The Social Implications of HIV - Essay Example

Social Implications of HIV: Stigma and Discrimination Introduction HIV discriminates against no one, people do. This statement has been in use ever since scientists and researchers identified the ways and means through which HIV can and cannot be transmitted from one person to another. However, even with the cosmic education and information about HIV, being circulated all over, the issue of stigma and discrimination in workplaces remains a persistent and pernicious problem. Stigma is a social problem in the whole world, especially in the developing countries (Ugarte et al. 166). Employers in South Africa are adopting the use of favorable conditions in the workplace. However, some still cling to their traditional beliefs that HIV/AIDS results from immorality and continue to stigmatize their employees in their process of carrying out their duties or their social interactions in the workplace. Stigmatization and discrimination are based on belief that HIV/AIDS is communicable, was acquired in an immoral way, could be a curse, and does not have a cure (Kalichmann and Simbayi 443-444). Many workers living with HIV/AIDS have and continue to suffer because of stigmatization from their colleagues and employers. Many efforts have been advocated especially on prevention of HIV/AIDS through continued public education and promotion of protection through use of condoms. Some employers have made progress on the war against HIV/AIDS by asking their employees to take up voluntary tests. However, stigma and discrimination of infected employees persists and employees are sometimes denied employment benefits, receive unfair treatment in human resource relations. Some employers have fired their employees because of their HIV/AIDS status in South Africa (Skinner and Mfecane 160). Discrimination has even caused some infected employees to stop taking their Antiretroviral (ARV) medication in South Africa (Dahab et al. 53.) Potential employees are sometimes also denied job opportunities because of their HIV/AIDS status. Individuals are, therefore, discouraged from taking HIV/AIDS tests, which reverses gains that made in the war against the scourge. Therefore, it is important to develop a favorable working environment policy that promotes fair treatment of employees. Stigma has been defined as a mark of infamy that is usually associated with a specific circumstance, condition, value or a human being (Jos et al. 3). Organizations that have been established to deal with HIV and HIV related issues have recorded some remarkable success in aspects such as HIV drugs distribution and production and establishing health centers specifically dealing with HIV patients among other aspects. However, these organizations have not yet succeeded in reducing or curbing workplace stigma, and the issues that come with stigmatization of HIV infected and effected people. Today, millions are already infected with HIV, yet there are many more who have already succumbed to the illness (Larson, Stefano and Piot 847). This work embarks on a discussion on a policy that can help solve stigma and discrimination in workplaces in South Africa organizations, its challenges, and ways to overcome them. The policy seeks to provide people living with HIV/AIDS protection from stigmatization and discrimination in the workplace, which also involves human resource relation policy that recruits and selects people without having to ask for their HIV status. The policy has procedures that do not discriminative HIV/AIDS people, for example, it does not subject potential employees to pre-employment HIV screening to assess health of an individual during recruitment and selection process. It should only allow disclosure of their status voluntarily and should avoid requesting confidential results of HIV/AIDS tests ever taken. The policy ensures that the job advertisements in organizations do not exclude individuals who live with HIV. Promotions and appointments do not stigmatize PLWA. Classification and grading policies do not discriminate against PLWH by denying them certain opportunities in the organization because of their status. The policy treat HIV/AIDS just like any other comparable medical and health conditions and, therefore, no one is unfairly stigmatized based on his or her status. It also involves taking steps to ensure that all opportunities available in the working environment are given equally to all without discrimination on HIV/AIDS status to promote equality. Compensation, terms, and employment benefits are not unfairly discriminated, for example, by offering less compensation pay than their colleagues on their status basis. Job assignment and working condition also do not discriminate based on HIV/AIDS status and all employees are given equal opportunities in jobs available and equal access to such facilities as toilets. Policy also includes training and development of all employees without unfairly discriminating against persons with HIV/AIDS. Performance evaluation, transfers or demotions, are also made in a fair way to all so that no individual is prejudiced because of his HIV/AIDS status. Disciplinary measures and dismissals are made according to fair measures and avoid unfair discrimination on people with HIV/AIDS in their policies and procedures. In addition, no employee should is fired based on his or her HIV/AIDS status. What are the root causes of HIV/AIDS stigma and discrimination? One factor that has led to increased stigma and discrimination is the criminalization of behaviors deemed “abnormal and immoral” by people. By 2013, about 63 % of countries in the world had passed bills and motions that had succeeded in considering acts of homosexuality or polyamorous relationships as illegal (Grossman and Stangl, 5). Gay people are treated as outcasts and as such, a big percentage of them are afraid of being tested and knowing their HIV status (Ward 410). This has directly affected the rate of the increase and spread of the epidemic since they are afraid of the stigma and punishment that comes with a person being HIV positive. The irony befalling these statutes is that