Policy advocacy to fight HIV discrimination and stigma - Essay Example

Policy advocacy to fight HIV discrimination and stigma Since the emergence of the HIV/AIDS more than half a million have died from HIV related Illness in the USA. There are currently about 1.3 million people living with HIV in the USA and about a fifth of the infected people are unaware of their infected. This poses high risks for continued infection to even more people (Messer, 386). The issues of stigma and discrimination remain a persistent and pernicious problem to the entire community as it prevents the infected and affected people from seeking medical and socio support solutions. It is therefore necessary for establishing a policy that would stop the discrimination and stigma of the HIV by the government general society. The reactions to the USA government to the AIDS and HIV epidemic has had mixed results, it has been noted that many of the preventions efforts and policy intervention has not been successful. For example in 2011, available data indicate that there were approximately 49,000 Americans infected with HIV. It is even appalling that some regions like Washington DC currently have prevalence rate of 3.2 %, infections rates that is similar to some parts of sub-Saharan Africa. Stigma and discrimination is a major problem in the fight against HIV as it makes it more difficult for people to come to terms with their HIV status and manage the illness as required. This has impact as the person easily develops the more serious full blown AIDs that are more complex to manage. The stigma also interferes with the policy intervention that is being implemented to fight the HIV and AIDs epidemic. In addition, the stigma that is associated with the HIV infections has prevented the government from taking fast and more effective actions that will drastically reduce the epidemic. It is therefore imperative that correct policies are proposed to effectively address the stigma and discrimination in the society (Grossman and Stangl, 3; Jos et al 169). The reduction of stigma will have an effect on the individuals that have been reluctant to go for HIV testing and care for those that are positive. HIV/AIDS stigma and discrimination The HIV/AIDS related stigma refers to the negative attitudes, prejudice or maltreatment that is directed at HIV infected people. Some of the consequences that are brought about by discrimination include being shunned by relatives and general community. It also takes the form of being maltreated in the healthcare, education institution and lack of rights. The stigma may also result in the psychological damage of the concerned individual (Larson, 380). With increased development of drugs that could improve the living condition of people living with HIV, research has shown that stigma is still the single most barriers to the policy actions of governments. It is therefore necessary to formulate and implement a policy that would reduce the stigma associated with HIV (Messer, 394). Stigma is the main reason why people are afraid to go the health institutions to determine if they are infected or not. One may therefore suspect that they are infected but would prefer to stay in denial so that he or she may not be publicly humiliated. The fear of the social disgrace from both friends and general society makes the HIV to become a killer disease despite the availability of retroviral medicines. It is the view of this paper that effective sex and HIV education policy needs to be established to prevent stigma. This would be a more effective way of preventing the devastation of AIDS epidemic in the USA as it would not only increase awareness of the scourge but equip the young people with skills to provide support to the infected and affected. HIV and sex education is the best policy that can effectively tackle the issue of HIV stigma and discrimination in the USA. Currently, the level and type of education that is offered in the school students in the United States is not standardized. It is depended on the regulations of the states, types of the college or school (Ugarte et al 166). This means that in some areas, the sex and HIV education is comprehensive and will incorporate the different ways of reducing stigma and discrimination, but in most schools, children may live schools without knowing anything about the HIV and AIDS. There is need to have a uniform system and regulatory system that will ensure a uniform system and curriculum is practiced throughout the country. Currently, twenty five states require that abstinence before marriage be emphasized on the sex education. While people may argue that the general attitude of the Americans have towards HIV have relaxed and are more supportive toward the people that have the HIV infected. This is because is not true parse. The HIV is a subject that once caused considerable panic due the nature of reporting that was carried out in the media. On the other hand, the press does not currently report on HIV with much hysteria. The introduction of the antiretroviral therapy in the middle of 1990s played a role in the reduction of the HIV scourge. The other improvement that has been made in the fight against HIV is the establishment of legislations. For example, the government made it clear by 1986 that they would prosecute the employers who discriminate against the people that become HIV positive. In addition, the America and with the disability Act has made it illegal to discriminate against the people with HIV. Why there is stigma related to HIV in US Despite the many development that have been done in both the medical research and legislative front to prevent the increase of infections and help the infected live healthy, we still find that there is increased new infections. HIV related Stigma and discrimination is still persistent in the United States of America. As such, many HIV infected people still finds that they are discriminated against on