Fight against HIV/AIDS - Essay Example

?Introduction HIV refers to Human immunodeficiency virus while AIDS stands for Acquired Immune Deficiency Syndrome. HIV causes AIDS which is a medical condition where a person’s immune system is too weak to fight off infections. HIV virus is transmitted from person to person through the exchange of body fluids such as blood, semen, breast milk and vaginal secretions. HIV AIDS is therefore transmitted through sexual contact, sharing needles when injecting drugs, during childbirth and breastfeeding. As HIV AIDS produces, it damages the body's immune system and the body becomes susceptible to illness and infection. As the virus gradually attacks the immune system cells and progressively damages these cells, the body becomes more vulnerable to infections. It is at the point of very advanced HIV infection that a person is said to have AIDS. Patients with HIV/AIDS have over the years experienced stigmatization and discrimination due to their condition. In many health conditions stigma is receiving increasing attention. According to Goffman (1990) stigma is an undesirable or discrediting attribute, reducing an individual’s status in the eyes of society. Aggleton et al. (2006) argue that stigma must be regarded as a social process in which people out of fear of the disease want to maintain social control by contrasting those who are normal with those who are different. Stigma and discrimination produce thus social inequality. Stigma exists when elements of labelling, stereotyping, separation, status loss, and discrimination occur together in a power situation that allows them (Link & Phelan 2001, p.377). AIDS related stigma and discrimination refers to prejudice, negative attitudes, abuse and maltreatment directed at people living with HIV and AIDS. They can result in being shunned by family, peers and the wider community; poor treatment in healthcare and education settings; an erosion of rights and psychological damage. This can negatively affect the success of testing and treatment. AIDS stigma and discrimination exist worldwide, although they manifest themselves differently across countries, communities, religious groups and individuals. They occur alongside other forms of stigma and discrimination, such as racism, homophobia or misogyny and can be directed towards those involved in what are considered socially unacceptable activities such as prostitution or drug use. Types of Stigma There are various types of HIV/Aids related stigma and discrimination and this include the government, family, community, employment, health care, and restrictions on travel and stay. under the government a country’s laws, rules and policies regarding HIV can have a significant effect on the lives of people living with the virus. Discriminatory practices can alienate and ostracise people living with HIV, reinforcing the stigma surrounding the disease. In 2010, UNAIDS reported that 71% of countries now have some form of legislation in place to protect people living with HIV from discrimination. There are many ways that governments can actively discriminate against people or communities with (or suspected of having) HIV/AIDS. Many of these laws have been justified on the grounds that the disease poses a public health risk. For instance in Uganda President Museveni supports the national policy of dismissing or not promoting members of the armed forces who test HIV position. Many countries also have laws that restrict the entry, stay and residence of people living with HIV. Foreigners with HIV positive status can be deported due to their status, while students living with HIV are barred from applying to study in certain countries Deportation of people living with HIV has potentially life threatening consequences if they have been taking antiretroviral drugs and are deported to a country that has limited treatment provision, as this could lead to drug resistance and death. Alternatively, people living with HIV may face deportation to a country where they would be subject to even further discrimination. In healthcare settings people with HIV can experience stigma and discrimination such as being refused medicines or access to facilities, receiving HIV testing without consent, and a lack of confidentiality. Such responses are often fuelled by ignorance of HIV transmission routes amongst doctors, midwives, nurses and hospital staff. Many people living with HIV/AIDS do not get to choose how, when and to whom to disclose their HIV status. Breaches of confidentiality by health workers is also high and doctors in healthcare setting in resource-poor areas with limited or no drugs have reported a frustration with the lack of options for treating people with HIV/AIDS, who are then seen as 'doomed' to die. This frustration may mean that AIDS patients are not prioritised or are actively discriminated against. Fear of exposure to HIV as a result of lack of protective equipment is another factor fuelling discrimination among doctors and nurses in under-resourced clinics and hospitals. In the workplace, people living with HIV may suffer stigma from their co-workers and employers. This may be in the form of social isolation and ridicule, or experience discriminatory practices, such as termination or refusal of employment. Fear of an employer’s reaction can cause a person living with HIV anxiety over there status. A community’s reaction to somebody living with HIV/AIDS can have a huge effect on that person’s life. If the reaction is hostile a person may be ostracised and discriminated against and may be forced to leave their home, or change their daily activities such as shopping, socialising or schooling. Community-level stigma and discrimination can manifest as ostracism, rejection and verbal and physical abuse and can even extend to murder. AIDS related murders have been reported in many countries. An example in sub Saharan Africa was in South Africa where in December 1998, Gugu Dhlamini was stoned and beaten to death by neighbors in her township near Durban, after speaking openly on World AIDS Day about her HIV status. Majority of the people living with HIV, therefore, fear social discrimination following their status disclosure. In most developing countries families are the primary caregivers when somebody falls ill. They play an important role in providing support and care for people living with HIV and AIDS. However, not all family responses are positive and HIV-infected members of the family can find themselves stigmatized and discriminated against within the home. There is concern that women and non-heterosexual family members are more likely than children and men to be mistreated. One suffering from HIV/Aids is likely to be alienated and