while all measures are being put in place to reduce the spread of HIV and AIDS; they appear to indirectly fuel the spread of the epidemic. These policies suggested that HIV transmission, with or without a person’s knowledge or consent are punishable by law, and to an extent, by jail terms. If an HIV positive person has sexual intercourse with an HIV negative partner, yet the negative person does not get infected, the positive person is still punishable by law, having to serve a jail term of 5 years for “the attempted spread of HIV, and for risking the life of another person”(Ugarte et al. 170). How does discrimination and stigma affect individuals and the organization? Having realized that stigma is real and that it is an issue in all countries, it is important to take a look into how stigma affects the organizations. When people are stigmatized, they feel and perceive themselves as social misfits in the organization. They are made to believe that they are not only impure, but they suffer from the condition due to their immoral and anti-norm behaviors (Larson, Bertozzi and Piot, 848). This, however, is not entirely true. Not all people are HIV infected because they are immoral, have irresponsible sexual behavior, are, or were drug users any other incorrect opinions. This is because, among the HIV infected people, there are others who got the virus from breastfeeding from their infected mothers, accidental mix-up of blood with that of an infected person whereas their partners who were not ready to open up about their status infected others. Two forms of stigma are, therefore, witnessed in the society; internal stigmatization and external stigmatization (Grossman and Stangl, 3; Jos et al. 169). In internal stigmatization, the people living with HIV does not accept himself, they live in self-denial of how they are and are afraid of interacting with people. They are afraid of letting their status known and do not take part in any community activities. Some of the effects of internalized stigma as depicted by a research in South Africa is as shown below. This research was carried out among an approximate 600 HIV infected people. Figure 1: Internal stigmatization (South Africa) On the other hand, external stigmatization occurs when people in the organization practice seclusion and unfair treatment of people. These two types of stigmatization are a threat the development of any organization. A research conducted in South Africa, a country with the highest number of HIV infected people in the world revealed that HIV infected people perceived stigma in different ways, and was depicted through gossip, being shunned among others as shown below. The fact that they do not undertake the tests means that they will not find out that they are positive and hence, they will not seek treatment at the right time. By the time they start their anti-retroviral treatment, they might not benefit much from it. The economic future of such people is, therefore, be at stake, same to that of their partners and families after the infected people have died. In addition, the people who have not been tested do not consider themselves as being at a risk of being infected. They distance themselves from the stereotypically stigmatized group. Another issue is that when individuals know that they are positive, they might be afraid to reveal their status to colleagues. Let us take the case of Person A, who is HIV positive, but has not taken a test. He, therefore, does not know whether he is positive or not. Assuming that Person A involves in irresponsible sexual behavior, the chances of him transmitting the disease from one person to another is very high. This leads to continuous and rampant spread of HIV. Stigma leads to denial and fear, and when this happens, treatment and prevention of HIV becomes a challenge (Hassan et al. 23). The people have limited chances of accessing information and patient care, further increasing the burden of the organization. Major challenges to curbing stigma and discrimination These include inadequate time, lack of management committees, funding, and involvement of enough employees. Inadequate time results from a lack of commitment by the persons involved and the policy is not regarded as a priority. People involved may not be ready to give their time maximally on planning, implementation, and evaluation of the policy requirements. Another challenge that faces organizations implementing the policy is the lack of management committees on HIV/AIDS to promote the activities. In addition, there may be less involvement of staff especially lower level staff. There may need adequate funding for activities, which creates a barrier in the implementation. Most of the activities that involve responding to HIV/AIDS activities in the companies have financial implications and organizations may be reluctant to finance activities because they view them as draining their profits. There is a challenge of inclusion of activities of families of the employees, which may pose a difficult task to implement in matters of providing knowledge and advice. Employees may also fear a breach of confidentiality when they disclose their status with a view of getting assistance. Solutions to stigma and discrimination .Arguments against opposition of unfair treatment of employees in the workplace can be solved through a number of ways through involving all stakeholders who are involved in employment matters. These include employees, employers, and trade unions taking steps to eliminate stigmatization of infected employees and adopting positive approaches. These methods include advocating for adoption and development of organizational programs that are equal to all regardless of HIV status, creating awareness, and information on rights of persons living with HIV/AIDS. They also involve the provision of support for infected and affected employees and putting in place disciplinary measures to deal with HIV/AIDS complaints in the organizations. Trade unions have a responsibility of ensuring members are involved in raising the needs of affected employees, development and implementations of HIV/AIDS programs, members