Helping people to understand
by Linda Plenert
Dear Ate Anna,
I just found out that my cousin who still lives in the Philippines is HIV+. I am saddened by the comments I hear from some of my family members. I know that I will talk to many of these people over the Christmas season. What can I say when they make negative comments?
What you are describing is HIV related stigma – a process of taking away a person’s value because they are HIV+. This type of stigma shows up in people’s attitudes, beliefs or comments directly to or about someone who is HIV+.
Sadly, HIV stigma can result in people being shunned by their family or community. For example, being asked not to come to a family wedding (or a Christmas gathering) because other people might not attend. People also internalize stigma. For example, a mother who is HIV+ chooses to breastfeed her newborn (although this could transmit the virus to her baby) even when free formula is available to her. Why? Because she worries people will find out about her HIV status and is afraid she will be kicked out of the family and rejected by her community.
In the bigger picture, HIV stigma and discrimination can contribute to poor care and services in healthcare and education settings. It also causes psychological damage that can affect a person’s ability or willingness to follow their treatment plan.
The roots of HIV stigma are deep and confronting it means talking about things that may make others uncomfortable. Many people do not really know where their attitudes come from. We do know that many people are needlessly afraid of becoming infected because they don’t have correct information about how HIV is transmitted. They worry that they can become infected through social contact – touching, hugging, shaking hands, using the same dishes as the person who is infected etc. HIV is a fragile virus and is not transmitted in these ways.
Taboos about sex, religious beliefs, or moral judgments about a person’s sexual behaviour contribute to stigma, as well. And yet, what do we really know about any one person’s story? Women who are HIV+ face a greater degree of stigma and shame. They are judged by the stereotype that a woman who has a sexually transmitted infection is cheating on her husband or a prostitute. Yet what power do most women have in their relationships to say “No – no sex unless we use a condom,” even if they suspect their husband is having sex outside the marriage.
The main causes of stigma relate to incomplete knowledge, fears of death and disease, sexual norms and people not recognizing their actions as stigma. Malina, educate yourself about HIV transmission so that you can give correct information to people who stigmatize out of ignorance. This may not be enough to change someone’s attitude, but it is a place to start.
By engaging in conversations with your family members, you will be able to identify what their information needs are. Asking about their fears can guide you in having these conversations. There is a common attitude that the person who is HIV+ did something to deserve it and their behaviour is immoral. Family members who want to support your cousin will need to re-evaluate their beliefs and be prepared to disagree with other family members who are not willing to change their attitude.
In the past HIV prevention campaigns often featured pictures of a person on their deathbed and these images may be what people remember. Remind people that treatment is available in many countries. While there is no cure, HIV is a chronic condition in these countries – not a death sentence.
One man said, “It’s not HIV that kills you. It’s the stigma and discrimination from society, the rejection that makes people go into depression and stop taking their medication – stop taking care of their health. That is when they get sick.”
Ask your family members: “How would you feel if you were stigmatized because of a health condition? If you were not invited to people’s homes because you had diabetes.” This might help people develop empathy for your cousin and other people who have been infected with the virus.
Ate Anna thinks that eliminating stigma is a very important part of the fight against HIV/AIDS. If the person with HIV is strong enough to live with that burden, we should be strong enough to help them carry it. December 1st was World AIDS Day. But any day of the year is a good time to start a conversation with someone and help to reduce HIV stigma.
Best of the season to you and your family.
Ate Anna welcomes your questions and comments. Please write to: Ate Anna, Suite 200- 226 Osborne St. N., Winnipeg, MB R3C 1V4 or e-mail: firstname.lastname@example.org. Please visit us at www.serc.mb.ca.