This WAR on HIV must be won by education & awareness!Combat HIV stigma
4 Dec 2007, 0001 hrs IST,Subhadra Menon
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Global AIDS numbers have dropped dramatically, but that is only half the battle won. Stigma towards HIV-positive people needs to be countered if the threat of AIDS is to be overcome.
An Indian soldier discovers he is HIV-positive and is forced to deal with the termination of his services. He must now move the courts for justice - a burden in itself. An HIV-positive pregnant woman from West Bengal has a sticker plastered on her forehead by hospital staff, is isolated in the ward and refused the urgent medical attention she needed. A couple is stoned, branded outcast by the only community they know simply because they are HIV-positive. A HIV-positive woman in Kolkata aborts her own foetus because hospital staff refuse to assist her. This intense stigma can be painful to endure.
The good news is that the number of people contracting HIV infection is dropping, worldwide. A few days ago, UNAIDS, releasing its AIDS Epidemic Update for 2007, said new data show global HIV prevalence (the percentage of people living with HIV) has levelled off and the number of new infections has fallen, in part as a result of the impact of HIV programmes. The new estimate of 2.47 million persons in India living with HIV (0.36 per cent of the adult population) released through the National Family Health Survey-III (NFHS-III) is less than half the official estimate for the previous year.
India now comes third among nations with the largest number of people living with HIV. The optimistic arithmetic apart, the experiences of ordinary people living with HIV tell another story. Stigma and not surveillance, is the biggest problem.
A 15-year-old boy from Ahmedabad committed suicide to escape the stigma piled on because his parents, both vegetable sellers, were HIV-positive. Two little children in Kerala roused a nation’s feelings when their grandfather stood up and fought against their expulsion from school because they were HIV-positive. In the 24 Parganas district of West Bengal, an HIV-positive child’s mother was forced to accept a refund of his school fees.
Stigma is hard to track and its impact even harder to measure. NFHS-III has generated data on stigma by including surveys on HIV/AIDS know-ledge, attitudes and behaviour. Overall acceptance measured through indicators like willingness to care for a positive person or buy vegetables from a positive person, or have a teacher who is positive continue teaching in the school is low - 34 per cent for women and 37 per cent for men. This corroborates a study by International Labour Organisation which says that two-thirds of positive persons face discrimination. The World Bank points to a study in India that found how 34 per cent of students, faculty and technical staff of the public health services would not associate with people living with HIV and AIDS.
Those vulnerable to and experiencing social stigma and discrimination will be puzzled if they were told that awareness and knowledge about HIV/AIDS is higher than before. Between 1998-1999 and 2005-2006, knowledge of AIDS in women (earlier rounds of the NFHS did not interview men) went up by 17 per cent (from 40 per cent to 57 per cent). But NFHS-III has also found how only 30 per cent of women with no education have heard about HIV/AIDS. Almost two-thirds of women and half of men still believe that a mosquito bite can transmit HIV infection. Awareness is not translating into tolerance or a shedding of stigma.
Protection against HIV and preventing its spread is certainly a key message, but protection using stigma and alienation will go nowhere. It is always challenging to fight for legislation and better policy outcomes. Kerala has a law against discrimination of HIV-positive children in schools. But laws and policies cannot be substitutes for a humane approach
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