a day to day basis. For instance, in 2007, a woman from New York State instituted a legal suit against a leading holiday camp for turning away her ten year old son for being HIV positive(Grossman and Stangl, 5). The national HIV and AIDS strategy has also admitted that addressing the stigma and discrimination associated with the stigma is one of the biggest challenges that is associated with fighting HIV and Aids in the society. The main cause of stigma and discrimination in the American society is caused by the misconceptions around the causes and transmission of HIV. For example, research has shown that about one in every American falling between the ages of 18 and 29 still believe that HIV can be transmitted through such things like sharing the drinking glass and sharing a swimming pool with the HIV positive person. It is really amazing that despite the increased awareness, the perception of the people in the general public who still hold some similar misconception about the HIV has not changed since 1987. The government attitude and policies have also contributed to the discrimination of the HIV positive people. This is explained by the fact that it is only until that there was full removal of the ban that had prevented HIV positive people from entering the country. Such a blanket entry of the HIV was intended at protecting the Americans from infections from people who were infected in other countries from spreading the disease in America. The following figure shows the relationships between the stigma and both treatment of HIV and prevention of HIV. In addition to the fear of contagion, HIV stigma is also caused by negative value based assumption about the morals the people who are infected (Grossman and Stangl, 11). The factors considered include: HIV is still considered a life threatening disease despite the improved medications HIV infection is associated with immoral behaviors like prostitution, homosexuality, drug addiction and having multiple sexual partners. All of these are already stigmatized in the society. The belief that most if not all infections are due to sexual activity, something that is defined by moral values of people. The inaccuracy of the information about HIV that is spread by different agents and opinion makers. Religion beliefs have also contributed to the stigmatization of HIV as it is viewed as punishment for the sins committed especially deviant sex and promiscuous behavior. The antiretroviral therapy and treated may have side effects that leads to disclosure of the HIV status leading to discrimination and stigma. It is therefore our view that the government should change to a more effective policy that would meet the changing nature of the fight against increasing HIV infections (Ugarte et al 166). This is because due to the effects of stigma and fear that is associated with HIV, individuals and families that contact the disease would no longer receive the support to deal with the disease. Currently this is the main factor that prevent the not only testing and disclosure of HIV status but also hinder effective use of the tools and behavior change that would enhance healthy lifestyle living. Proposed policy for dealing reducing stigma in the USA According to the US center for the health and human services in the Center for Disease Control, education is an effective way to reduce the stigmatization and help in the control of the spread of the disease. This is because HIV is mostly caused by human behavior that can be modified by implementation of education programs that will provide the relevant information that will help in preventing HIV infection and providing support to the people that are infected or affected (Jos et al 3). The education programs can be implemented to the target group using the appropriate strategies to teach young people to understand the disease and remove all the misconceptions. Another importance for education is that it can be modified to suit the context and value system of the targeted. The Government need to come up with the policies that would provide guidelines that can be used by should and other interested organizations to train the people about HIV and aids and remove all the fear that may be associated by the rumors and hears says(Larson, Stefano and Piot, 847). It is important that the different stakeholders be empowered by a government policy on the AIDS education to deliberate on the content of the HIV education. The government can only facilitate the process by empowering these stakeholders like educators, parent and other concerned members of the community to tailor the education material based on the prevalence behavior in the community that increases risk to HIV epidemic. Planning and implementing of the HIV/AIDS education to fight stigma The public and private schools in the country have a capacity and responsibility to ensure that they help the students to understand the full nature of the HIV epidemic and the specific actions that can be taken to prevent being infected (Parker et al, 4). Due to the wide coverage of the implementation of the HIV education policy, the contents of the HIV education would be determined at the local levels so that they are consistent with the community values. The development of the school district policies can be the first step in the education programs for HIV. Due to the emotional and moral elements that that prevent the people from accessing the correct information about the disease leading to huge misconceptions, it is important to include the representatives of various communities in developing the health education policies that would be used in the HIV education in the locality. The involvement of the local people would allow the representatives to resolve various perspectives that may be conflicting and agree on a standard HIV education program. Such a policy is not far fetch but just an improvement of the Welfare Reform Law of 1996 that set aside $100 