are aware of their rights. Businesses have a role to ensure that none of their employees is lost through HIV/AIDS by ensuring affected employees are properly supported by linking with various companies that support employees affected by the scourge. Employees can help to reduce discrimination by identifying and dealing with fears and misconception in the workplace in order to raise awareness and understanding that helps to support individuals affected by removing the stigma associated with HIV/AIDS. It can also involve conducting training and providing information in the workplace, which in turn counters the discrimination of HIV/AIDS persons. The role of employers is to ensure there is a commitment in resolving discriminations related to HIV/AIDS in the working environment by showing by example through fair treatment and zero stigmatizations of PLWHA. Employers also have a responsibility of providing an environment that shows concern to PLWHA through provision of funding for HIV related activities. Despite the arguments against the workplace policy, they can be overcome through creation of an HIV/AIDS committee, providing funding, broadening inclusion of members. The committee compromises of management representatives, trade union representative, and employees living with HIV/AIDS, who work to oversee and implement the policy in the workplace. They also advocate for rights of employees living with HIV/AIDS and facilitate the development of relations with other organizations working on HIV/AIDS projects. Organizations should also support funding for activities of people living with HIV/AIDS by allocating resources to their activities. Organizations should ensure that they have a database on all employees living with HIV/AIDS and those at risk in order to plan well for such as absenteeism, ill health. There should also be involvement of all parties in the development of programs for people living with HIV/AIDS that improve participation and all members feel they are recognized and supported. The programs should also be reviewed periodically to ensure that they conform to the best policies and laws in the country. The organization should also support voluntary testing of their employees in order to test their HIV/AIDS status with a view of accessing treatment when it is already early. An organization should ensure its policies on workplace is clearly written or visible and advocates for fair treatment of employees with disciplinary measures for those who fault. The workplace policy indicates support to those who undertake an HIV/AIDS tests and promises to assist them and maintain such matters as confidential. In addition, HIV related stigma can be curbed is by carrying out new research and investigative studies. This will be pertinent in ensuring that new means and ways shall be developed in order to cater with the changes in the organization. Companies today, changes and revolutionizes at a rampant speed and hence, the solutions that worked before might not work today. This gives a new insight on which organizations shall think and shall be used to mobilize and challenge everyone to embrace the people living with HIV (Parker and Aggleton 16). This will be a quintessential action which will greatly affect the way organizations perceive the people who are HIV positive. The incidences and rates of stigmatization will most likely reduce when such action is taken. New and old conceptual studies should also be combined, improvements made on the past, and existing knowledge related to HIV. This will greatly affect the content of knowledge that will be distributed, which will be related to HIV. The Human Rights Commission also has a major role to play in aiding towards the reduction and management of HIV related stigma and discrimination. This group of people campaigns for the respect of human rights for all people. By getting involved in HIV related issues, they will help in ensuring that people living with HIV will not be discriminated upon (Parker 20). This, therefore, means that people will not be afraid of being tested, and they will not be afraid of disclosing their status to other people. This, in return, will drastically reduce the other social problems that are borne from stigma and discrimination of the patients. The Human rights groups should ensure that laws and policies made in the country or any community also consider fairness in relation to HIV/AIDS patients (Hassan et al. 24). This action will play a great role in encouraging the HIV infected and affected people to accept their conditions, and take measures to ensure that they live their lives to the maximum. The advantage to putting this policy is that it will cost nothing, as it is just a law that will be past, and revision on the past legislation. This will be advantageous and beneficial in empowering the HIV infected people, and in educating organizations against discrimination of HIV infected people when it comes to job allocation, promotions, travelling issues among others. The previous policies that had been made sought to treat HIV infected people as felony criminals and this should not be happening at the present day and age. Why should be people be punished for engaging in behaviors that are natural and legal (sexual involvement), especially if they are adults? The fact that one uses a condom means that the person is responsible enough and not that he or she is just fuelling the spread of HIV. People might take this as a license to engage in behaviors that are more immoral. When this happens, the rate of spread of HIV might shoot up instead of decreasing. Critics might argue that this move by the government is aimed to further promote immoral behaviors instead of observing and protecting the needs of the majority (that in this case are the uninfected category). This solution is a long-term one and hence, after sometimes, critics and any other person who might not understand why it should be applied shall witness its effect in curbing and reducing the rate of stigma and discrimination. Since it shall be a permanent solution, its benefits shall be experienced at a high degree and extent. Conclusion