HIV/AIDS: STIGMA

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1.                 MAJOR CHALLENGES: STIGMA AND HIV/AIDS

“Stigma in terms of HIV/AIDS is any form of behaviour towards a person living with HIV/AIDS that leaves the individual feeling unwanted or dejected. It can occur in different settings – healthcare setting, home, office, church or community. HIV/AIDS-related stigma is a real or perceived negative response to a person or persons by individuals, communities or society. It is characterized by rejection, denial, discrediting, disregarding, underrating and social distance. It frequently leads to discrimination and violation of human rights.” [1]

The Joint United Nations Programme on HIV/AIDS has defined HIV/AIDS-related discrimination as follows “Any measure entailing any arbitrary distinction among persons depending on their confirmed or suspected HIV serostatus or state of health”.

HIV/AIDS is not the only disease that is affected by stigma other conditions like epilepsy, cancer, tuberculosis, syphilis and psychiatric illnesses are stigmatizing diseases, what differentiates HIV from them is that people living with HIV are stigmatized for a multi-dimensional number of reasons which go beyond the physical illness itself. Some of the reasons are:

• HIV is associated with a number of behaviours that are regarded as deviant by society, i.e. homosexuality, drug use, promiscuity etc.
• People are afraid of getting infected with the virus
• HIV has no cure and finally
• Religious or moral beliefs lead some people to conclude that having HIV/AIDS is the result of a moral fault that deserves punishment and that God is punishing people that is why some people are HIV positive.

Causes of Stigma in HIV/AIDS

The cause of stigma and discrimination can be reduced to the following points:

• Fear: Fear is a powerful feeling. When people are afraid of something they run away from it and as they run away from it the less correct and accurate information they will get about the object of their fear. This leads to the fear increasing and a vicious cycle is continued.
• Ignorance: Ignorance is the harbinger of fear, and the source of misinformation.
• Intolerance: This occurs when people are unwilling to cooperate and compromise. Intolerance is breed by people’s inability to accept diversity and difference
• Denial: Is a phenomenon whereby instead of people facing the reality of a situation they would rather avoid the situation.
• Misinformation: This one of the biggest causes of stigma. When people are ignorant of certain information they will make up stories or embellish the stories to suit their own thoughts and values about the situation.

Forms of Stigma

There are 2 major forms of stigma.

1. Felt Stigma: Self Stigma -This refers to the stigma that a PLWHA develops towards him/herself as a result of all the negative misconception that the individual has about a positive HIV result. Self Stigma can be manifested in the following ways: loss of interest, withdrawal, dejection, loss of self-esteem, guilt, isolation, etc.
2. Enacted Stigma: This refers to the stigma that a PLWHA faced from his environment because of his status as HIV positive. The various form of enacted stigma are:

• Family Stigma: This refers to stigma within the family and friends. Manifestations of stigma in family include: rejection of infected person by family members and friends, family refuse to share food, room or talk with infected person, etc.
• Community Stigma: This refers to stigma within the community and community member refuses to interact with PLWHAs
• Religious Stigma: This refers to stigma within religious Organizations, such as churches and mosques. Religious stigma are manifested in the same way as does mentioned in the area of community stigma but it is unique because the PLWHA will be labelled a sinner and is can be regarded as deserving the HIV punishment for his/her sins.
• Media related Stigma: This refers to stigma that is perpetrated by the mass media. This includes referring to PLWHAs as “victims” or “promiscuous people”, or disclosing the status of a PLWHA without consent.
• Office/Work Place Stigma: This refers to stigma that occurs within an Office or work place.

Consequences of Stigma and Discrimination

Stigma and discrimination affects the individual but it also affects the society at large when it continues and is not remedied. Below are some of the consequences of Stigma and discrimination:

• It Limits peoples access to healthcare because people fear stigmatization that may occur if they go to HIV clinics and others people get to find out.
• It increases HIV prevalence and incidence in the country because people are afraid to disclose their HIV status for fear of stigma caused by lack of disclosure.
• When PLWHA are discriminated against economically (unjustly sacked) the loss is that of the whole family which is affected by the loss in income
• Because of the fear of disclosing their HIV status, PLWHA are not able to access the social support available to them in the society
• There is increase in psychological and emotional disturbances amongst PLWHA which takes a toll on the society as a whole
• The PLWHA may Loss self esteem and confidence and this may leave the person unable to face challenges ahead of him/her.

Strategies to Address Stigma and Discrimination

The issue of stigma and discrimination can only be resolved with a concerted effort from all levels. As shown stigma and discrimination can occur anywhere and can be perpetrated by anybody even loved ones. All stakeholders in the fight against HIV have to be involved in addressing the issue of stigma and discrimination and how to combat it. Some strategies which have worked in other countries and can be adopted appropriately can be found below:

• Planning and formulating of comprehensive HIV prevention and care activities that will involve all necessary stakeholders.
• Advocacy/sensitization of communities about HIV/AIDS to demystify it
• Inclusion of HIV/AIDS into various curricula across the country to ensure that all young people are aware and knowledgeable about HIV/AIDS.
• The Government should ensure that policies aimed at reducing stigma and protecting the rights of PLWHA are adopted and implemented.
• HIV Counselling and Testing should be promoted and encouraged with emphasis on the benefits of knowing ones status.
• Improving access to HIV treatment, care and support by increasing the number of HIV treatment centres across the country
• Giving the virus a human face through PLWHA activist who will speak out about living with the virus
• Promoting the establishment of autonomous self-help groups/support groups that will act as support system and advocates for PLWHA in the country

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[1] Definition of HIV-AIDS related stigma produced from Stigma-AIDS 2001, discussions and Regional Consultation on Stigma and HIV/AIDS in East and Southern Africa, 2001

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