million that was spent in education programs that was based on abstinence only. This amount was increased under the presidency of George Bush in which by 2007 more than 1.5 million had been used for abstinence only education programs. As much as it is good morally research has shown that it is abstinence programs teaches young people to abstain from all sexual activities till marriage (Hassan et al, 25). This is because it does not teach the students how to protect themselves and may lead to high level of stigmatization and discrimination in the event that one fails to meet the high moral stands. As a result, May states rejected the federal funding’s targeted for the abstinence programs only. President Obama in the 2009 budget proposed the need to replace the abstinence only programs with a more inclusive education programs that would not only delay the sexual activity among young people but would also increase the use of contraceptive and consequently reduce pregnancy in the teens. But the 2010 funding reduced the funding for abstinence programs from a record $176 million that was allocated in 2007 to only $50 million without establishment of a comprehensive nationwide education programs. Cost and Benefit Arguments for HIV stigma education According to the available data, the federal budget for the financial year 2011 that was allocated to the AIDS pandemic was 20.4 billion(Messer, 378). This was an increase of the 2010 funding to the HIV/AIDs reduction activities by 4%. However, a significant percentage of the amount is for care and treatment for infected, 14% of the AIDS Budget is for Research, 13% is for provision for housing and other assistance while only 14% of the amount goes to prevention programs. The government policy of fighting the HIV and AIDs is reactive (Parker et al, 4). On the other hand, the proposed HIV education policy is proactive. It is therefore of essence that the government allocated more funds to the prevention and education on the HIV scourge to reduce the stigma associated with the disease. As more people have accurate information on the HIV and how to deal with in the event that they get infected, they would not be afraid to get testing and change their behavior to make them live healthily with the Virus. Feasibility of the HIV education to reduce stigma In addition to the basic education about the nature of AIDS and HIV and how it is contaminated, the spread of the disease can be reduced by providing education that would help in overcoming stigma. The society needs to be trained on how to show support for the people with HIV so that they can live positively with the disease. When people are provided with the correct information on all the elements of HIV, there would be a reduction of stigma associated with the disease and more people would not be afraid to go for testing (Wright, 1179). One way of confronting HIV in the community is making people to understand that contracting the disease is not the end of the road; an individual can still live and fulfill their purpose when they live with the disease positively. The government needs to invest in active learning that will enable people not only have the information about the HIV infection and how to prevent it, but go a step ahead to equip people with skills to apply even when they contract the disease. The holistic HIV education proposed in this document is better than the abstinence only education that was implemented under Bush in 2007. This is because not all people In America consider abstinence an important value. This abstinence policy led to increased criminalization and stigma as the people were not taught how to protect themselves in case they are involved in sexual activity. This theory also increased stigmatization as it trains the student to that sex before marriage is wrong and once of the consequence of premarital sexual behavior is HIV while the other is unwanted pregnancies. The young people that find themselves in that condition are therefore discriminated by friends, family and society for failing the absolute moral test of chastity. What arguments do opponents of your policy make arguments? The opposition to the introduction to this policy would be based on the argument that the Americans currently are aware of the dangers of HIV and yet each year, millions of people get infected with the HIV virus. As such, this policy on the educating people does not help in the improvement of decision making especially when the ideas cannot be practically used. The second opposition may come from the religious institutions that were favored with the Abstinence only education (Fee 1747). They would argue that some element of the sex and HIV education would be like encouraging promiscuous and immorality behavior. Conclusion It is unfortunate that despite the great improvement in the society, sex and HIV education is still faced with the conflicting interests between various groups. America is one of the developed countries with very high level of new HIV infections. As a matter of fact, the current infection rates of some states like Washington DC are at the same level with sub-Saharan African countries. It is there time to institute a policy that would respond to the challenges faced by the society (Larson, Stefano and Piot, 822). The ideological messages like sexual abstinence used in the sex an education does is not responsive to the fact that young people are still engaging in sex anyway. The main reason why the form of sex education programs does not produce required result is that they are in direct conflict with the values of the society (Wright, 1184). This means that some topics are not allowed to be taught in class. The sex and HIV education proposed here involve providing information based on research that the student can apply based on their lifestyle choices. This means that they would not only be able to take care of their sexual behavior but also know exactly what to do in