By Carolyn Hemminger
10 June 2009 [MEDIAGLOBAL]: HIV-related stigma has become a major obstacle to HIV treatment and prevention in the developing world.
Marcela Rojo, a communications officer from the Global Fund to Fight AIDS, Tuberculosis, and Malaria, told MediaGlobal, “Stigma and discrimination associated with AIDS delays treatment and care for HIV-positive people, and prevents people coming forward for testing.”
This discrimination exists everywhere, but it can manifest itself differently among countries, communities, religious groups, and individuals. It often shows itself alongside other forms of prejudice, such as racism, sexism, homophobia, and discrimination against socially unacceptable behaviors such as drug use and prostitution.
HIV-related stigma makes it difficult for people to come to terms with their status, and it also makes it difficult to manage the epidemic as a whole because societies who are unwilling to admit the existence of the disease cannot take the steps necessary to overcome it.
“Stigma remains the single most important barrier to public action. It is a main reason why too many people are afraid to see a doctor to determine whether they have the disease, or to seek treatment. It helps make AIDS the silent killer, because people fear the social disgrace of speaking about it, or taking easily available precautions. Stigma is a chief reason why the AIDS epidemic continues to devastate societies around the world,” says United Nations Secretary-General Ban Ki-moon.
There are several factors that contribute to HIV-related stigma.
For example, many die from this disease, especially if it is left untreated, so people become afraid that they could suffer the same fate if they come into contact with someone who is HIV-positive.
Since AIDS is often associated with prostitutes, drug-users, and promiscuous individuals, societies may look at the disease as punishment for bad behavior.
Many people are simply ignorant of how HIV is transmitted, and so they treat all those who are infected as village lepers.
HIV/AIDS is a relatively recent disease, and the fears established at the beginning of the epidemic are still fresh in the minds of many.
Stigma is especially debilitating for both the individual and the societal care of HIV/AIDS. Because people are afraid of being stigmatized, they often refuse to be tested. If they test positive, they frequently do not reveal their status to anyone. They also might try to hide that they are getting treatment, sometimes inconsistently taking medication, or they might refuse treatment all together. It also makes it difficult for HIV-positive persons to use preventative methods to avoid further infections, such as using condoms. Because if they insist on using condoms, people might assume they have the disease.
Stigma can lead to many challenges in developing countries. People who are discriminated against because of their HIV-status can lose their jobs, their spouses, or their families. Many are shunned from their communities. This can lead to HIV-positive people falling into depression and not taking care of themselves because it seems like nobody cares about them. They can start to behave recklessly, which can potentially spread the infection to others.
All of these instances exacerbate the expansion of the epidemic.
Without public action and awareness about how HIV is transmitted and how it can be managed, the epidemic will spiral out of control. One of the most important ways to reduce AIDS-related stigma is for civil society as well as governments, to publicly recognize and manage HIV as just a disease, and not something to be feared. Only then can it be dealt with properly at all levels.
The international community is beginning to realize the effect that AIDS-related stigma is having on the spread of the disease. Partnerships between countries and international organizations are taking steps to counteract this occurrence.
Several of their projects have the potential to make big changes in HIV-related stigma.
To improve knowledge among its youth, Jamaica, with the help of the Global Fund, has created a hotline where young people can be advised and informed about sex, relationships, and sexually-transmitted infections, especially related to HIV. The hotline also provides young people with referrals to youth-oriented organizations where they can receive face-to-face counseling or voluntary counseling and testing. The staff is completely trained to be sensitive and knowledgeable toward any questions that its callers might have. It is hoped that this hotline will give young people the real facts about HIV/AIDS, so that they can make choices that will limit their risk for contracting the disease and reduce related stigma.
China, with the help of the International Labor Organization (ILO), is also trying to raise awareness about the facts of HIV/AIDS. It has plans to release a new film, Never Abandon, Never Give Up, on its national railway television station that will combat HIV stigma, which is prevalent in the country. Dr Bernhard Schwartlander, UNAIDS country coordinator in China, said, “This movie is an excellent production which can help to reduce stigma and discrimination against people living with HIV.” The movie will star a famous Chinese actor, and will be shown in 500 stations and could be viewed by as many as 400 million people. It has the potential to enlighten many people, de-stigmatize HIV, and halt the spread of the disease in China.
Once HIV/AIDS becomes an open topic of conversation among groups, communities, and nations, then people can learn the facts surrounding it, which can dramatically reduce its stigma.