Stigmatization and discrimination are vices that slowly eat into organizations, slowly widening the levels of poverty and promoting the differences that already exist between people (Grossman and Stangl, 3). Organizations need to grow and develop, and this cannot happen when some people are secluded and barred from inputting their ideas and contribution to the companies, on the grounds of their medical status. If chances and opportunities are given to people who are disabled and physically handicapped, why not to those infected with HIV. Touching, embracing or sharing a meal with an HIV patient does not lead to AIDS transmission, and this is what the H.R 1353 REPEAL HIV discrimination act is all about. You cannot succeed in the awareness campaigns unless the criminalizing and treatment of HIV people as felony criminals stops. Discrimination and stigma increase the vulnerability of people, and further leads to internal despite and low esteem of oneself. Everyone has a role to play including employees, employers, trade unions, and business owners and all should take up arms against HIV. If this does not happen, people will remain adamant of taking HIV tests, those who test positive will be afraid of revealing their status and thirty-plus years after AIDS became known, companies would still be struggling with the reduction of the spread of this epidemic. It is pertinent that the above solutions be adopted if the face of the organization to change and encourage the use and implementation of policies against stigmatization and discriminations. Works cited Dahab, Maysoon, et al. "Contrasting reasons for discontinuation of antiretroviral therapy in workplace and public-sector HIV programs in South Africa." AIDS patient care and STDs 25.1 (2011): 53-59. The article brings the aspect of discontinuation of ART because of fear of stigmatization and discrimination in the work place. Workers fail to seek treatment because of fear of their supervisors and employers. Some line managers see the follow up visits to clinics made by infected employees often as time wasting and abuse of leave especially if the employee looked healthy. As a result, this lead to continued confrontation between managers and employees because line managers fail to grant leave to attend clinics. This makes employees to stop going to hospital for medical follow-ups and reduces their usage of usage. Employees are also in fear of discrimination because continued use of ARV drugs has side effects that cause reduced productivity. Employee fear they could be fired if their employer or live managers realized this and so they avoid using the medicine. 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 the society. 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 helpful in providing 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 insight on the countries’ most affected by the HIV menace and throughout their discussion, they show that HIV stigma and discrimination are 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 incredible 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. Kalichman, Seth C., and Leickness C. Simbayi. "HIV testing attitudes, AIDS stigma, and voluntary HIV counseling and testing in a black township in Cape Town, South Africa." Sexually transmitted infections 79.6 (2003): 442-447. This article examine the different attitudes held by people in a black township in Cape Town, South Africa. It reveals that many people associate HIV/AIDS with different perceptions such as witchcraft, curses and lack of cure makes it worse especially for the infected employees. This leads to discrimination of PLWHA making less people to go for HIV testing. It further explains that only one in five people in South Africa know their status because of the perceptions held by the people, as they fear testing. 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 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. 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 could 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 Angleton 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. Skinner, Donald, and Sakhumzi Mfecane. "Stigma, discrimination and the implications for people living with HIV/AIDS in South Africa: original article.” SAHARA: Journal of Social Aspects of HIV/AIDS Research Alliance 1.3 (2004): 158-162. This article explores the discrimination that is faced by PLWHA which includes discrimination in the workplace. Employees have lost their jobs because of employer knowledge of their medical status. Example of affected employees is the domestic workers who were fired because of their medical history. Doctors sometimes breach the confidentiality of their patients and inform their employers who in turn act by discrimination through firing of the employees. It also includes the view of some employers that employees should be separated in the workplace based on their HIV/AIDS status. 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. Ward, Kevin. "Religious institutions and actors and religious attitudes to homosexual rights: South Africa and Uganda." Human rights, sexual orientation, and gender identity in The Commonwealth: Struggles for decriminalization and change (2013): 409-411. This article seeks to explain the perceptions and attitudes held by people against gays and lesbians. It explains that gays are faced with problem of acceptance and have a lower self-esteem because of fear to be known. Employees who are gays or lesbians have a fear that they could be stigmatized because of the association of sexual identity with HIV/AIDS. In addition, religion does not spare them because Christians and Muslims have a strong belief against it. Employees who are in such environment have a fear of stigmatization and face a high level of violence. 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 people’s fault, because 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 to accommodate 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 that is easily comprehended by any person interested in the article. It proved very helpful in providing 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