the even that they suspect that they are infected. This would reduce the stigma and discrimination in the society as more and more people are exposed to HIV information. Works cited Dos, Santos, Monika, Minez, Kruger, Pieter, Mellors, Shaun and Wolvaardt, Gustaf. “An exploratory survey measuring stigma and discrimination experienced by people living with HIV/AIDS in South Africa: The people living with HIV stigma index”. BMC Public Health, 14(1), 1-24. This journal article introduces the concept of Stigma not just in South Africa, but all over the world. However, much emphasis is laid on HIV victims in South Africa, and it embarks on providing, analyzing and discussing the findings from a research conducted in the country. It provides an exploratory direction and angle under which stigma and discrimination can be measured. In this article and research, the authors discover issues such as gossip, being shunned from the community, blaming themselves and being barred from participation in community activities and programs as ways and forms through which stigma and discrimination is portrayed. HIV victims were the participants in the research study. The researchers found the main forms of stigma and discrimination and present their findings in data form to aid in understanding. The work is credible and the solutions and measures given are applicable to the contemporary society. These authors also have many other articles about HIV and other issues affecting the community published and this further increases the credibility of this particular article. On a scale of 10, the article would score an 8. Fee, Elizabeth. “The Stigma of HIV”. American Journal of Public Health. 103(10). 1747-1747. 2013. Print. Fee works on bringing out the disastrous effects on stigma and discrimination on HIV infected people and on the society at large. The article gives a reflection on the state of things in the world concerning HIV, and Fee adequately reveals how laws, policies and decisions that affect HIV related people are made. Fee clearly brings out how policies and laws affect the performance of the society; how the laws and policies place HIV victims are always at a disadvantage, restricting them from participating in activities in the community. Fee also shows how this stigma and discrimination affects the society such that HIV keeps spreading and the menace caused by it increases. In the article, Fee campaigns against the rapid spread of stigma discrimination in the society and advises that people should look at the condition from its hazardous angle and shun away from it. She uses simple language that is easily understood. The information in this article is very credible as it is published in a journal widely known and recommended by others, especially because it is peer –reviewed. Grossman, Cynthia., and Stangl, Anne. “Global action to reduce HIV stigma and discrimination”. Journal of International Aids Society, 2(16), 1-6. 2013. Print. This source was really helpful in providing an insight on the actions and steps that can and should be taken in an attempt to curb the rapidly rising, yet unspoken about issue of HIV stigma and discrimination. In this article, Grossman and Stangl collectively show the effects of stigma and discrimination creep back and end up affecting our society. The two authors also provide an insight on the countries’ most affected by the HIV menace and throughout their discussion, they show that HIV stigma and discrimination is not just an individuals or a one country problem but rather, it is a global problem. They give solutions such as community participation and intervention problems, creation of awareness and the role of Human rights groups as some of the major solutions to discrimination and stigma. These two authors have also written other articles that have been published in credible and highly rated journals. Its credibility is further enhanced by the fact that the journal is peer reviewed and only the best of articles are published here. The language used is direct and understandable and on a scale of 10, this article would score an 8.5. Hassan, Tanvir, Nath, Samir, Khan, Nabilah, Akram, Owasiwa and Gomes, Tony. “Internalized HIV/AIDS related stigma in a sample of HIV positive people in Bangladesh”. Journal of Health, Population and Nutrition. 30(1), 22-30. 2012. Print. This article was very helpful in providing enlightenment on how internalized stigma occurs and its effects. The authors intelligently depict how the internal stigmatization slowly increases the spread of HIV, and how this in return, affects our society. The research study represented was conducted in Bangladesh but the findings, solutions and recommendations are definitely applicable in any place. After all, they represent the state of things in most of the countries in the world. The HIV positive people who were involved in the research study reflected an opinion of other HIV infected people in the world. The main focus was on internalized stimulation, but it has adverse and detrimental effects as the external stigma, and the authors call people to actions that will reduce stigma towards HIV positive people. The journal of Health, Population and Nutrition has been rated as one that publishes the best credible articles and hence, this particular article is definitely a good one to refer to. The fact that it draws its content from a firsthand information (Bangladesh people living with HIV) makes it even more credible and effective in providing recommendations that are realistic and applicable in the contemporary society. Larson,Heidi, Bertozzi, Stefano., and Piot, Peter. “Redesigning the AIDS response for long term impact”. Bull World Health Organ, 89(1), 384-396, 2011. Print. This article is an advice that if our society and the perceptions that people have towards HIV is to change; we need to restructure our view on how we address HIV related issues. The article was very helpful o showing that times have really changed, and gone are the times when HIV was talked about in whispers. With the much revolution and progress that has taken place in countries, the rate of new infections in HIV continues to increase, and this is mostly fueled by the high rate of stigma and discrimination, especially because people do not open up about their HIV status. According to the authors, new measures and plans need to be developed if HIV spread is to be combated, and one way of doing this is by creating awareness and addressing the issue of stigma and discrimination. On a scale of 10, this article’s credibility would score a 7. Messer, Donald. “Getting to zero embracing science, breaking the silence and overcoming the stigma”. Ecunemical Review, 63(4), 384-396. 