By Ifeanyi Nsofor
ABUJA, Oct 7 2019 – As a Public Health Doctor, I often meet people who experience stigma simply because they live with HIV. One person who still haunts me is a woman who is HIV positive and when she was in labor, a midwife would not help her. Instead she shouted at her to just push out the baby and then she stood far away from the bedside, disgusted by the woman’s HIV status. No one should go through such stigma at a vulnerable situation when they are about to birth life.
Another lady I met was denied university admission because she is HIV positive. She was screened for HIV without her consent, her HIV-positive status was disclosed publicly, and she was asked to leave the private university.
This is not okay. All forms of HIV-related stigma must stop. When people experience stigma and discrimination they may be afraid or ashamed to access HIV services. This fear of stigma has far-reaching implications – it could cause people to delay being tested and knowing their HIV status and getting help, before it’s too late.
Globally, there are approximately 37.9 million people living with HIV, with 770,000 deaths, based on 2018 data. In 2018, there were 1.7 new HIV infections. Seventy-five million people have been infected by HIV since the epidemic began and 32 million have died as a result. HIV-related stigma can have serious consequences.
These are ways to deal with it.
Americans wrongly believe that HIV can be transmitted through sharing glass (27%); touching toilet seat (17%); and swimming in a pool with someone who is HIV positive (11%)
First, government across the globe should increase investments in health education to improve people’s knowledge of HIV and its modes of transmission. It should not be taken for granted that people are aware.
For instance, according to a survey of Americans by the Kaiser Family Foundation, Americans wrongly believe that HIV can be transmitted through sharing glass (27%); touching toilet seat (17%); and swimming in a pool with someone who is HIV positive (11%). Instead, one can get HIV when there is contact with body fluids such as blood, semen, vaginal fluids and breast milk.
Targeted information should be deployed on platforms where people congregate and interact. Social media platforms such as Facebook, Instagram, Twitter and WhatsApp serve this purpose and should be used. Globally, there about 3.5 billion social media users – an estimated than 2.7 billion of these are Facebook users.
In 2016 at peak of the Zika virus epidemic in Brazil, Facebook pulled anonymized posts about conversations on Zika virus. This was shared with UNICEF to design a campaign that provided the right information for individuals to protect themselves against Zika virus. Facebook can replicate the same to tackle misinformation about HIV and reduce stigma.
Second, enforce HIV antidiscrimination laws to deter offenders from discriminating against people living with HIV. For instance, In 2015, the Nigerian President Jonathan signed the HIV/AIDS Anti-Discrimination law.
One of the objectives of the law is to help more Nigerians to seek testing, treatment and care services without fear of facing stigma and discrimination. The law does not permit HIV screening as a prerequisite for employment and school admissions.
There are fines of $1400 for individuals and $5,700 for institutions who violate the law. The fines could come with prison term of up to one year in addition to these fines. Although not as robust as Nigeria’s HIV antidiscrimination law, Ghana’s patient’s charter protects individuals from discrimination based on type of illness.
Third, end the discrimination against key populations like men who have sex with men, sex workers and transgender people as this discourages them from accessing care, pushes them underground and increases their risk of transmitting HIV.
Globally, these populations account for 54% of new HIV infections – 88% in Western and central Europe and North America; 95% in Middle East and North Africa; and 64% in Western and central Africa.
Compared to non-key populations, the risk of acquiring HIV is 22 times higher among men who have sex with men and injection drugs users; 21 times higher among sex workers and 12 times higher for transgender people.
Specific changes include ending discriminatory laws. Countries including Algeria, Morocco, Nigeria, Pakistan, Kenya, Zambia and others criminalize LGBT folks and that needs to change. Further, transgender people are harmed and killed without consequences for the perpetrators.
For example, recently, a black transgender woman was burned to death in Florida. Therefore, donors must keep working with governments to repeal these laws and punish those who perpetrate violence against key populations.
The Former Wales rugby captain, Gareth Thomas’ revelation this month that he is HIV positive because someone threatened to blackmail him, shows that no one is immune to stigma. As long as new HIV infections occur, governments, donors, private sector and communities must continue work to end HIV-related stigma and discrimination.