“HAVING gone for Voluntary Counseling and Testing (VCT) and disclosed my status, was the worst thing that I regret having done because it subjected me and my family to all kinds of discrimination and name calling from my community,” these were the words of Hildah Siatwiinda, 45, of Livingstone’s Libuyu Township.
Ms Siatwiinda says she regrets having gone for an HIV test and disclosed that she was positive after being advised by the medical personel at Maramba Clinic that she should disclose her status to close friends and her relatives.
She recalls that after undergoing the test, she went home and did as she was advised by the health professionals, however, she became depressed when people in her coommunity starting looking down on her.
Ms Siatwiinda said the response from her community and neighbours made her lose hope for the future.
“Being diagnosed with HIV can be a traumatic experience especially when people around you start condemning you and their continued judgmental attitude. Whether you’re 15 or 55, the emotions that accompany an HIV diagnosis can be overwhelming because of the misunderstandings from society on how you were infected,”
“So can the millions of questions, small and large, that start shooting through your mind: How could this happen to me? How will my life change? Who should I tell? Will anyone still love me? Will I have to take treatment for the rest of my life? How will society look at me morally? Hence need to educate society on the dangers of stigma and discrimination,” she recalled.
Because HIV is sexually transmitted, it is often presumed that those living with the virus have brought the disease upon themselves by having many sexual partners.
Women are especially vulnerable to this prejudice, and they may also be blamed for infecting their children even though the father may have been the first one to be infected.
Victims of stigma suffer physical and social isolation from their family, friends and community; they are made to feel guilty, ashamed and inferior.
Those associated with people living with HIV also suffer from stigma, as do those thought to be responsible for spreading infection, such as sex workers, traders and migrant workers even if they are not themselves known to be infected.
Stigma does not just cause agony to individuals, but also hampers prevention and care programmes. Those who fear becoming stigmatised are unwilling to volunteer for an HIV test, even buying condoms or discussing safer sex may be seen as an indication that is infected.
Ms Siatwiinda noted that stigma was the greatest enemy to the fight against HIV/AIDS because very few people could stand the pressure of being stigmatised.
People who know or suspect that they are HIV positive may be reluctant to reveal their status even to their partners and family or to come forward for treatment.
Managing a life-threatening and socially stigmatised illness is difficult for adolescents and the aged, this burden can be eased if people stop stigmatising the infected and the affected.
Tragically, some of the worst discrimination occurs in clinics and hospitals. Patients known or suspected to have HIV are sometimes given very low priority and may be subjected to degrading treatment, they may even be denied drugs and treatment.
The majority of people who develop AIDS are in their productive years and are often the sole breadwinners in their households. When an adult falls ill, other family members, in particular children that are kept home from school must try to raise money or tend crops as well as looking after their ailing relative.
Much of the cash they (parents) make is spent on medical care and, ultimately, funeral costs. When a parent dies, survivors can be left destitute.
People in need have traditionally been supported by their extended families, but the toll of the epidemic is now so great that family structures can no longer cope. Stigma compounds the problem, as many of those affected by AIDS become socially excluded.
And to make matters worse, when the male head of a household dies it is not unheard of for his entire property to be “grabbed” by his relatives despite laws meant to prevent this, leaving his widow and children with nothing. Desperate people will inevitably turn to risky occupations or migration.
Ms Siatwiinda disclosed that when she got ill, every productive activity in her family became static and the family suffered a lot of shame and hunger.
She said very little did she know that disclosing her status would cost her family and bring a lot of suffering to both her children and herself, adding that even her children suffer discrimination and stigma at their various schools.
Thousands of children are abandoned due to stigma or simplly lack of resources, while others run away because they have been mistreated and abused by foster families. Many such children congregate in the big cities, where they live by begging, stealing and prostitution.
Fears about family rejection, loss of a job, and public shunning impede the effectiveness of HIV/AIDS prevention, care efforts and worse off, the fight against this disease.
Stigma and discrimination discourages those who are infected with and affected by HIV/AIDS from seeking needed services because seeking services may reveal their HIV status to their families, workplace colleagues, or community.
Ideas about the lifestyles of people living with HIV/AIDS contribute to a sense that HIV/AIDS is a problem that affect “others,” which may undermine individuals’ estimation of their own risk and reduce their motivation to take preventive measures.
HIV-related stigma and discrimination remains an enormous barrier to the fight against the scourge not only in Zambia but worldwide.
Fear of discrimination often prevents people from getting tested, seeking treatment and admitting their HIV status publicly hence affecting the much needed progress in the fight against the epidemic.
Since laws and policies alone cannot reverse the stigma that surrounds HIV infection, more and better AIDS education is needed in Africa and throughout the world to combat the ignorance that causes people to discriminate. There are several factors that contribute to the spread of HIV/AIDS pandemic and among them is stigma and discrimination.
Stigma and discrimination are on record in all the research on HIV/AIDS of discouraging people from going for Voluntary Testing and Counseling (VCT).
Recently, Ministry of Health, Anti-retroviral (ARVs) programme coordinator Albert Mwango expressed concern at the number of people going for VCT and accessing ARVs in all the health centers countrywide.
Dr Mwango said in Lusaka that only about 400,000 people countrywide were aware of their status after going for VCT and yet the country has a population of more than 11.1million, adding that the only sure way to fight HIV/AIDS was for people to go for VCT.
“Knowing your status in the best way to fight this disease that has for 24 years now impacted negatively on the economy of this country. Stigma and discrimination are often the major cause for people shunning away from knowing their status,” he said.
The fear and prejudice that lies at the core of HIV/AIDS discrimination needs to be tackled at both community and national levels.
Sexually transmitted diseases are well known for triggering strong responses and reactions. In the past, in some epidemics, for example TB, the real or supposed contagiousness of the disease has resulted in the isolation and exclusion of infected people.
In the early days of the AIDS epidemic, a series of powerful images were used that reinforced and legitimised stigmatisation, for example, two images depicting human beings before and after being infected with AIDS.
Stigma and discrimination can arise from community-level responses to HIV/AIDS. The harassing of individuals suspected of being infected or of belonging to a particular group has been widely reported.
By blaming certain individuals or groups, society can excuse itself from the responsibility of caring for and looking after such populations. This is seen not only in the manner in which ‘outsider’ groups (i.e truck drivers and cross border traders) are often blamed for bringing HIV into a country, but also in how such groups are denied access to the services and treatment they need.
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