2011. Print. Messer comprehensively argues on why it is important for the silence on stigma and discrimination to be broken. The author argues that the silence is what promotes the increased stigma and discrimination as many people are not willing to openly discuss HIV and HIV related issues. The article proved useful in providing ways and suggestions on how the issue of stigma and discrimination can be addressed. The society, the HIV infected people, relatives and organizations concerned with HIV issues all have a part to play, and unless this is done, HIV will keep spreading and increasing. We all need to speak up, advises Messer. Messer uses examples and illustrations that make it even easier for one to understand the adverse effects of stigma and discrimination on the society. On a scale of 10, this journal article can be placed at 8. Nsubuga, Yusuf, and Bonnet, Sandrine. “HIV education in the formal curriculum”. Prospects. 39(4), 321-334. 2009. Print. Nsubuga and Bonnet comprehensively argue and bring out the benefits and need for inclusion for HIV in the school curriculum. This has been neglected in many places and these two authors remind people on why it is imperative. HIV is no longer an individual problem but a global concern and all people should openly learn about it. All the myths and misconceptions within HIV and which lead to an increased stigma and discrimination level are due to lack of awareness. Where else would be the best starting place to create awareness if not in schools? It was also a helpful article as it provided a solution form a unique angle. The authors clearly show and illustrate on how introducing HIV in the school curriculum shall be of help. It is written in a simple, understandable and easy to comprehend language that anybody can study it. Parker, Richard., and Aggleton, Peter. “HIV and AIDS-related stigma and discrimination: A conceptual framework and implications for actions”. Social Science and Medicine, 57(1), 13-24. 2003. Print. As the title suggests, this article provides a critical look and reflection on HIV and AIDS related stigma and discrimination. It also provided a conceptual framework on actions that people can take to decrease and address the issue of stigma and discrimination. It was a helpful source, credible and recommendable to others. They also provide a sample of recommendations and actions that can be take to address the issue of stigma and discrimination. On a scale of ten, this article by Parker and Aggleton would score a healthy eight. The Social Science and Medicine journal publishes high quality articles and hence, there is little to be questioned on the credibility of this journal. The fact that it is peer reviewed further added on its credibility. The authors have also written and had other articles published in different journals, especially those that deal with issues affecting the human population. Ugarte, William, Hogberg, Ulf, Elliete, Catryn, and Essen, Birgitta. “Measuring HIV and AIDS related stigma and discrimination in Nicaragua: Results from a community based study”. Aids Education and Prevention, 25(2), 164-178. 2013. Print. This particular article is about the results of a research conducted in Nicaragua to find out the rate and level of discrimination here. The article clearly brings out the differences between how “normal” people and the HIV infected people are treated, even at the hospitals. It further shows how stigma is brought out in Nicaragua, and how it is slowly increasing every day. This study was carried out in a particular community where the participants were both HIV positive and uninfected people. Views from both sides were taken and this was important in enhancing a further understanding of stigma and discrimination in the society. On a scale of 10, this article can be rated at 8.5. In addition, the fact that it drew the findings and discussion issues from a firsthand category makes it easy to apply in the modern world. Its credibility is also quite high as this particular journal has been known to publish only the best articles. Wright, Joe. “Only your calamity”. American Journal of Public Health, 103(10), 1178-1188. 2013. Print.2010. In this journal article, Wright brings out the concept of how HIV is viewed as a person’s fault, as a result of their own mistakes and as a result of their sexual immorality. The title was captive and lured the reader to read more on the topic of HIV. This article was helpful in demonstrating how people criticize and shun away from HIV positive people since the calamity that befalls them is their own doing. Wright advises on how this should not be the case and emphasizes on the need for people to try accommodating each other, and this will make the burden of HIV people bearable. The author develops and brings out his arguments in a clear and understandable way which is easily comprehended by any person interested in the article. It proved very helpful in providing an insight on how HIV infected people feel. The American Journal of Public Health is reputed as one that publishes only the best and reliable articles and hence, there is a high credibility associated with Wright’s sense. Read More