not allowed to share anything with the rest of the family. Stigma in the family can also be manifested in particular avoidance, exaggerated kindness and being asked to conceal one's status, which can lead to psychological distress on the patient. Impact of stigmatization and stereotyping on the fight against HIV/AIDS Stigma not only makes it more difficult for people trying to come to terms with HIV and manage their illness on a personal level, but it also interferes with attempts to fight the AIDS epidemic as a whole. On a national level, the stigma associated with HIV can deter governments from taking fast, effective action against the epidemic, whilst on a personal level it can make individuals reluctant to access HIV testing, treatment and care. A study of 1,268 adults in Botswana found that stigmatising attitudes had lessened three years after the national programme providing universal access to treatment was introduced. The study concluded that although improving access to antiretroviral treatment may be a factor in reducing stigma, it does not eliminate stigma altogether and does not lessen the fear of stigma amongst HIV positive people. Antiretroviral treatment can prevent the onset of AIDS in a person living with HIV, but many people are still diagnosed with AIDS today. This is because in many resource-poor countries antiretroviral treatment is not widely available and many individuals are not covered by health insurance and cannot afford treatment. In countries where antiretroviral drugs are available, patients are wary to go for the drugs as this will make them be identified and thus suffer alienation from the family or community. Many people are also never tested for HIV and only become aware they are infected with the virus once they have developed an AIDS related illness. These people are at a higher risk of mortality, as they tend to respond less well to treatment at this stage. Taking a HIV test is associated with immorality and possible infection and thus most people shun it. With less stigmatization people would be willing to take up the HIV test and if positive treatment would start early. HIV-related stigma and discrimination severely hamper efforts to effectively fight the HIV and AIDS epidemic. Fear of discrimination often prevents people from seeking treatment for AIDS or from admitting their HIV status publicly. People with HIV may be turned away from healthcare services and employment, or refused entry to a foreign country. In some cases, they may be evicted from home by their families and rejected by their friends and colleagues. The stigma attached to HIV/AIDS can extend to the next generation, placing an emotional burden on those left behind Handling stigma should be approached from the individual, environmental and policy levels. Health care workers need to be made aware of the negative effect that stigma can have on the quality of care patients receive; they should have accurate information about the risk of HIV infection, and they should be encouraged not to associate HIV with immoral behavior. Facilities should have sufficient equipment and information for health workers to carry out universal precautions and prevent exposure to HIV. Policies within health care settings can use programmes that involve participatory methods like role play and group discussion, as well as training on stigma and universal precautions. The involvement of people living with HIV could lead to a greater understanding of patients’ needs and the negative effect of stigma. Economies and infrastructures in a country are also affected since life expectancy has reduced by as much as 20 years. Young adults in their productive years are the most at-risk population, causing a slow-down in economic growth and an increase in household poverty. HIV and AIDS makes it difficult for persons infected and affected fend for themselves in already struggling economies. Conclusion Stigma and discrimination will continue to exist as long as societies have a poor understanding of HIV and AIDS and the pain and suffering caused by negative attitudes and discriminatory practices. We can fight stigma by enlightening laws and policies that are key. This begins with being open and having the courage to speak out. Schools should teach respect and understanding while religious leaders should preach tolerance. The media should condemn prejudice and use its influence to advance social change, from securing legal protections to ensuring access to health care. The fear and prejudice that lie at the core of the HIV/AIDS discrimination need to be tackled at the community and national levels, with AIDS education playing a crucial role. A more enabling environment needs to be created to increase the visibility of people with HIV/AIDS as part of any society. According to McIntyre (2004) “the presence of treatment makes this task easier; where there is hope, people are less afraid of AIDS; they are more willing to be tested for HIV, to disclose their status, and to seek care if necessary.” In the future, the task is to confront the fear-based messages and biased social attitudes, in order to reduce the discrimination and stigma of people living with HIV and AIDS. Response to the epidemic has been intensified and the global percentage of people infected with HIV has stabilized. These should however not lead to complacent attitudes. In all parts of the world, people living with HIV still face AIDS related stigma and discrimination, and many people still cannot access sufficient HIV treatment and care. Prevention efforts that have proved to be effective need to be scaled-up and treatment targets reached. Commitments from national governments right down to the community level need to be intensified and subsequently met. Therefore governmental and non-governmental organizations should continue to provide key services in the mitigation of stigma. With that, the world might see an end to the global AIDS epidemic. References Aggleton, P., 2007. Same-sex sexualities and HIV in the developing world. In Keynote address to a Human Sciences Research Council Invitation Conference. Johannesburg, South Africa. Aggleton, P., Ball, A. & Mane, P. eds., 2006. Sex, drugs and young people: international perspectives, Abingdon: Routledge. Goffman, E., 1990. Stigma: notes on the management of spoiled identity, London: Penguin. Link, B.G. & Phelan, J.C., 2001. Conceptualizing stigma. Annual Review of Sociology, 27, pp.363-385. McIntyre, B., 2004. HIV/AIDS Stigma and Discrimination - HIV and AIDS in Zambia - Healthcare and Medical. The Zambian. Available at: http://thezambian.com/healthcare-medical/b/aids/archive/2004/03/09/hiv-aids-stigma-and-discrimination.aspx [Accessed April 28, 2011].  Read More