Stephen Leahy
TORONTO, Canada, Aug 17 2006 (IPS) – The promise of new vaccines and more effective prevention programmes will fail to halt the spread of HIV/AIDS unless fear and social stigma can also be eliminated including among those living with the disease, experts say.
Beyond the personal misery it brings, this stigma also means that many people refuse to be tested or follow up on the results, or even to take life-extending medications.
Only 10 percent of people living with HIV in the world are aware of their HIV status, said Kevin De Cock, director of the World Health Organisation s (WHO) department of HIV/AIDS at the 16th annual International AIDS Conference in Toronto.
Researchers here report that some HIV-positive pregnant women in South Africa have refused to take a free drug that would dramatically reduce the odds of the virus being passed along to their babies, because it would mean acknowledging they were infected, and the discrimination within their communities against those who are HIV-positive is so powerful they would risk the health of their children.
The two biggest celebrities at the conference, former U.S. President Bill Clinton (1991-2000) and Bill Gates, co-chair of the Bill Melinda Gates Foundation, also called on world leaders to do more to combat the stigma surrounding HIV/AIDS.
Julia Göd, chair of the Onghalo Association and a medical doctor in a Vienna, Austria hospital who has worked in AIDS clinics in various African countries, agrees that, Many people in Africa and elsewhere are denying there is a problem, even those who have been infected.
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The Austrian-based Onghalo Association raises funds to help a grassroots home-care support group in northern Namibia that educates and trains HIV-affected families in how to cope.
They don t feel there is real danger from the disease, Göd told IPS in an interview in Vienna last week.
As a result, there is not the urgency or awareness of the problem that would generate widespread use of condoms and reduce risky behaviours, she said, adding that, Infected people are often neglected by their families, who sometimes think the disease is a punishment from God.
Through counseling, this fear can be reduced and families learn how they can help, she said.
Still, misconceptions about HIV remain widespread 25 years after it was first identified. People in both urban and rural areas in Ethiopia, Tanzania, Vietnam and Zambia commonly expressed the fear that the virus could be transmitted through ordinary, daily interactions with people living with HIV or AIDS, according to a study by the International Centre for Research on Women (ICRW).
In a 2004-05 survey conducted in Tanzania, ICRW found that more than half of people with HIV/AIDS had experienced at least one form of stigma or discrimination, including isolation, physical and verbal abuse, and job loss. In nearly every case, women reported experiencing stigma more often than men. Women also experienced acts of physical violence twice as often as men.
In many parts of the world, people living with HIV and AIDS are in constant fear of their status being found out and what will happen to them and their families when that happens, said ICRW President Geeta Rao Gupta.
If we re to end the AIDS pandemic, we must address AIDS stigma and discrimination, she stressed.
ICRW is a Washington-based non-governmental organisation dedicated to improving the lives of women in poverty.
People s fear of AIDS stigma reduces the effectiveness of HIV/AIDS prevention, treatment and care programmes because people who are infected may be reluctant to use these services, said Laura Nyblade, ICRW s lead researcher on AIDS stigma.
And the disclosure delays we re finding after testing even among spouses are deeply troubling for preventing further transmission of the virus and accessing care, support and treatment, she said.
Often, people do not return after testing to find out their results because they fear that a positive result will mean they are blamed for bringing the disease into their family.
Joe Amon, director of HIV/AIDS programmes at Human Rights Watch, says that voluntary counseling should be included in all testing programmes, although less than one percent of adults in the world now have access to such services.
In fact, some government testing policies not only violate individual rights and fail to contribute to HIV prevention and treatment goals, but they actually have the effect of worsening discrimination, Human Rights Watch says. These include a proposal by the state government of Goa in India to require mandatory premarital testing, despite opposition by women s groups and AIDS activists; and mandatory HIV testing in Saudi Arabia for foreign workers, who are then confined to locked hospital rooms and deported if found to be HIV-positive.
The group also criticised proposals in the last few years by Malawi and Sierra Leone to test all journalists; in China to test all workers in the tourism sector and beauty parlors in the city of Guiyang; in Botswana to test all students applying for scholarships; and in India to test all individuals wishing to obtain or retain a driver s license in Punjab state.
By contrast, a programme in Uganda that provides treatment, counseling, condoms and voluntary at-home HIV testing has decreased HIV transmission by 98 percent.
There is little or no evidence that HIV testing by itself has any impact on this deadly epidemic, said Amon in a statement. But voluntary HIV testing programmes that respect rights, ensure confidentiality and are linked to counseling and treatment have been enormously successful.
Human Rights Watch also warned that governments are increasingly adopting or strengthening laws criminalising HIV transmission, and that these laws are often arbitrarily applied.
