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Stigmatising VCT?
Masimba Biriwasha
November 30, 2006
http://www.healthdev.org/kc/
This article is extracted from Unveiling the truth: Shedding
light on HIV stigma and discrimination, a collection of essays and
reports written during the XVI International AIDS Conference in
Toronto, August 2006. The full report is available at: www.hdnet.org
"Stigma is secretive, subversive and operates in silence,
undermining many efforts that have been made to fight the epidemic."
Most people in Zimbabwe are reluctant
to access voluntary counselling and testing (VCT) services because
of fear of stigma and the implications of death often associated
with a positive diagnosis. This, despite the fact that VCT has long
been recognised as an important entry point that enables people
infected with HIV to live positively and access appropriate services
and support. The non-availability of treatment options has only
worsened the culture of silence and secrecy around the disease by
providing a further disincentive to test or reveal HIV status.
Stigma is secretive, subversive and
operates in silence, undermining many efforts that have been made
to fight the epidemic. It undermines prevention and care strategies
and increases the devastating impact of the epidemic.
Speaking at the XVI International AIDS
Conference in Toronto, Anand Grover, Director of the Lawyers Collective
HIV/AIDS Unit (LCHAU) in India said: "The real challenge is
to control stigma within the communities and within the individuals.
We should focus our energies on that. What we need is a massive
investment in programmes to destigmatise HIV and make people living
with HIV acceptable in society."
Despite high levels of awareness and
knowledge of HIV and AIDS, the disease remains highly stigmatised
in Zimbabwe. People’s lived experience of AIDS consists mainly of
pain, isolation and death, which in turn evoke feelings of hopelessness.
Consequently, there is tremendous fear and reluctance around being
tested for HIV.
To make matters worse, voluntary counselling
and testing centres in the country are not available in rural areas
where 70% of the population resides. The vast majority prefer to
remain under the cloud of ignorance and denial, and only get tested
when they are seriously ill.
Often people living with HIV are perceived
as having done something wrong, something which they and their families
should be ashamed of. Most people are therefore unwilling to face
the feelings of degradation that accompany knowledge of HIV status.
There’s no assurance that the consequences
of undergoing HIV testing will not be discrimination, particularly
in the underserved rural communities where neither VCT nor health
facilities exist.
The widespread lack of HIV care and
other support services has further compounded the situation, forcing
most people to opt out of being tested for HIV at all.
Even in recent years, when a sizeable
number of PLHIV have opened up about their status, stigma remains
and tends to prevent them from receiving adequate care and treatment.
The Eden Home Health Centre in Zimbabwe
has surveyed HIV-related stigma and discrimination in communal farming
communities and found that community leaders, chiefs, headmen, and
others are frequently making discriminatory statements, even during
their graveside messages at funerals. The centre stresses the need
for HIV education (in local languages) targeting traditional leaders
in remote areas.
It appears that people already carry
their own notions of stigma and fears that inhibit them from testing
for HIV, even though VCT is an important entry point for the prevention,
care, and support continuum.
There’s a great need for VCT to address
the local manifestation of stigma and for the process to promote
love and understanding for those infected and affected by HIV.
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