it’s shame, distance, or confirmation that they’re alone.

Siegel shared an example of a campaign encouraging people to “be there” for friends with mental illness. For some viewers with depression, the message didn’t feel hopeful — it reinforced the fear that no one would be there for them.

“It made me feel incredibly isolated, as though I would likely have no one to turn to if times got hard,” research participant.

Remember: Always test messaging with the community being represented. Not as a courtesy, but as core quality control.

2). Stigma is not just interpersonal — it is built and maintained by systems

Dr. Elena Jeffreys reminded us that stigma is not only about personal attitudes. It is designed and held in place by institutions and systems — law, policing, border controls, child protection, healthcare, welfare systems, and norms about family and sexuality. These systems are structured in ways that exclude stigmatised groups, and that exclusion is not accidental. It is built in.

“The oppression of sex workers is not because of sex work. In sex worker theory, the oppression of sex workers is because of systems that are upholding heteronormativity, monogamy and structures of the family. And those systems activate stigma for a reason,” Dr. Elena Jeffreys

Remember: Stigma reduction must involve structural change, not just attitude change.

3). Disclosure is not always safe — and campaigns often pretend it is

Campaigns often encourage people to “be open,” “tell their story,” or “come forward” — assuming visibility will reduce stigma. But visibility is only safe when systems are safe. For many sex workers, people who use drugs, migrants, and those living under policing or surveillance, disclosure can lead directly to negative and adverse outcomes.

In the webinar, Professor Marco Yzer spoke about some study participants experiencing mental health conditions who had been disowned by family members. Dr. Elena Jeffreys reinforced the message.

“For sex workers, especially in criminalised settings, simply stepping forward does not resolve the fact that those systems are built on anti–sex work concepts. When we come forward, we risk punishment, rejection, humiliation, or criminalization,”  Dr. Elena Jeffreys

Remember: Do not build campaigns that push disclosure as a goal. If disclosure is unsafe, the work is to change the system, first.

4). Language shapes power — and the “rescue narrative” makes stigma worse

Aisya A. Zaharin highlighted that language isn’t neutral, every word carries assumptions about power, agency, legitimacy, and who is positioned as needing to be “helped.” When campaigns use language of pity, innocence, or rescue, they reinforce the idea that some people are passive, dependent, or broken.

“Most of the time, people think sex work is an industry that needs to be rescued. But many of us are in this work because we want it, because we find it empowering. And for a lot of trans women, this is the last safety net to earn,” Aisya A. Zaharin.

Remember: Avoid framing communities as recipients of help. Use language that reflects self-determination, leadership, and expertise within the community itself.

5). There is no single audience — groups are not homogenous

We often talk about a “group” as if everyone in it is the same. But a community, whether that’s sex workers, people who use drugs, people living with HIV, or any other stigmatised group, is made up of individuals with different identities, risks, needs, histories, and levels of safety. That diversity within a group is heterogeneity.

When campaigns treat the whole group as if everyone shares the same experience, the message may support some people, miss others entirely, and actively harm those whose realities weren’t considered.

“We would love to get to the point where we can really pull apart the different experiences within a stigmatised group and go deeper — but we’re not even doing the first step. Most evaluations of anti-stigma campaigns don’t look at how the campaign affects the people with the condition. Step one is to actually listen to them. And then, yes — the more we understand the heterogeneity, the more we can tailor, and the better off we’ll be,” Professor Jason T. Siegel.

Remember: Break audiences down into smaller, specific groups and tailor the message to each — stop designing campaigns for a theoretical “general public” or a flattened version of a community.

6). Telling people what to think can trigger resistance

Professor Marco Yzer explained that many anti-stigma campaigns assume that if we just provide the “right” information, people will accept it. But messages are never received in isolation — people interpret them through their own beliefs, identities, and motivations. When a campaign tells people what they should think or how they ought to behave, it can trigger resistance.

And while campaigns often repeat messages to make them stick, repetition can actually intensify that resistance if the message feels instructional or corrective.

“When we tell people what they should do and what they should not do, psychologically that can create resistance. The response becomes: ‘Don’t tell me what to do,’” Professor Marco Yzer

Remember: Don’t instruct audiences. Invite them. Use messages that open space for reflection, shared values, curiosity, or recognition — not directives.

Should we stop running anti stigma campaigns?

We don’t need to stop running anti stigma campaigns — we need to stop running them on assumptions. The people most affected must be centered in message design, testing, and decision-making.

To go deeper into the evidence and typologies discussed in this session, read the paper Adverse Unintended Effects of Antistigma Campaigns and Intervention Messages: A Typology of Iatrogenic Outcomes Among the General Population and Those With Stigmatized Conditions here.